This document discusses central line-associated bloodstream infections (CLABSIs), including the pathogenesis and risk factors. It focuses on the Central Line Bundle, which consists of 5 evidence-based practices to prevent CLABSIs: hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of line necessity with prompt removal of unnecessary lines. Adherence to the Central Line Bundle, especially the 5 key components, can significantly reduce the risk of CLABSIs.
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!!
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".
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.
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!!
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".
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.
A short brief on 'Hospital Acquired Infections' (HAI) or 'Nosocomial Infection' (NI) for M Phil, MPH and Advance Course in Hospital Management/ Administration
A short brief on 'Hospital Acquired Infections' (HAI) or 'Nosocomial Infection' (NI) for M Phil, MPH and Advance Course in Hospital Management/ Administration
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Central Venous Catheter Care- A Nursing skill Tse Sona
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How University of Utah Health's Burn Trauma ICU Eliminated Central Line Infec...University of Utah
Is zero possible? In the case of central line infections, the answer once was no. A CLABSI (central line associated blood stream infection) was once considered a car crash, or an expected inevitability of care. When University of Utah’s Burn Trauma Intensive Care Unit started treating CLABSIs like a plane crash, or a tragedy demanding in-depth investigation and cultural change, zero became possible. This presentation outlines the process and how to implement in your institution. To learn more, visit Accelerate: https://uofuhealth.utah.edu/accelerate/
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FCPS Physiology
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Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
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Recognize different abnormalities of taste perception and their causes.
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Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
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Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
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Rapid adaptation of taste sensation
Role of Saliva in Taste:
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Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
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Abnormalities of Taste Detection:
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Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Central line associated bloodstream infections
1. By
Dr.Nagu Penakacherla MBBS, MEd(USA),
DNB(Family Medicine)
Central Line-Associated
Bloodstream
Infection (CLABSI) Prevention
The Central Line Bundle and YOU!
2. Central Line or Central Vascular
Catheter
• Intravascular catheter that terminates at or close to the
heart or one of the great vessels
• Nontunneled CVCs (subclavian, jugular)
• Tunneled CVCs (Broviac, Hickman, Groshong)
• Dialysis catheter (Quinton)
• Peripherally inserted central catheters (PICCs)
• Implanted ports (Permacath)
• Used increasingly to provide long-term venous access in
all care settings, including outpatient
• Note: midline catheters are not in this category
3. Pathogenesis of CLABSI
More Common Mechanisms
• Extraluminal: Pathogens migrate along external surface
of catheter
- More common in early period following insertion, < 7 days
• Intraluminal: Hub contamination, migration along
internal surface
• - More common >7 days, intraluminal colonization
Less Common Mechanisms
• Hematogenous seeding from another source
• Contaminated infusates
4. Biofilms
• Complex aggregation of microorganisms
growing on a solid substrate
• Form on catheter surfaces
• Contribute to risk for CLABSI
5. CLABSI Risk Factors
• Multiple catheters and/or multiple lns
• Emergency insertion
• Prolonged duration of CVC
• Prolonged hospital stay prior to CVC insertion
• Excessive manipulation of the catheter
• Neutropenia
• Prematurity
• Total parenteral nutrition
6.
7. How Can We IMPACT Central Line
Associated Blood Stream Infections
(CLABSIs)?
• What is the Central Line Bundle?
Includes the following bundle of 5 care
components:
1. Hand hygiene
2. Maximal barrier precautions
3. Chlorhexidine skin antisepsis
4. Optimal catheter site selection
5. Daily review for line necessity and
assessment with prompt removal of
unnecessary lines
8. HAND HYGIENE – Just do it!
• Before and after palpating catheter insertion sites
• Before and after inserting, replacing, accessing,
repairing, or dressing a catheter
• When hands obviously soiled or contamination
suspected
• Before and after invasive procedures
• Between patients
• Before donning and after removing gloves
9. MAXIMAL BARRIER PRECAUTIONS
Use strict adherence as the inserter and all involved
with the placement of a central line or guidewire
exchange with the following:
• Compliance with hand hygiene
• Wear cap, mask, sterile gown and sterile gloves
• Cap – covers all hair
• Mask – covers nose and mouth tightly
• Sterile drape – covers patient from head to toe
with a small opening for line placement
10. CHLORHEXIDINE SKIN PREP
• Chlorhexidine (CHG) skin prep prior to
placement and for dressing change.
• PINCH wings on CHG applicator.
• PRESS sponge against the skin allowing the
solution to penetrate the pad.
• PREP covering a large area using a back and
forth, up and down, and diagonal friction
scrub for at least 30 seconds. Allow to dry. Do
not wipe, blot or fan.
11. OPTIMAL CATHETER SITE SELECTION
Subclavian vein is the preferred site for non-tunneled catheters and
is associated with lower risk of CLABSIs rather than the jugular
vein.
-Femoral site is associated with greater risk of infection and DVTs in
adults.
University and International Hospitals preferred sites:
• Subclavian and Internal jugular are preferred sites.
• Femoral site would be an option for:
1. ECMO
2. Neuroprotective hypothermia-thermaguard
3. Other insertion sites are not able to be accessed due to poor
vascular upper extremities, etc.
4. A need for dialysis or other patient emergencies
12. DAILY LINE ASSESSMENT AND REVIEW
• The risk of CLABSIs increases over time.
• Complete daily assessment of central line for infection.
• Prompt removal of unnecessary lines.
• The replacement of temporary catheters in the presence of
bacteremia is not an acceptable replacement strategy. The
source of infection is usually colonization of skin tract from
the insertion site to the vein.
Roles in Daily Site Assessments:
• Physicians should assess and document daily the criteria for
the patient to maintain a central line.
– For example: “R internal jugular CVC- clear, dry, intact, no erythema
noted. Still necessary for IV access on pressors, etc.”
• Should be discussed during daily attending rounds.
13. Empower nurses and others to
“STOP THE LINE”
if any of bundle components are
missing
14. 1.7
0.9
3
1.1
6.8 6.8
1.5 1.5
1.3 1.3
0
1
2
3
4
5
6
7
8
CENTRAL LINE ASSOCIATED BLOOD STREAM INFECTION FROM
MARCH 2014- MARCH 2015
FBG
INICC
NHSN
INTERNAL
BENCHMARK B.G
Road