Use of Central Venous Catheter-Related Bloodstream Infection Prevention Practices by US Hospitals

Krein, Sarah L.; Hofer, Timothy P.; Kowalski, Christine P.; Olmsted, Russell N.; Kauffman, Carol A.; Forman, Jane H.; Banaszak-Holl, Jane; Saint, Sanjay
June 2007
Mayo Clinic Proceedings;Jun2007, Vol. 82 Issue 6, p672
Academic Journal
OBJECTIVE: To examine the extent to which US acute care hospitals have adopted recommended practices to prevent central venous catheter-related bloodstream infections (CR-BSis). PARTICIPANTS AND METHODS: Between March 16, 2005, and August 1, 2005, a survey of infection control coordinators was conducted at a national random sample of nonfederal hospitals with an intensive care unit and more than 50 hospital beds (n=600) and at all Department of Veterans Affairs (VA) medical centers (n=119). Primary outcomes were regular use of 5 specific practices and a composite approach for preventing CR-BSis. RESULTS: The overall survey response rate was 72% (n=516). A higher percentage of VA compared to non-VA hospitals reported using maximal sterile barrier precautions (84% vs 71%; P=.01); chlorhexidine gluconate for insertion site antisepsis (91% vs 69%; P<.001); and a composite approach (62% vs 44%; P=.003) combining concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Those hospitals having a higher safety culture score, having a certified infection control professional, and participating in an infection prevention collaborative were more likely to use CR-BSI prevention practices. CONCLUSION: Most US hospitals are using maximal sterile barrier precautions and chlorhexidine gluconate, 2 of the most strongly recommended practices to prevent CR-BSIs. However, fewer than half of non-VA US hospitals reported concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Wider use of CR-BSI prevention practices by hospitals could be encouraged by fostering a culture of safety, participating in infection prevention collaboratives, and promoting infection control professional certification.


Related Articles

  • Prevention of Catheter-Related Bloodstream Infections: Looking to the Department of Veterans Affairs Health Care System for Guidance. Snydman, David R. // Mayo Clinic Proceedings;Jun2007, Vol. 82 Issue 6, p665 

    The author comments on the capability of the hospitals of the U.S. Department of Veterans Affairs (VA) in the prevention of catheter-related bloodstream infections throughout the country. He cited the survey conducted by S. L. Krein and colleagues, which is published within the issue, as an...

  • New Guidelines Aim to Prevent Catheter-Related Bloodstream Infections. Theuvenin, Frederique H. // Pulmonary Reviews;Jun2011, Vol. 16 Issue 6, p17 

    The article presents evidence-based recommendations for preventing intravascular catheter-related bloodstream infections, as part of the guidelines issued by researchers led by the Society of Critical Care Medicine. These include periodic evaluation of healthcare personnel's knowledge and...

  • MRSA in the ICU. Kuehn, Bridget M. // JAMA: Journal of the American Medical Association;2/16/2005, Vol. 293 Issue 7, p790 

    Examines efforts to prevent the spread of methicillin-resistant Staphylococcus aureus (MRSA) infections in hospital intensive care units. Results of a study which indicate that standard precautionary measures do not prevent the transmission of MRSA; Development of preventive measures in hospital...

  • Should We Teach Every Soldier How to Start an IV? Mabry, Robert L.; Cuanca, Peter J. // Military Medicine;Jun2009, Vol. 174 Issue 6, preceding p557 

    The author talks about the necessity of requiring U.S. soldiers to be competent in placing an intravenous (IV) line and initiating treatment with IV fluids under the existing combat lifesaver (CLS) standards. He argues that such requirement may not be the best use of training resources as IV...

  • Cardiac troponin I release and cytokine response during experimental human endotoxaemia. van Bockel, Esther A. P.; Tulleken, Jaap E.; Muller Kobold, Anneke C.; Ligtenberg, Jack J. M.; van der Werf, Tjip S.; Spanjersberg, Rob; Zijlstra, Jan G. // Intensive Care Medicine;Sep2003, Vol. 29 Issue 9, p1598 

    Objective. To study the relationship between cytokine levels and cardiac troponin I (cTnI). Design. Prospective experimental study. Setting. Intensive care unit of a university hospital. Participants. Six healthy male volunteers. Interventions. Endotoxin, 4 ng/kg, was given as a 1-min...

  • Programmable Infusion Pumps in ICUs: An Analysis of Corresponding Adverse Drug Events. Nuckols, Teryl K.; Bower, Anthony G.; Paddock, Susan M.; Hilborne, Lee H.; Wallace, Peggy; Rothschild, Jeffrey M.; Griffin, Anne; Fairbanks, Rollin J.; Carlson, Beverly; Panzer, Robert J.; Brook, Robert H. // JGIM: Journal of General Internal Medicine;Jan2008 Supplement 1, Vol. 23 Issue S1, p41 

    Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable. To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software...

  • Surveillance of antimicrobial use and antimicrobial resistance in intensive care units (SARI): 1. Antimicrobial use in German intensive care units. Meyer, Elisabeth; Schwab, Frank; Jonas, Daniel; Rueden, Henning; Gastmeier, Petra; Daschner, Franz D. // Intensive Care Medicine;Jun2004, Vol. 30 Issue 6, p1089 

    Objective. To study antimicrobial use for benchmarking and ensuring quality of antimicrobial treatment and to identify risk factors associated with the high use of antimicrobials in German intensive care units (ICUs) through implementation of the SARI (Surveillance of Antimicrobial Use and...

  • Centralization of paediatric intensive care: are critically ill children appropriately referred to a regional centre? Goh, Adrian Y.; Mok, Quen // Intensive Care Medicine;Apr2001, Vol. 27 Issue 4, p730 

    Objectives: To evaluate the appropriateness of emergency referrals for inter-hospital transfers by local physicians in hospitals without intensive care facilities to a regional tertiary paediatric intensive care unit (PICU). Design: A prospective, descriptive study in a tertiary PICU and...

  • Clinical Performance and Nursing Satisfaction of a Transparent Chlorhexidine Gluconate IV Securement Dressing with Peripherally Inserted Central Catheters. Maryniak, Kim // Journal of the Association for Vascular Access;Winter2009, Vol. 14 Issue 4, p200 

    Background: Bloodstream Infections (BSI) caused by central venous catheters, including peripherally inserted central catheters, can result in longer patient stays and increased complications. Using methods of best practice is needed to reduce the occurrence of these infections. Objective: To...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics