NURS 4221 Week 2 Discussion
A central line-associated bloodstream infection (CLABSI) is characterized as a laboratory-confirmed bloodstream infection that occurs within 48 hours of central line placement and is unrelated to other infection sites. CLABSIs are among the costliest healthcare-associated infections, with an estimated cost of approximately $46,000 per case.
These infections lead to extended hospital stays, increased healthcare expenses, and higher mortality rates. Intravascular devices are associated with the majority of the estimated 250,000 annual bloodstream infections. In intensive care units (ICUs) in the United States, the estimated CLABSI rate is 0.8 per 1000 central line days. Most cases can be prevented through the implementation of proper aseptic techniques, surveillance, and management strategies (Haddadin & Regunath, 2018).
NURS 4221 Week 2 Discussion
In my conversation with the nursing supervisor and Assistant Chief Nursing Officer (ACNO), I discovered that our facility has an established system for identifying and monitoring healthcare-associated infections (HAIs). HAIs are documented weekly, starting with the nursing staff, followed by the nursing supervisor, who reports the information to the infection control nurse responsible for reporting specific data at the state and national levels. Our interventions to reduce or prevent CLABSIs include:
Weekly sterile dressing changes, with additional changes as needed.
Proper utilization of Swab caps.
Maintaining a sterile field during central line insertion and until the dressing is applied.
Timely removal of central lines when they are no longer necessary.
Prompt removal of central lines upon expiration.
Consistent adherence to good hand hygiene practices.
NURS 4221 Week 2 Discussion
Research studies have demonstrated that implementing passive disinfection caps (swab caps) resulted in a 34% decrease in hospital-wide HA-CLABSI rates, with a reduction from a combined baseline rate of 2.66 to 1.75 per 1,000 catheter days by the end of the study period. This decrease was observed among high-risk patients but not general oncology patients. Furthermore, the use of passive disinfection caps led to a 63% reduction in blood culture contamination in high-risk units and a 51% reduction in general oncology units, estimating a reduction of 242 blood culture contaminants with coagulase-negative Staphylococcus (CONS). These reductions in HA-CLABSI and blood culture contamination corresponded to an estimated annual cost savings of $3.2 million in direct medical expenses (Kamboj et al., 2015).
NURS 4221 Week 2 Discussion
In my opinion, I have confidence in our facility’s ability to maintain low CLABSI rates through ongoing education on central line insertion and proper care. This is also an opportune time to remind nurses about the cost implications of CLABSIs. Based on discussions with colleagues, we believe it would be beneficial to implement weekly dressing changes on the same day. Nurses should be more informed about infection rates in their respective units, as this knowledge enhances their awareness and attentiveness to unit-specific issues.
References:
Haddadin, Y., & Regunath, H. (2018). Central line-associated bloodstream infections (CLABSI). StatPearls Publishing. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK430891/Kamboj, M., Blair, R., Bell, N., et al. (2015). Use of disinfection cap to reduce central-line-associated bloodstream infection and blood culture contamination among hematology-oncology patients. Infection Control and Hospital Epidemiology, 36(12), 1401-1408. doi: 10.1017/ice.2015.219
