Daily Review
Daily review of central line necessity will prevent unnecessary delays in removing lines that are no longer clearly needed for the care of the patient.
Many times, central lines remain in place simply because they provide reliable access and because personnel have not considered removing them. However, it is clear that the risk of infection increases over time as the line remains in place and that the risk of infection decreases if the line is removed. 6 |
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- The CDC guidelines state that catheter replacement at scheduled time intervals as a method to reduce CLABSI has not lowered rates of infection.
- Additionally, routine replacement is not necessary for catheters that are functioning and have no evidence of causing local or systemic complications.
- The guidelines further note that replacement of temporary catheters over a guidewire in the presence of bacteremia is not an acceptable replacement strategy, because the source of infection is usually colonization of the skin tract from the insertion site to the vein. 6
- Ceballos, K., Waterman, K., Hulett, T., & Makic, M. F. (2013). Nurse-driven quality improvement interventions to reduce hospital acquired infection in the NICU [Continuing Education]. Advances in Neonatal Care, 13(3), 154-163. http://dx.doi.org/10.1097/ANC.0b013e318285fe70
- Doellman, D. (2012, Fall). The litigation environment for central line-associated bloodstream infections: Hospitals face greater risk when they fail to follow standards of care. Journal of Legal Nurse Consulting, 24(2), 31-34. Retrieved from http://www.aalnc.org
- Jeong, I. S., Park, S. M., Lee, J. M., Song, J. Y., & Lee, S. J. (2013, February 5). Effect of central line bundle on central line-associated bloodstream infections in intensive care units. American Journal of Infection Control, 41(8), 710-716. http://dx.doi.org/10.1016/j.ajic.2012.10.010
- O’Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O., ... Saint, S. (2011). Guidelines for the prevention of intravascular catheter-related infections. Retrieved from http://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.html
- Williams, D. W. (2015, January/February). Use of a policy-driven education program to reduce central line-associated bloodstream infection rates. Journal of Infusion Nursing, 38(1), 63-68. http://dx.doi.org/10.1097/NAN.0000000000000076
- How-to Guide: Prevent Central Line-Associated Bloodstream Infections (CLABSI). Cambridge, MA: Institute for Healthcare Improvement; 2012. (Available at www.ihi.org)
- https://www.jointcommission.org/assets/1/18/CLABSI_Monograph.pdf
- Adapted from US Centers for Disease Control and Prevention. National Healthcare Safety Network. DeviceAssociated (DA) Module. Protocol and Instructions: Central Line– Associated Bloodstream Infections (CLABSI) Event. Jan 2012. Accessed Mar 20, 2012. http://www.cdc.gov/nhsn/PDFs /pscManual/4PSC_CLABScurrent.pdf.