Abstract
This document is an executive summary of the APSIC Guide for Prevention of Central Line Associated Bloodstream Infections (CLABSI). It describes key evidence-based care components of the Central Line Insertion and Maintenance Bundles and its implementation using the quality improvement methodology, namely the Plan-Do-Study-Act (PDSA) methodology involving multidisciplinary process and stakeholders. Monitoring of improvement over time with timely feedback to stakeholders is a key component to ensure the success of implementing best practices. A surveillance program is recommended to monitor outcomes and adherence to evidence-based central line insertion and maintenance practices (compliance rate) and identify quality improvement opportunities and strategically targeting interventions for the reduction of CLABSI.
Highlights
Central line–associated bloodstream infections, or Central Line Associated Bloodstream Infections (CLABSI), are associated with increased morbidity, mortality, and health care costs [1]
It is recognized that CLABSIs are largely preventable when evidence based guidelines are followed for the insertion and maintenance of Central Venous Catheters (CVC) [2]
This document is a summary of the CLABSI prevention guidelines developed by the Asia Pacific Society of Infection Control (APSIC)
Summary
Central line–associated bloodstream infections, or CLABSIs, are associated with increased morbidity, mortality, and health care costs [1]. 1. Workgroup Composition APSIC convened Infection Prevention and Control experts from the Asia Pacific region to develop the APSIC Guide for Prevention of Central Line Associated Bloodstream Infections (CLABSI). Expert consensus on selection of recommendations and strength of recommendations was obtained from the workgroup to develop the draft, which was submitted to APSIC Executive Committee and national Infection Control societies in the Asia Pacific region. Weigh the risk and benefits of placing a central venous device at a recommended site to reduce infection against the risk of mechanical complications (e.g., pneumothorax, subclavian artery puncture, subclavian vein laceration, subclavian vein stenosis, hemothorax, thrombosis, air embolism, and catheter misplacement). 1. Prepare and clean the skin site with an alcoholic chlorhexidine solution containing a concentration of 0.5 to 2 % chlorhexidine and 70 % alcohol before central venous catheter insertion and during dressing changes. Use a sterile sleeve to protect pulmonary artery catheters during insertion. (IB)
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