Prevention Of Catheter-associated Bloodstream Infections Research Articles

Prevention of catheter-associated bloodstream infections and care of central venous catheter (CVC)

To address the spread of pathogenic agents and minimize the risk of infection, it is essential to apply measures for proper antiseptic treatment of the surgical site prior to an invasive medical procedure to effectively reduce the incidence of surgical site infection and associated complications. Knowledge of the concepts and standards for the use of antiseptic and disinfectant agents helps health care providers to effectively prevent the spread of infectious agents and provides a scientific basis for their rational use. Research on the mechanisms of action of antiseptics has not only scientific but also practical importance for nurses and clinicians, which is related to more effective use of these drugs in professional activities and potential development of new promising compounds and their combinations.

Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units.

Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care. To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units. A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level. There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001). Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.

Prevention of Catheter-Associated Bloodstream Infections in Hemodialysis Patients

This study aimed to assess the efficacy of preventive measures against catheter-associated bloodstream infections in hemodialysis patients. Seventy patients undergoing hemodialysis treatment at our hospital from January 2020 to January 2023 were recruited and randomly assigned in a 1:1 ratio to receive either conventional nursing (control group) or targeted preventive nursing (observation group), with 35 cases in each group. Outcome measures for nursing effects assessment included nursing outcomes, the incidence of catheter-related bloodstream infections, patient stress, and quality of life. Targeted preventive nursing demonstrated a significantly lower incidence of catheter-related bloodstream infection and adverse catheter events compared to conventional care (P &lt;0.05). Moreover, targeted preventive nursing significantly reduced catheter retention duration in comparison to conventional care (P &lt;0.05). The higher quality of nursing associated with targeted preventive nursing was evident in the elevated nursing quality scores (P &lt;0.05). Patients who underwent targeted preventive nursing exhibited milder stress compared to those receiving routine care, as indicated by lower hemodialysis stress scale (HSS) scores (P &lt;0.05). Furthermore, the observation group, receiving targeted preventive nursing, reported higherWorld Health Organization quality of life (WHOQOL-BREF) scores than the control group, suggesting an improved quality of life (P &lt;0.05). Targeted preventive care for catheter-associated bloodstream infections in hemodialysis patients not only fortifies the rigor and standard of care but also effectively reduces the infection rate, shortens catheter retention time, alleviates patient stress, and enhances their overall quality of care and survival.

APLICATIVOS SOBRE TERAPIA INTRAVENOSA E PREVENÇÃO DE INFECÇÃO DE CORRENTE SANGUÍNEA ASSOCIADA AO CATETER: PROSPECÇÃO TECNOLÓGICA

ABSTRACT Objective: to identify mobile applications on intravenous therapy and prevention of catheter-associated bloodstream infection. Method: technological prospection, with data search in Patent Bases and Virtual Stores, data collection occurred from May to August 2021. Inclusion criteria: mobile applications focused on Intravenous Therapy; mobile applications focused on the prevention of bloodstream infection. The analysis was carried out in a qualitative comparative way, recognizing the functions developed by the applications and their potential for use in clinical practice. Results: 19 applications were selected and organized into themes: applications to assist in catheterization; applications for catheter maintenance; applications on bloodstream infection prevention; and applications on diagnosis of catheter-associated bloodstream infection. Conclusion: The identification of few apps on the theme serves to promote the construction of new apps.

Use of chlorhexidine for the prophylaxis of nosocomial infections in ICU

This review summarizes published data on the use of chlorhexidine for the prevention of nosocomial infections in the intensive care units (ICU). The use of a 0.5–2.0% alcohol solution of chlorhexidine is strongly recommended for the surgical site decontamination before surgical intervention or vascular puncture for the prevention of surgical site infections and catheter-associated bloodstream infections. The following measures could be considered: daily skin decontamination with water solution of chlorhexidine (chlorhexidine bathing) in ICU for the prevention of catheter-associated bloodstream infection; the use of impregnated with chlorhexidine dressing for the prevention of catheter-associated bloodstream infections and catheter colonization; cleaning of the urinary meatus with water solution of chlorhexidine for the prevention of catheter-associated urinary tract infections. A routine use of chlorhexidine solution for oral care to prevent ventilator-associated pneumonia is not reasonable. The risks of contact dermatitis, anaphylaxis and emergence of chlorhexidine-resistant microorganisms should be considered when using chlorhexidine.

580 A Systematic Approach to Preventing Central Venous Catheter-Associated Bloodstream Infection in Patients Receiving home Parenteral Nutrition

Background and AimsCentral venous catheter-associated bloodstream infection (CBSI) is a serious complication in home parenteral nutrition (HPN) patients. Prevention of CBSI in hospitals is well-established, but in the home environment...

A prospective double-blind randomized trial comparing intraluminal ethanol with heparinized saline for the prevention of catheter-associated bloodstream infection in immunosuppressed haematology patients

The aim of this study was to prospectively evaluate the use of intraluminal ethanol for the prevention of catheter-associated bloodstream infection (CABSI) in immunosuppressed haematology patients. Patients receiving chemotherapy for haematological malignancy or haematopoietic cell transplantation were randomized in a double-blinded manner to receive either intraluminal 70% ethanol/water or heparinized saline locks on a daily basis throughout a prophylactic treatment period. The primary endpoint was an episode of CABSI (defined as 'bacteraemia in a febrile patient with a central venous catheter that was in use within the preceding 48 h and with no other identified focus of infection'). The trial was registered with the Australian Clinical Trials Register: number ACTRN012605000383662. There were 34 and 30 prophylactic treatment periods in the ethanol and control groups, respectively. CABSI occurred in 3 (9%, 0.60/100 catheter-days) and 11 (37%, 3.11/100 catheter-days) prophylactic treatment periods in the ethanol and control groups, respectively (OR = 0.18, 95% CI 0.05-0.65, P = 0.008). Eleven (32%) and 5 (17%) patients in the ethanol and control groups, respectively, remained afebrile throughout the prophylactic treatment (P = 0.18). The daily administration of ethanol locks into lumens of central venous catheters effectively reduces the incidence of CABSI.

The effectiveness of a nurse-initiated intervention to reduce catheter-associated bloodstream infections in an urban acute hospital: An intervention study with before and after comparison

Background Catheter care is considered to be important for prevention of catheter-associated bloodstream infections (CABSIs) although epidemiological evidence is sparse. Objectives To identify problems associated with catheter care and evaluate the effectiveness of nurse-initiated interventions to reduce CABSIs. Design An intervention study with before and after comparison. Settings CABSI surveillance was conducted in a 560-bed acute hospital located in a major urban area in Japan. Participants Patients were enrolled in this study from April 2000 to December 2002 based on the following criteria: (1) adult inpatients; and (2) those in whom central venous lines or Swan-Ganz catheters were inserted for 2 days or longer. Methods In the first year, risk factors for CABSI and problems associated with catheter care were identified by inspection of the infection control nurse (ICN) or four trained link nurses, and the laboratory results. In the subsequent 2 years, the following interventions based on the surveillance results were implemented: (1) enhanced skin preparation by scrubbing with regular bathing soap and tap water; (2) a new method for stabilisation of the catheter inserted into the internal jugular vein, where additional dressing was placed over the sterilised dressing; (3) educating the staff on maximal sterile precautions by teaching staff members at their section meetings and displaying posters; (4) use of a check list and observation of catheter insertion by link nurses to monitor compliance; and (5) selection of a disinfectant that requires shorter contact time and has longer residual effect. Results After these interventions were implemented, the overall bloodstream infection (BSI) rate declined from 4.0/1000 device-days to 1.1/1000 device-days ( p<0.005). Conclusions We identified four problems—those related to skin preparation, dressing, sterile precautions and disinfectant. We implemented a series of interventions to reduce CABSIs; the overall CABSI rate decreased significantly.

The Effect of an Education Program on the Incidence of Central Venous Catheter-Associated Bloodstream Infection in a Medical ICU

To determine whether an education initiative could decrease the rate of catheter-associated bloodstream infection. Preintervention and postintervention observational study. The 19-bed medical ICU in a 1,400-bed university-affiliated urban teaching hospital. Between January 2000 and December 2003, all patients admitted to the medical ICU were surveyed prospectively for the development of catheter-associated bloodstream infection. A mandatory education program directed toward ICU nurses and physicians was developed by a multidisciplinary task force to highlight correct practices for the prevention of catheter-associated bloodstream infection. The program consisted of a 10-page self-study module on risk factors and practice modifications involved in catheter-related bloodstream infections and in-services at scheduled staff meetings. Each participant was required to complete a pretest before reviewing the study module and an identical test after completion of the study module. Fact sheets and posters reinforcing the information in the study module were also posted throughout the ICU. Seventy-four episodes of catheter-associated bloodstream infection occurred in 7,879 catheter-days (9.4 per 1,000 catheter-days) in the 24 months before the introduction of the education program. Following implementation of the intervention, the rate of catheter-associated bloodstream infection decreased to 41 episodes in 7,455 catheter days (5.5 per 1,000 catheter-days) [p = 0.019]. The estimated cost savings secondary to the decreased rate of catheter-associated bloodstream infection for the 24 months following introduction of the education program was between $103,600 and $1,573,000. An intervention focused on the education of health-care providers on the prevention of catheter-associated bloodstream infections may lead to a dramatic decrease in the incidence of primary bloodstream infections. Education programs may lead to a substantial decrease in medical-care costs and patient morbidity attributed to central venous catheterization when implemented as part of mandatory training.

An educational intervention to prevent catheter-associated bloodstream infections in a nonteaching, community medical center.

To evaluate the effectiveness of an evidence-based intervention to prevent catheter-associated bloodstream infections among intensive care unit patients at a nonteaching, community hospital. Nonrandomized pre/post observational trial. Two intensive care units at Missouri Baptist Medical Center, Saint Louis, MO. Nurses and critical care physicians. A ten-page, self-study module on the prevention of catheter-associated bloodstream infections, lectures, and posters given between July and September 1999. The incidence of nosocomial catheter-associated bloodstream infection and patient demographics were measured for patients admitted between March 1998 and July 2000. Thirty cases of catheter-associated bloodstream infections during 6110 catheter-days were noted in the preintervention period (4.9 cases/1000 catheter-days) vs. 11 cases during the 5210 catheter-days in the postintervention period (2.1 cases/1000 catheter-days). The relative risk for catheter-associated infection in the postintervention period was 0.43 (95% confidence interval, 0.22-0.84). Among catheterized patients, Acute Physiology and Chronic Health Evaluation II score (25.2 preintervention vs. 25.1 postintervention; p =.86), hemodialysis (91 of 647 [14%] patients vs. 69 of 541 [13%]; p =.70), and the mean number of catheter days per patient (9.1 vs. 9.6 days; p =.46) did not differ between the pre- and postintervention periods. A focused, educational intervention among nurses and physicians in a nonteaching community hospital resulted in a significant, sustained reduction in the incidence of catheter-associated bloodstream infection.