Introduction:
Central Line-Associated Bloodstream Infection (CLABSI) is a significant healthcare-associated infection (HAI) that is associated with increased morbidity, mortality, and healthcare costs. CLABSI, a bloodstream infection caused by microbes entering the bloodstream via a central catheter (CVC), is possible. CLABSI, a potentially preventable HAI, can be controlled by strict infection control (Hsu et. al. 2016, 2016).
Problem Statement:
CLABSI is still a major cause of mortality and morbidity, especially in the critical care setting. CLABSI prevention guidelines are available, but implementation is difficult. CLABSI is a serious problem in the clinical setting. More research is required (Hsu and colleagues, 2016).
PICOT question:
Do bundled interventions reduce CLABSI in critically ill adults with central vein catheters?
Clinic Setting
It is located in the Intensive Care Unit, (ICU), of a major urban teaching hospital.
Health/Disease Issue:
CLABSI prevention in adult patients who have central venous catheters is a major health concern.
Summary:
Numerous studies have examined the efficacy of bundled interventions to reduce the risk of CLABSI. Hsu and colleagues (et al. Hsu et al. (2016) discovered that an intervention that combined chlorhexidine, maximum barrier precautions during catheter insertation, daily evaluation of catheter necessity, and a multifaceted approach to CLABSI reduction was effective.
Marschall, et. al. Marschall et al. (2014) discovered that an infection prevention package that contained an alcohol-based, chlorhexidine-based skin preparation and chlorhexidine dressings was linked to a significantly lower incidence of CLABSI.
Description of the Case:
Critically ill 65-year-old patient was admitted into the ICU. She required a central vein catheter to provide hemodynamic monitoring and administer medication. Patient had diabetes mellitus, hypertension and chronic kidney disease. This bundled procedure included daily monitoring of the catheter’s necessity and chlorhexidine skin prevention. The patient’s central venous catheter was removed after 5 days, and the patient did not develop CLABSI.
Ideas for Solutions
Bundled interventions have been proven to reduce the risk of CLABSI among critically ill patients who are using central venous catheters. This should include chlorhexidine-based skin protection, maximum barrier precautions for catheter insertion and daily evaluation of catheter necessity (Hsu, Marschall, 2014).
In addition, a study by Garcia-Teresa et al. A 2015 study by Garcia-Teresa et al. found that antimicrobial locks were associated with significant decreases in CLABSI among critically ill patients who had central venous catheters. Antimicrobial locks may be recommended for patients who are at higher risk of CLABSI. But, antimicrobial resistance is possible.
Conclusion:
CLABSI prevention is a challenge in critical care. CLABSI incidence can be significantly reduced by using bundled interventions. These include: chlorhexidine, maximal barrier precautions at catheter insertion, daily assessment for catheter necessity, and chlorhexidine as a skin treatment. In patients who are at higher risk of CLABSI, an antimicrobial lock solution might be recommended. Additional research is required to find additional ways to avoid CLABSI among critically ill patients who have central venous catheters.