There are two terms used to describe central line infections: central line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI). CLABSI is defined as a bloodstream infection where the patient had a central line within 48 hours before onset. CRBSI requires lab testing to confirm the catheter as the infection source. Central lines are essential for patient care but can lead to costly and life-threatening infections if not properly inserted and maintained. Adhering to evidence-based practices like maximum barrier precautions and chlorhexidine skin antisepsis can significantly reduce central line infection rates.
Central-Line-Associated Bloodstream Infections (CLABSI) pause a major health problem in hospitalized patients. This disease is associated with people with a central line/tube inserted through the skin into the large vein, which can be used to give medicines, fluids, nutrients, or blood products to patients in critical conditions. The disease occurs when microbes enter through the central line invading the bloodstream.
Using the Central Line Bundle
Hand Hygiene
Remove Unnecessary Lines
Use of Maximal Barrier Precautions
Chlorhexidine for Skin Antisepsis
Avoid femoral lines
Report CLABSI rates to the units
Celebrate success!!
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Central-Line-Associated Bloodstream Infections (CLABSI) pause a major health problem in hospitalized patients. This disease is associated with people with a central line/tube inserted through the skin into the large vein, which can be used to give medicines, fluids, nutrients, or blood products to patients in critical conditions. The disease occurs when microbes enter through the central line invading the bloodstream.
Using the Central Line Bundle
Hand Hygiene
Remove Unnecessary Lines
Use of Maximal Barrier Precautions
Chlorhexidine for Skin Antisepsis
Avoid femoral lines
Report CLABSI rates to the units
Celebrate success!!
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Catheter-associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) is the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed.
Catheter Associated Urinary Tract Infections (CAUTI)Ujjwal Shah
This was prepared by Ujjwal Kumar Shah, a medical student at BPKIHS, for a seminar presentation on the topic "Health-care associated Infections" and the subtopic "CAUTI".
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
It is important to realize that guidelines cannot always account for individual
variation among patients. They are not intended to supplant physician judgment
with respect to particular patients or special clinical situations. The IDSA considers
adherence to these guidelines to be voluntary, with the ultimate determination
regarding their application to be made by the physician in the light of each patient’s
individual circumstances.
Catheter-associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) is the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed.
Catheter Associated Urinary Tract Infections (CAUTI)Ujjwal Shah
This was prepared by Ujjwal Kumar Shah, a medical student at BPKIHS, for a seminar presentation on the topic "Health-care associated Infections" and the subtopic "CAUTI".
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
It is important to realize that guidelines cannot always account for individual
variation among patients. They are not intended to supplant physician judgment
with respect to particular patients or special clinical situations. The IDSA considers
adherence to these guidelines to be voluntary, with the ultimate determination
regarding their application to be made by the physician in the light of each patient’s
individual circumstances.
This comprehensive lecture by Dr. Anthony Perez discusses the epidemiology, presentation, management and preventive strategies against surgical site infections
Infection Control Guidelines for Prevention of Catheter Associated Urinary Tract Infection
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Comment1Nursing practice has changed in how nurses handle and ca.docxdivinapavey
Comment1
Nursing practice has changed in how nurses handle and care for central lines as well as how central lines are inserted specifically peripherally inserted central catheters. The reduction of CLABSI’s (central line associated blood stream infection) and the use of an insertion bundle have greatly improved patient outcomes in the last many years. These practice changes have reduced patient mortality and decreased the length of patient stay in the ICU. Through these studies and by implementation of new processes brings awareness to nursing staff on what needs to be done to better care and protect our patients. The findings have changed my overall view of central lines. When I cared for central lines I was more careful at assessing, accessing, documenting and advocating for earlier removal of these devices when no longer needed in my patient. At the hospital where I work, dressing changes of central lines are a two person process and the use of CUROS caps to cover needless connectors or injectable ports on tubing is required to prevent infection. The insertion bundle is utilized by our PICC team who do their part in following strict guidelines when placing the central line catheter.
Comment2
Hospital Acquired Pressure Ulcers (HAPU) is a topic of great concern in health care delivery due health impact and complications on affected patients, as well as the cost and reimbursement issues. The costs of pressure ulcers are extremely high. Patients die from sepsis related to pressure ulcers that become chronic. According to National Pressure Ulcer Advisory Panel 2017, more than 2.5 million patients develop pressure injury (PI) a year, national incidence rate of 2.5% in hospitals, and 60, 000 death a year (William Padula, John Hopkins University). PI injury cost US Health system $9-11 billion a year. In an effort to prevent HAPU, death caused by sepsis related to pressure ulcers, Stage II and III pressure Ulcers are among the eight preventable conditions identified by Medicare and Medicaid which extra payment are eliminated. Medicare and Medicaid stop reimbursing hospitals for certain hospital-acquired conditions considered preventable in the hospital setting, private insurance also follow this step. Pressure ulcers are a potential complication of prolonged bed rest and are included in the category of hospital-acquired conditions. Incontinent patients are especially prone to pressure ulcers if moisture is not managed adequately. The key to prevent pressure entails is to first identify patients at risk; and second implementing strategies for all patients who are identified at risk. Health care delivery has the duty to focus patient care to prevent PI by inspecting skin daily, managing moisture on skin, conducting a pressure ulcer admission assessment for all patients, minimizing pressure, optimizing nutrition and hydration, reassessing risk for all patients daily. Following these steps help improving patient care and prevent in ...
Definition of Hospital acquired infection, incidence of HAI, chain of infection, epidemiology triad (agent, host, environment). types of transmission, types of HAIs [VAP, CAUTI, SSI, CLABSI] management measures for HAIs. Bundles of care for HAIs.
Chronic Infection Related To Tunneled Catheter for Hemodialysis with Presence...komalicarol
Although the recommended vascular access for hemodialysis is
the arteriovenous fistula, tunneled central venous catheters (CVC)
are commonly used for treatment. In hemodialysis patients, infections are the most common cause of morbidity and are the second
most common cause of mortality of which CVCs are common potential causes. Prevention, timely detection, and proper treatment
of infections related to percutaneous vascular accesses are defining
factors in the reduction of complications. The first most common
pathogens that cause infections are gram-positive bacteria (S. aureus and coagulase-negative staphylococci); the second most common cause are gram-negative bacteria (Pseudomonas aeruginosa in
E. coli, Klebsiella pneumoniae, and Acinetobacter baumanii); and
less frequently, fungal infections (Candida Albicans). Although
acute infections can be eliminated with an antimicrobial course,
biofilm infections are not as easily eradicated and may cause recurrent infections that only resolve with the removal of the catheter.
Strict adherence to aseptic measures before, during, and after the
insertion and manipulation of Central Venous Catheters area fundamental preventive measure for catheter-related bacteremia.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
2. According to the National Health Safety Network (NHSN), a central
venous catheter or central line is “an intravascular catheter that :
o Terminates at or close to the heart or
o Is in one of the great vessels which is used for infusion, withdrawal of blood or
hemodynamic monitoring”.
The great vessels include the
o Aorta
o Pulmonary artery
o Superior and inferior vena cava
o Brachiocephalic veins
o Internal jugular veins
o Subclavian veins
o External iliac veins
o Common iliac veins
o Femoral veins,
o And in neonates, the umbilical artery/vein.
3. Venous access is one of the most basic yet critical components of
patient care both in hospital and ambulatory settings.
It is estimated that almost 300 million catheters are used each year
and nearly 3 million are central venous catheters (CVCs), otherwise
known as central lines.
They play an integral role in modern health care allowing for the
administration of IV fluids, medications, blood products, parenteral
nutrition as well as hemodialysis access and hemodynamic
monitoring.
For as long as patients have had CVC’s, infections have occurred.
o Central Venous Catheters are the most frequent cause of healthcare
associated bloodstream infection.
o An estimated 41,000 central line associated bloodstream infections occur in
U.S. Hospitals each year, causing prolonged hospital stays, increased
costs, and risk of mortality.
o Estimated costs for one central line infection ranges from $6,000 to
$30,000.
o Of all patients diagnosed with a central line infection, one in four will die.
4. Definition One
Central line-associated
bloodstream infections (CLABSI)
is a term used by US Centers for
Disease Control and
Prevention’s (CDC’s) National
Healthcare Safety Network
(NHSN)
Refers to a primary blood
stream infection in a patient that
had a central line within the 48
hour period before the
development of the blood
stream infection and is not
related to an infection at another
site.
Its definition is more practical for
Definition Two
Catheter related bloodstream
infection (CRBSI) is a more
clinical definition that requires
specific lab testing to identify the
catheter as the source for the
bloodstream infection and is not
typically used for surveillance
purposes.
There are 2 terms to describe intravascular catheter related infections and are
often used interchangeably even though their meanings differ.
5. National estimates of CLABSI rates are available through CDC’s NHSN, a
surveillance system of healthcare associated infections and are available on the
CDC’s website.
Recent acute rates range from 1.2 to 2.1 per 1000 catheter days.
The unit of measurement for these infections is based on the concept of "catheter
days." This combines the number of large vein catheters in use with the number of
days they are being used.
o For example, if in one particular month there were 12 cases of central line
associated bloodstream infections, the number of cases would be 12 for that
month.
o We want to be able to understand that number as a proportion of the total
number of days that patients had central lines. Thus, if 25 patients had central
lines during that month and, for purposes of example, each kept their line for 3
days, the number of catheter days would be 25 x 3 = 75 for that particular month.
The CLABSI Rate per 1,000 catheter days then would be 12/75 x 1000 = 160.
Even though the overall risk for central line related infections in the home setting are
low when compared to the inpatient setting, it is important to understand the
significant cost and human suffering related to this preventable problem.
Currently home health companies are not required to report incidences of catheter
related infections but are estimated to range from 0.24 to 0.45 per 1000 catheter
6. Risk factors for CLABSI can be either Intrinsic or
Extrinsic.
Age, gender, and underlying health conditions are all
examples of Intrinsic factors.
CLABSI rates are higher among children, particularly
neonates, and highest in Pediatric ICU’s, Adult Burn,
trauma and critical care units.
Hematological and Immunological deficient patients have
higher risk of CLABSI as well as underlying
gastrointestinal and cardiac diseases.
Female gender has lower incidences of CLABSI.
7. Extrinsic factors are potentially modifiable.
They include prolonged hospital stay prior to insertion of CVC,
multiple catheters, multi-lumen catheters, duration of catheter,
TPN administration, CVC site, and catheter type.
Femoral and internal jugular access sites have higher CLABSI
rates than subclavian sites in adult patients.
Non tunneled CVC’s account for the majority of CLABSIs.
Tunneled catheters and peripherally inserted central catheters
(PICC) have a lower rate of infection than non tunneled.
Implanted ports have the lowest infection rates.
Insertion procedure of central venous catheter plays a large
role in development of CLABSI.
Lack of maximum sterile barriers (cap, mask, sterile gloves,
sterile gown and full sterile drape) all increase risk as well as
insertion in an ICU or emergency department.
9. CLABSI can be prevented through proper insertion techniques,
management of the CVC while in place, and removal as soon as the
catheter is no longer necessary.
CVCs can be contaminated with microorganisms via 2 major routes,
extra-luminal and intra-luminal.
Extra luminal catheter infections typically occur within the first week
of placement.
The patient’s skin is considered the primary source of contamination
but can also include the healthcare provider’s hands.
During catheter insertion, organisms attach to the catheter as it
passes through the epidermis.
Attention to strict skin antisepsis and hand hygiene is likely the most
important intervention in preventing catheter associated infection.
10. Intra luminal infections occur when microorganisms directly enter
the internal catheter during manipulation of the IV system such as
accessing or connecting injection caps, tubing, or syringes to the
catheter.
Additionally, direct contamination from patient’s skin or own body
fluids can occur.
Less commonly, catheters become seeded from a secondary site of
infection such as a UTI or pneumonia.
Rarely, contamination of infusate such as IV fluid or medication can
be the source of infection.
11. Within minutes of venous access device insertion into the
bloodstream, the patient’s body reacts to the presence of a
foreign body and the damage to the endothelial lining of the
vein.
A fibrin layer or sheath begins to form on the catheter surface.
o Within 24 hours, a layer of platelets and white blood cells are
trapped in the fibrin layer.
o A thrombus may eventually form.
