1
|
Hoyler M, Niederman MS, Girardi NI. What every intensivist should know about..Patient safety huddles in the ICU. J Crit Care 2024; 82:154788. [PMID: 38553353 DOI: 10.1016/j.jcrc.2024.154788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 06/01/2024]
Abstract
Patient safety huddles are brief, multidisciplinary conversations that focus on a specific topic or event. Huddles have been shown to improve communication among healthcare providers in a variety of settings, including the intensive care unit (ICU). This paper presents key features of patient safety huddles and describes the ways in which huddle techniques may be particularly relevant to the practice of critical care.
Collapse
Affiliation(s)
- Margo Hoyler
- Division of Critical Care Medicine, Department of Anesthesiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.
| | - Michael S Niederman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Natalia Ivascu Girardi
- Division of Critical Care Medicine, Department of Anesthesiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| |
Collapse
|
2
|
Casimero C, Smith RB, Davis J. Integration of Riboflavin-Modified Carbon Fiber Mesh Electrode Systems in a 3D-Printed Catheter Hub. MICROMACHINES 2023; 15:79. [PMID: 38258198 PMCID: PMC10818592 DOI: 10.3390/mi15010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Catheter line infection is a common complication within clinical environments, and there is a pressing need for technological options to aid in reducing the possibility of sepsis. The early identification of contamination could be pivotal in reducing cases and improving outcomes. METHOD A sensing rationale based on a riboflavin-modified electrode system integrated within a modified 3D-printed catheter needle-free connector is proposed, which can monitor changes in pH brought about by bacterial contamination. RESULTS Riboflavin, vitamin B2, is a biocompatible chemical that possesses a redox-active flavin core that is pH dependent. The oxidation peak potential of the adsorbed riboflavin responds linearly to changes in pH with a near-Nernstian behavior of 63 mV/pH unit and is capable of accurately monitoring the pH of an authentic IV infusate. CONCLUSIONS The proof of principle is demonstrated with an electrode-printed hub design offering a valuable foundation from which to explore bacterial interactions within the catheter lumen with the potential of providing an early warning of contamination.
Collapse
Affiliation(s)
| | - Robert B. Smith
- Institute for Materials and Investigative Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
| | - James Davis
- School of Engineering, Ulster University, Belfast BT15 1ED, UK;
| |
Collapse
|
3
|
Menger J, Kaase M, Schulze MH, Dudakova A, Rosin K, Moerer O, Scheithauer S. Central venous catheter contamination rate in suspected sepsis patients - an observational clinical study. J Hosp Infect 2023; 135:98-105. [PMID: 36907334 DOI: 10.1016/j.jhin.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND More than 160,000 central-line-associated bloodstream infections (CLABSIs) are estimated for Europe each year leading to about 25,000 deaths. We aimed at characterising the contamination of administration sets in suspected CLABSI cases in the intensive care unit (ICU). METHODS In ICU patients (period 02/2017-02/2018) with suspected CLABSI, all sampled central venous catheters (CVCs) were examined in 4 segments (from CVC tip to connected tubing systems) for contamination. A risk factor analysis using binary logistic regression was performed. RESULTS 52 consecutively sampled CVCs with 1,004 elements were analysed with 45 elements being positive for at least one microorganism (4.48%). There was a significant association with the duration of catheterisation (p=0.038, n=50) with a daily increase of contamination risk by 11.5% (OR 1.115). The mean number of CVC manipulations was 40 within 72 hours (SD: 20.5), with no association with contamination risk (p=0.381). The contamination risk of the CVC segments decreased from proximal to distal. Non-replaceable components of the CVC had a high risk (14 times higher; p=0.01). A significant positive correlation was detected between positive tip cultures and microbial growth in the administration set (r(49)=0.437, p=0.001). CONCLUSION Although only a minority of CLABSI-suspect patients had positive blood cultures, the contamination rate of central venous catheters and administration set was high, possibly indicating a relevant under-reporting. The finding of identical species in adjacent segments underlines the role of upward or downward spread of microorganisms within the tubes, therefore aseptic tasks should be emphasized.
