Preventing Catheter-Associated Bloodstream Infections in Adults: A Practical Guide
Brief Introduction
Catheter-associated bloodstream infections (CABSIs) are a significant concern in healthcare settings, posing a risk to patient safety and well-being. These infections can lead to increased morbidity, mortality, and healthcare costs. In this article, we will provide a practical guide on preventing CABSI in adults, highlighting evidence-based strategies and best practices.
Understanding CABSI
CABSI occurs when bacteria or other microorganisms enter the bloodstream through a central venous catheter (CVC). CVCs are commonly used in healthcare settings for administering medications, fluids, and nutrients. However, they can also provide a conduit for microorganisms to enter the bloodstream, leading to infection (O’Grady et al., 2011).
Risk Factors for CABSI
Several risk factors contribute to the development of CABSI, including:
– Type of catheter: The type of catheter used can increase the risk of CABSI. For example, temporary catheters are more likely to be associated with CABSI than tunneled catheters (Mermel, 2000).
– Insertion technique: The technique used for catheter insertion can also impact the risk of CABSI. Proper hand hygiene, skin preparation, and sterile technique are essential for reducing the risk of infection (Pronovost et al., 2006).
– Catheter maintenance: Poor catheter maintenance, such as inadequate dressing changes and hub disinfection, can increase the risk of CABSI (Loveday et al., 2014).
Prevention Strategies
Several evidence-based strategies can help prevent CABSI, including:
– Proper hand hygiene: Hand hygiene is essential for preventing CABSI. Healthcare workers should perform hand hygiene before and after interacting with the catheter or patient (WHO, 2009).
– Sterile insertion technique: Using a sterile technique for catheter insertion can reduce the risk of CABSI. This includes using sterile gloves, gowns, and drapes (O’Grady et al., 2011).
– Catheter site care: Proper catheter site care, including dressing changes and hub disinfection, can help prevent CABSI. Chlorhexidine-based solutions are effective for skin preparation and hub disinfection (Loveday et al., 2014).
– Catheter removal: Removing unnecessary catheters can reduce the risk of CABSI. Healthcare workers should regularly assess the need for the catheter and remove it when it is no longer necessary (Mermel, 2000).
Best Practices
Several best practices can help prevent CABSI, including:
- Developing policies and procedures: Healthcare facilities should develop policies and procedures for catheter insertion, maintenance, and removal. These policies should be based on evidence-based guidelines and best practices (O’Grady et al., 2011).
– Providing education and training: Healthcare workers should receive education and training on proper catheter insertion, maintenance, and removal techniques. This can help reduce the risk of CABSI and improve patient outcomes (Pronovost et al., 2006).
– Monitoring and surveillance: Healthcare facilities should monitor and surveil CABSI rates to identify areas for improvement. This can help reduce the risk of infection and improve patient safety (Loveday et al., 2014).
Conclusion
Preventing CABSI requires a multifaceted approach that includes proper hand hygiene, sterile insertion technique, catheter site care, and catheter removal. By implementing evidence-based strategies and best practices, healthcare facilities can reduce the risk of CABSI and improve patient outcomes.
References:
Loveday, H. P., Wilson, J. A., Pratt, R. J., Golsorkhi, M., Tingle, A., Bak, A., … & Wilcox, M. (2014). epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, 86, S1-S70.
Mermel, L. A. (2000). Prevention of intravascular catheter-related infections. Annals of Internal Medicine, 132(5), 391-402.
O’Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O., … & Raad, I. I. (2011). Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases, 52(9), e162-e193.
Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S., … & Goeschel, C. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-2732.
WHO. (2009). WHO guidelines on hand hygiene in healthcare. World Health Organization.