Like the fibrin layer, biofilm formation begins at the same time.
o Microorganisms introduced through the skin during venipuncture
and infusions colonize and interact with the fibrin.
o Some bacteria produce an extracellular polysaccharide known as
slime, which protects the bacteria from antibiotics.
o Bacteria from the biofilm that detach from either the internal or
external catheter surface can lead to a catheter associated
bloodstream infection.
o It can also result in a serious focal infection such as endocarditis.
o Once a biofilm is formed, eradication is difficult thus elimination of
microbial entry is paramount to prevention.
13. Coagulase negative staphylococci, staphylococcal
aureus, aerobic gram negative bacilli and Candida
albicans most commonly cause catheter related
bloodstream infections.
In most cases of non-tunneled CVC related bacteremia
or fungemia, the catheter should be removed.
For management of tunneled CVCs and implanted ports,
the decision to remove the device should be based on
the
o severity of the illness,
o presence of complications such as endocarditis, tunnel infection,
septic thrombosis or metastatic seeding.
14. Safe and reliable venous access is an important issue in
daily practice to prevent CLABSI.
In the acute care setting “bundles” or groups of
evidenced-based interventions have been created for
patients with central lines.
Conceived by the Institute for Healthcare Improvement
(IHI) these “bundles” result in better outcomes than when
implemented individually.
While there are no evidence-based “bundles” specific to
the homecare setting we must utilize the standards
provided and adapt to them to the homecare setting.
15. The key components of the IHI Bundle are:
o Hand hygiene
• http://www.ihi.org/knowledge/Pages/Changes/HandHygiene.aspx
o Maximum barrier Precautions upon Insertion
• http://www.ihi.org/knowledge/Pages/Changes/MaximalBarrierPrecaution
sUponInsertion.aspx
o Chlorhexidine Skin Antisepsis
• http://www.ihi.org/knowledge/Pages/Changes/ChlorhexidineSkinAntisep
sis.aspx
o Optimal Catheter Site selection, with avoidance in femoral vein for
Central Venous Access in adult patients
• http://www.ihi.org/knowledge/Pages/Changes/OptimalCatheterSiteSelec
tionwithAvoidanceofFemoralVeinforCentralVenousAccessinAdultPatient
s.aspx
o Daily review of Line Necessity with prompt removal of Unnecessary
Lines
• http://www.ihi.org/knowledge/Pages/Changes/DailyReviewofLineNeces
sitywithPromptRemovalofUnnecessaryLines.aspx
16. Since implementing the 5 elements in the Central Line
Bundle which was created in the 1990’s, hospitals
across the nation have seen results in lowering the
incidence of central line infections.
The CDC’s recommendations for Vascular catheter-
related infection prevention provides further measures
but are not limited to:
o Dressing change frequency
o Catheter replacement
o Antisepsis of injection ports
o Catheter selection
o Prophylactic antimicrobials
o Education.
17. Infections in the acute and home setting are preventable.
As a healthcare provider and role model, we must be
knowledgeable about infection transmission.
We must hold the highest standards and adhere to and
educate infection prevention interventions such as hand
hygiene, aseptic technique and infusion-related care.
It is our responsibility to ensure our patients receive the
best care determined by evidence-based research.
Tools to reduce and eliminate infections have been
provided to us. It is our role to utilize these tools to
improve our patients’ outcomes.
18. Joint Commission.org: Preventing Central Line-Associated Bloodstream Infections: A Global
Challenge, A Global Perspective
http://www.jointcommission.org/preventing_clabsi/
Gorski, L. Home Healthcare Nurse: 2010(28) 221-229
NHIA.org: CVAD guidelines for Home Infusion 2011(17)29-36
Poole, S. NHIA.org: Central Line Infection: Improving Our Surveillance, Treatment and Prevention
in the Home Setting 2009(15)31-35
CDC: 2011 Guidelines for the Prevention of Intravascular Catheter Related Infections
http://www.cdc.gov/hicpac/bsi/bsi-guidelines-2011.html
IHI: Implement the Central Line Bundle
http://www.ihi.org/knowledge/Pages/Changes/ImplementtheCentralLineBundle.aspx
Seigel, M, Kramer-Cain, J. Advance For Nurses: Vascular Catheter-Associated Infections. Learn
what measures can and should be taken. http://nursing.advanceweb.com/Article/Vascular-
Catheter-Associated-Infections-2.aspx