Collapse
Affiliation(s)
- Johanna Menger
- Department for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany; Department of Anesthesiology, University Medical Center Goettingen, Goettingen, Germany
| | - Martin Kaase
- Department for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Marco H Schulze
- Department for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Anna Dudakova
- Institute for Medical Microbiology and Virology, University Medical Center Goettingen, Goettingen, Germany
| | - Katharina Rosin
- Department for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany
| | - Onnen Moerer
- Department of Anesthesiology, University Medical Center Goettingen, Goettingen, Germany
| | - Simone Scheithauer
- Department for Infection Control and Infectious Diseases, University Medical Center Goettingen, Goettingen, Germany.
| |
Collapse
|
4
|
Corrêa Carvalho G, Miguel Sábio R, Spósito L, de Jesus Andreoli Pinto T, Chorilli M. An overview of the use of central venous catheters impregnated with drugs or with inorganic nanoparticles as a strategy in preventing infections. Int J Pharm 2022; 615:121518. [DOI: 10.1016/j.ijpharm.2022.121518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/17/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
|
5
|
Simon A, Fahrendorf W, Hitschmann G. Preclinical evaluation of passive disinfection caps with a long-term catheter for the prevention of catheter-related bloodstream infection in pediatric cancer patients. GMS HYGIENE AND INFECTION CONTROL 2021; 16:Doc20. [PMID: 34113538 PMCID: PMC8167456 DOI: 10.3205/dgkh000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The use of passive disinfection devices (disinfection caps) may be a beneficial part of a maintenance care bundle, aiming at the prevention of catheter-related bloodstream infections in pediatric cancer patients. This preclinical in vitro investigation tested the visual and mechanical integrity of a Broviac™ catheter hub after simulation testing with 122 3M™ CurosTM Stopper Disinfection Caps for Open Female Luers repeatedly attached and removed over 6 months. We found that these catheter hubs were compatible, fully operational, and airtight with use of 3M Curos stopper caps after 6 months of use with 122 caps per catheter hub.
Collapse
Affiliation(s)
- Arne Simon
- Pediatric Oncology and Hematology, Children's Hospital Medical Center, Saarland University Hospital, Homburg/Saar, Germany
| | - Wolfgang Fahrendorf
- 3M Medical Solutions Division, Health Care Business Group, 3M Central Europe Region, 3M Deutschland GmbH, Neuss, Germany
| | - Guido Hitschmann
- Medical Solutions Division Laboratory, Europe, Middle East and Africa, 3M Deutschland GmbH, Neuss, Germany
| |
Collapse
|
6
|
Greene ES. Challenges in reducing the risk of infection when accessing vascular catheters. J Hosp Infect 2021; 113:130-144. [PMID: 33713758 DOI: 10.1016/j.jhin.2021.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Injection safety is essential to reduce the risk of healthcare-associated infections (HAIs) when accessing vascular catheters. This general review evaluates the contamination of vascular catheter access ports and associated HAIs in acute care settings, focusing on open lumen stopcocks (OLSs) and disinfectable needleless closed connectors (DNCCs). PubMed was searched from January 2000 to February 2021. OLS intraluminal surfaces are frequently contaminated during patient care, increasing the risk of HAIs, and neither an isopropyl alcohol (IPA) pad nor a port-scrub device can reduce contamination effectively. In contrast, DNCCs can be disinfected, with most studies indicating less intraluminal contamination than OLSs and some studies showing decreased HAIs. While the optimal DNCC design to reduce HAIs needs to be determined, DNCCs alone or stopcocks with a DNCC bonded to the injection port should replace routine use of OLSs, with OLSs restricted to use in sterile fields. Compliance with disinfection is essential immediately before use of a DNCC as use of a non-disinfected DNCC can have equivalent or greater risk of HAIs compared with use of an OLS. The recommendations for access port disinfection in selected national and international guidelines vary. When comparing in-vitro studies, clinical studies and published guidelines, consensus is lacking; therefore, additional studies are needed, including large randomized controlled trials. IPA caps disinfect DNCCs passively, eliminate scrubbing and provide a contamination barrier; however, their use in neonates has been questioned. Further study is needed to determine whether IPA caps are more efficacious than scrubbing with disinfectant to decrease HAIs related to use of central venous, peripheral venous and arterial catheters.
Collapse
Affiliation(s)
- E S Greene
- Department of Anesthesiology, Albany Medical College, Albany, NY, USA.
| |
Collapse
|
7
|
Laupland KB, Coyer F. Physician and Nurse Research in Multidisciplinary Intensive Care Units. Am J Crit Care 2020; 29:450-457. [PMID: 33130861 DOI: 10.4037/ajcc2020136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses. METHODS One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed. RESULTS Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines. CONCLUSIONS Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.
