Innovative Strategies for Preventing Central-Line Associated Infections

作者: E. Bouza , M. Guembe , María J. Pérez-Granda

DOI: 10.1007/S40506-013-0001-1

关键词: Catheter insertionSkin disinfectionAntisepticChecklistIntensive care medicineCatheterMedicineHealth careIntensive careCentral line

摘要: In recent years, healthcare associated infections (HAIs), and central line-associated bloodstream in particular (CLABSI), are being viewed as “preventable” events. It has been estimated that up to 70 % of CLABSI episodes may be preventable with the implementation evidence-based strategies pretending reach zero incidence. The most effective procedures, which have demonstrated reduce significantly rates, preventive bundles, consists a set measures carried out during both catheter insertion maintenance. These mainly following: implementing continuous education training personnel workers, using maximal sterile barrier precautions insertion, performing skin disinfection 2 % alcoholic chlorhexidine, avoiding femoral site, removing unnecessary catheters. However, these performed intensive care units (ICUs) much less emphasis efforts non-ICU wards. There is also need introduce other novel rates such lock antiseptic solutions, impregnated sponges dressings, designating surveillance nurse monitor lines, or keeping record maintenance procedures checklist.

参考文章(121)
Steve Z Menyhay, Dennis G Maki, None, Disinfection of needleless catheter connectors and access ports with alcohol may not prevent microbial entry: the promise of a novel antiseptic-barrier cap. Infection Control and Hospital Epidemiology. ,vol. 27, pp. 23- 27 ,(2006) , 10.1086/500280
Eric J. McGrath, Ralph Salloum, Xinguang Chen, Yifan Jiang, Kathrina Boldt-MacDonald, Cristie Becker, Roland Chu, Jocelyn Y. Ang, Short-Dwell Ethanol Lock Therapy in Children Is Associated With Increased Clearance of Central Line–Associated Bloodstream Infections Clinical Pediatrics. ,vol. 50, pp. 943- 951 ,(2011) , 10.1177/0009922811409568
Venessa French, Lynelle Foster, Peter Gallagher, John R Gowardman, Li Zhang, Alice McClymont, Michael Whitby, Claire M Rickard, Joan Webster, Marianne C Wallis, Nicole Marsh, Matthew R McGrail, Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial The Lancet. ,vol. 380, pp. 1066- 1074 ,(2012) , 10.1016/S0140-6736(12)61082-4
Nathorn Chaiyakunapruk, David L. Veenstra, Benjamin A. Lipsky, Sean D. Sullivan, Sanjay Saint, Vascular Catheter Site Care: The Clinical and Economic Benefits of Chlorhexidine Gluconate Compared with Povidone Iodine Clinical Infectious Diseases. ,vol. 37, pp. 764- 771 ,(2003) , 10.1086/377265
L. A. Mermel, What Is The Predominant Source of Intravascular Catheter Infections Clinical Infectious Diseases. ,vol. 52, pp. 211- 212 ,(2011) , 10.1093/CID/CIQ108
Robert J. Sherertz, David K. Warren, Leonard A. Mermel, Michael Allon, Emilio Bouza, Donald E. Craven, Patricia Flynn, Naomi P. O'Grady, Issam I. Raad, Bart J. A. Rijnders, Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America Clinical Infectious Diseases. ,vol. 49, pp. 1- 45 ,(2009) , 10.1086/599376
M. R. Miller, M. F. Niedner, W. C. