The document discusses central line-associated bloodstream infections (CLABSIs), including how they occur when bacteria grow in a central line and spread into the bloodstream. It provides details on risk factors, signs and symptoms, prevention methods like proper hand hygiene and dressing care, and personal protective equipment used by healthcare workers to prevent infection when handling central lines. The goal is to help reduce infections by carefully managing central lines and following infection control protocols.
2. Central Line-Associated Bloodstream Infection
• Infection can occur when bacteria grow in the
line and spread into the bloodstream.
• is a primary blood stream infection (BSI) in a
patient that had a central line within the 48 hour
period before the development of the BSI
• If BSI develops in a patient within 48 hours of
discharge from a location, attribute the CLABSI to
the discharging location.
3. Central Line-Associated Bloodstream Infection
• Signs or symptoms: temperature above
normal, fever, chills, or the skin around the
central venous catheter (CVC) is
painful, red, swollen or oozing,
4. Laboratory Confirmed Bloodstream Infection
CRITERIA 1 Organism cultured
Patient has a recognized from blood is not
pathogen cultured from one related to an infection
or more blood cultures No at another site.
Yes
Yes
No
CRITERIA 2
Patient has at least one of the
following signs or symptoms: fever
(>38ºC), chills, or hypotension
No
Yes
Signs and symptoms and
positive laboratory results NO
are not related to an Central line associated
infection at another site No bloodstream infection
Yes
Common skin contaminant
is cultured from two or
more blood cultures drawn
on separate occasions No
Yes
Central line associated
bloodstream infection
5. Central Line or Central Venous Catheter
• A vascular infusion device that terminates at
or close to the heart or in one of the great
vessels and is used for infusion, withdrawal of
blood, or hemodynamic monitoring.
6. The following are considered great vessels for
the purpose of reporting central line associated
infections and counting central line days
• Aorta • Brachiocephalic veins
• Pulmonary artery • Internal jugular veins
• Superior vena cava • Subclavein veins
• Inferior vena cava • External iliac veins
• Umbilical artery and
vein for neonates • Common femoral
veins
7. Modifiable Risk Factors
Characteristic Greater Risk Lower Risk
Insertion Emergency elective
sercumstances
Skill of inserter General specialized
Insertion site 70% alcohol 2% chlorhexidine
10% povidone-
iodine
Catheter lumens Multilumen single lumen
Duration of catheter Longer duration of
use use greater risk
Barrier precautions Submaximal maximal
8. Central Line Care
A. Dressing:
1. All dressing shall be changed using sterile technique.
2. Initial dressing should be left in place for 24hrs unless heavy soild
3. Gauze dressing should be changed daily for seven (7) days following
insertion, then every forty eight (48) hour if no signs of infection or if the
dressing becomes loose, wet or soiled.
9. B.Frequency of Flushing
1. A physician’s order is required to flushed with heparin 10 u/ml.
2. Flush before and after every use of antibiotics blood products utilize SASH
technique.
S- Flush the device with 10 ml 0.9% sterile saline
A- administer the medication/ drw blood work
S- Flush the device with 10ml 0.9% sterile saline
H- Flush the device with 2ml heparin (10 u/ ml)
3. Flushed twice a day, if no IV fluids infusing or treatment.
10. C. The catheter is to be looped and anchored
with taped.
D. Required to keep vein open
E. Not required to swab for culture and
sensitivity from central line insertion site that
appears infected, however the physician must
be notified that the site looks infected
F. Change all injection ports every three days.
11. To prevent catheter-associated bloodstream infections
doctors and nurses will:
• Choose a vein where the catheter can
be safely inserted and where the risk
for infection is small.
Subclavian Vein
First Choice
12. • Clean their hands
with soap and water
or an alcohol-based
hand rub before
putting in the
catheter.
13. • Wear a
mask, cap, sterile
gown, and sterile gloves
when putting in the
catheter to keep it
sterile. The patient will
be covered with a sterile
sheet.
14. • Clean their hands, wear
gloves, and clean the catheter
opening with an antiseptic
solution before using the
catheter to draw blood or give
medications. Healthcare
providers also clean their
hands and wear gloves when
changing the bandage that
covers the area where the
catheter enters the skin.
15. • Clean the patient’s skin
with an antiseptic
cleanser before putting
in the catheter.
16. • Decide every day if the
patient still needs to
have the catheter. The
catheter will be
removed as soon as it is
no longer needed.
18. Some patients are sent home from the hospital with a catheter in order to
continue their treatment.
• Make sure you understand how to care for the
catheter before leaving the hospital. For
example, ask for instructions on showering or
bathing with the catheter and how to change
the catheter dressing.
• Make sure you know
who to contact if you
have questions or
problems after you
get home.
19. Some patients are sent home from the hospital with a catheter in order to
continue their treatment.
20. • Make sure you wash
your hands with soap
and water or an
alcohol-based hand
rub before handling
your catheter.
21.
22. • Watch for the signs and symptoms of
catheter-associated bloodstream
infection, such as soreness or redness
at the catheter site or fever, and call
your healthcare provider immediately
if any occur.
26. Personal Protective Equipment ( PPE)
Refers to protective
clothing, helmets, goggles,
or other garment or
equipment designed to
protect the worker’s body Purpose
from injury by blunt
impacts, electrical
hazards, heat, chemicals
and infection, for job- Designed to protect
related occupational safety the skin and mucuos
and health purposes membranes of the
eyes, nose and mouth
from exposure to
blood or other
potentially infectious
material.
