Central Line Associated Blood Stream Infection: A Case Study

Central Line Associated Blood
Stream Infection

Definition of CLABSI ?
“Central associated blood stream infection
(CLBSI) is defined as a positive blood culture with central venous access without evidence of other infectious sources” (Smith et al., 2011, p.1038).

PICO Question
In critically ill patients with central lines, does implementation of the new evidenced based nursing practice changes help to prevent central line associated blood stream infection (CLABSI)?

Literature on CLABSI
Prevention
Using Evidence-Based Practice to Reduce Central

Line Infections
“Complications from CRBSIs (Catheter-related

blood-stream infections) impact healthcare costs as well as patient morbidity and mortality” (Brungs and Render, 2006, p. 723).
In 2003, 9
healthcare systems participated in a two-

year project to reduce hospital-acquired infections, including CRBSIs.
 Focused on central line “bundle” elements
 Reduced CRBSIs by 50%

Literature on CLABSI
Prevention

CLABSI prevention success pressures

hospitals to adopt similar programs
Hospitals need CLABSI prevention measures
CDC urges action by hospitals
Using checklists for insertion
Staphylococcus aureus vs. Gram-negative

rods

Evidence Based Research
In critically ill patients with central lines,

implementation of new evidence based nursing practice does help to prevent central line associated blood stream infection(CLABSI).
Preventing central venous catheter associated

infections should be a goal of all health care providers. Catheter related blood stream infections are common, costly, and deadly
The average cost to treat infection related to CLABSI ranges from 25,000-45,000 per occurrence (Hernage,
2007)

Infection Prevention
Routine education provided to staff.
Sterile technique and proper skin

preparation/cleansing at time of placement.
Full barrier precautions.
Dressing management using sterile technique with the use Chloraprep and application of BIOPATCH.
Proper connecting system.
Flushing per protocol.
Frequent site monitoring.

What changes can we make that will result in improvement? Empower nursing
hand hygiene
Keep soap/alcohol-based hand hygiene

dispensers prominently placed and make universal precautions equipment, such as gloves, only available near hand sanitation equipment. Post signs
Initiate a campaign using posters
Create an environment with reminders

Conclusion
The effects of treatment place patients at high risk for central line associated blood stream infections, which directly reflect the care provided at the time of insertion and through the lifetime of the central line. These infections are can be reduced by adequate implementation of protocols

References
 Smith, J. W., Egger, M., Glenn, F., Harbrecht, B., & Richardson, D. J. (2011).















Central Line-Associated Blood
Stream Infection in the Critically Ill Trauma Patient. Medical Sciences--Surgery, 77(8), 1038-1042. Retrieved from http://library.gcu.edu:2048/login?url=http://search.proquest.com.library.gcu. edu:2 048/docview/883658932? accountid=7374 Beyond CLABSI Bundle (photograph) (2011, May 30). Ivteam.com. Retrieved February 20,
2012, from http://www.ivteam.com/beyond-clabsi-bundles/ Brungs, Suzanne. M., & Render, Marta. L. (2006). Using Evidence-Based Practice to
Reduce Central
Line
Infections. Clinical Journal of Oncology Nursing, 10(6),
723-725. Retrieved from http://web.ebscohost.com.library.gcu.edu:2048/ehost/pdfviewer/pdfviewer?sid= e3e8ddb2-ea00-490b-949636e0195837e4%40sessionmgr4&vid=8&hid=19
CLABSI prevention success pressures hospitals to adopt similar programs. (2011, April 1).
Hospital Infection Control &
Prevention, 38(4).
37-48. Retrieved from http://web.ebscohost.com.library.gcu.edu:2048/ehost/pdfviewer/pdfviewer?sid=e3e8ddb2ea00-490b-9496-36e0195837e4%40sessionmgr4&vid=9&hid=19 Duane, T., Brown, H., Borchers, C., Wolfe, L., Malhotra, A., Aboutanos, M., & Ivatury, R. (2009).
A central venous line protocol decreases bloodstream infections and length of stay in a trauma intensive care unit population. American
Surgeon, 75(12), 1166-1170.
Harnage, S. (2007). Achieving zero catheter related blood stream infections: 15 months success in a community based medical center. Journal Of The Association For Vascular
Access, 12(4), 218-224.
Improving central- line infection rates. (2011). Healthcare Traveler, 19(4), 18.
Smith, J. W., Egger, M., Glenn, F., Harbrecht, B., & Richardson, D. J. (2011). Central Line-Associated
Blood
Stream Infection in the Critically Ill Trauma Patient. Medical Sciences--Surgery, 77(8), 10381042. Retrieved from http://library.gcu.edu:2048/login?url=http://search.proquest.com.library.gcu. edu:2048/docview/883658932? accountid=7374 Traynor, K. (2011). Central line infections fall in ICUs. American Journal Of Health-System
Pharmacy, 68(8), 650-652.
doi:10.2146/news110023