Collapse
Affiliation(s)
- Kevin B. Laupland
- Kevin B. Laupland is an intensivist, Intensive Care Services, at Royal Brisbane and Women’s Hospital, and a professor at the School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Fiona Coyer
- Fiona Coyer is a professor of nursing with a joint appointment in Intensive Care Services at Royal Brisbane and Women’s Hospital and the School of Nursing, Queensland University of Technology (QUT)
| |
Collapse
|
8
|
Hjalmarsson LB, Hagberg J, Schollin J, Ohlin A. Leakage of isopropanol from port protectors used in neonatal care-Results from an in vitro study. PLoS One 2020; 15:e0235593. [PMID: 32634171 PMCID: PMC7340296 DOI: 10.1371/journal.pone.0235593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/18/2020] [Indexed: 11/25/2022] Open
Abstract
Background To decrease contamination of needleless catheter hubs, caps or port protectors impregnated with isopropanol (IPA) have been developed and shown to be superior to other disinfection methods. The safety of the caps has been questioned, as they can be associated with alcohol leakage across the hub membrane. Objectives We evaluated the use of IPA caps and the scrub-the-hub method from the safety standpoint of possible alcohol leakage across the hub membrane. Methods Circuits imitating an intravenous line were constructed. Circuits with an IPA cap were flushed with sodium chloride after the hub had been exposed to the cap for 1 hour, 24 hours, and 7 days. At the end of each period the fluid was collected and amounts of IPA in it were measured, using gas chromatography. Scrub circuits without IPA caps were also tested and ethanol from these was measured using the same method. Results In this in vitro study, IPA was detected in all samples from cap circuits, and ethanol was detected from all scrub circuits. Leakage increased over time in IPA circuits. After 24 hours and 7 days of exposure, the first injection resulted in higher amounts of IPA; thereafter, the levels decreased. The amounts of ethanol measured from the scrub circuits were low. Conclusions IPA caps can cause leakage of alcohol across the hub membrane. Leakage increased over time, and a 30 sec drying time was not sufficient to solve the problem. Scrub-the-hub seems safe to use with regard to alcohol leakage.
Collapse
Affiliation(s)
- Louise Björkman Hjalmarsson
- Department of Paediatrics, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, Sweden
- * E-mail:
| | - Jessika Hagberg
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jens Schollin
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Andreas Ohlin
- Department of Paediatrics, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, Sweden
| |
Collapse
|
9
|
Aghdassi SJS, Geffers C, Behnke M, Gropmann A, Gastmeier P, Kramer TS. Management of peripheral venous catheters and implementation of guidelines in Germany: a national survey. J Hosp Infect 2019; 105:311-318. [PMID: 31887334 DOI: 10.1016/j.jhin.2019.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/20/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Due to their frequent use, peripheral venous catheters (PVCs) are of importance in terms of catheter-related infections and their prevention. In 2017, revised national guidelines for the prevention of PVC-related infections were published in Germany. AIM To describe PVC handling practices and assess the implementation of national guidelines for the prevention of PVC-related infections in German acute care hospitals, 10 months after their release. METHODS An online survey on the management of PVCs in hospital wards was conducted. For this, 1191 acute care hospitals participating in the national surveillance system for healthcare-associated infections in Germany were invited to participate. Each hospital was asked to complete the survey for an intensive care unit (ICU), as well as a medical ward and a surgical ward. Participation in the survey was voluntary. FINDINGS In total, 701 hospitals (response rate 59%) participated and provided data on 1449 wards (599 ICUs, 446 medical wards, 404 surgical wards). Approximately 43% of wards reported that they had implemented the new national guidelines where necessary. Structured surveillance for PVC-associated infections was established in only 21% of wards. While 94% of wards reported the inclusion of aspects of PVC handling in their general infection prevention education, questions on the training methods yielded diverse results. Approximately 59% of wards reported that they did not routinely use a combination of alcohol and a remanant disinfectant for skin disinfection before PVC insertion. CONCLUSION Generally, PVC management in Germany is well organized. However, potential for improvement was identified, particularly considering surveillance and implementation of selected national guidelines.
Collapse
Affiliation(s)
- S J S Aghdassi
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.
| | - C Geffers
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - M Behnke
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - A Gropmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - P Gastmeier
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| | - T S Kramer
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany
| |
Collapse
|
10
|
Hankins R, Majorant OD, Rupp ME, Cavalieri RJ, Fey PD, Lyden E, Cawcutt KA. Microbial colonization of intravascular catheter connectors in hospitalized patients. Am J Infect Control 2019; 47:1489-1492. [PMID: 31345614 DOI: 10.1016/j.ajic.2019.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/25/2019] [Accepted: 05/26/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Central line-associated bloodstream infections may be due to catheter connector colonization and intraluminal migration of pathogens. We assessed the colonization of the split septum catheter connector system, and subsequently the luer lock catheter connector system. METHODS This was a prospective, 2 phase, quality improvement study at a tertiary referral center. Each phase of the study was performed over 3 consecutive days in hospitalized patients receiving an active infusion; first with a split septum lever lock connector and second with a luer lock connector and alcohol port protector. The connectors were inoculated onto blood agar plates and incubated. Plates were assessed for microbial growth after 48-72 hours. RESULTS In phase I, 98 (41.9%) of 234 split septum connectors yielded microbial growth. In phase II, 56 (23.1%) of 243 luer lock connectors yielded microbial growth. In phase II only, there was a significant increased rate of contamination in peripheral catheters compared with all other catheters, and the rate of contamination on the acute care wards was significantly higher when compared with the intensive care units. CONCLUSIONS Bacterial colonization of the lever lock system was unacceptably high among all catheter types and hospital locations. Transition to luer lock catheter connectors and alcohol port protectors decreased the colonization; however, colonization still remained substantial. Causation of colonization cannot be determined with these results.
Collapse
Affiliation(s)
- Richard Hankins
- Department of Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE
| | - O Denisa Majorant
- Department of Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE
| | - Mark E Rupp
- Department of Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE
| | - R Jennifer Cavalieri
- Department of Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE
| | - Paul D Fey
- Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Elizabeth Lyden
- Epidemiology, University of Nebraska Medical Center, Omaha, NE
| | - Kelly A Cawcutt
- Department of Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE.
| |
Collapse
|
11
|
Vasilopoulos T, Fahy BG. Approaches to assessing perioperative sterility. J Clin Anesth 2019; 56:140-141. [DOI: 10.1016/j.jclinane.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 02/12/2019] [Indexed: 11/25/2022]
|
12
|
Optimizing vascular-access device decision-making in the era of midline catheters. Infect Control Hosp Epidemiol 2019; 40:674-680. [PMID: 30924436 DOI: 10.1017/ice.2019.49] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This narrative review addresses vascular access device choice from peripheral intravenous catheters through central venous catheters, including the evolving use of midline catheters. The review incorporates best practices, published algorithms, and complications extending beyond CLABSI and phlebitis to assist clinicians in navigating complex vascular access decisions.
Collapse
|
13
|
Khalil GM, Azqul MM. Risk factors and microbial profile of central venous catheter related blood stream infection in medical cardiac care units, National Heart Institute, Egypt. Egypt Heart J 2018; 70:361-364. [PMID: 30591755 PMCID: PMC6303371 DOI: 10.1016/j.ehj.2018.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/14/2018] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Catheter related blood stream infection (CRBSI) is the main complication of central venous catheter (CVC) use. The aim of the study is to improve the safety of patients with central venous catheter in National Heart Institute (NHI) medical cardiac care units. METHODS A Prospective cohort study was conducted on one hundred and eleven cardiac patients in (NHI) cardiac care units from August 2017 to February 2018. All patients subjected to central venous catheter (CVC) in cardiac care units, NHI, were included except: 1. Patients with obvious source of infection, 2. Immunocompromised patients, 3. patients having infective endocarditis, 4. patients whose catheter was put outside NHI. RESULTS Noncompliance of health care providers to care bundle elements of CVC of Centers for Disease Control and Prevention (CDC) represents a risk factor for CRBSI occurrence. Coagulase negative staphylococci was the most common isolated organism. CONCLUSION Health care providers should adhere care bundle elements recommended by CDC during insertion and handling of CVC. This will in turn decrease CRBSI.
Collapse
Affiliation(s)
- Ghada Mahmoud Khalil
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Egypt
| | | |
Collapse
|
14
|
Fernández Moreno I, Píriz Marabaján M. Antisepsis in the handling of vascular access connections. Med Intensiva 2018; 43 Suppl 1:44-47. [PMID: 30396792 DOI: 10.1016/j.medin.2018.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 07/30/2018] [Indexed: 11/15/2022]
Abstract
Needleless connectors provide easy access points to the vascular system for the administration of fluids, avoiding the risk of accidental punctures and increasing safety in vascular access manipulation. Non-aseptic manipulation can favor contamination, turning connectors into the penetration route for endoluminal contaminants with the capacity of triggering infectious complications, with serious consequences for the patient. Considering catheter-related bacteremia as a serious and avoidable adverse effect, prevention programs should incorporate measures to combat predisposing factors, such as improved staff training, the safe design of devices, improved disinfection procedures, and optimized antiseptic use. Monitoring adherence to safe practices and reporting results are important to promote understanding of the risks and benefits of decontaminating connections and thus to improve patient safety. safety. This article is part of a supplement entitled "Antisepsis in the critical patient", which is sponsored by Becton Dickinson.
Collapse
Affiliation(s)
- I Fernández Moreno
- Enfermería, Control Infecciones, Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España.
| | - M Píriz Marabaján
- Enfermería, Control Infecciones, Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| |
Collapse
|
15
|
Flynn J, Slater K, Cooke M, Rickard CM. Needleless connector decontamination: To use, or not to use, chlorhexidine? Am J Infect Control 2018; 46:959-960. [PMID: 29680292 DOI: 10.1016/j.ajic.2018.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 01/12/2023]
|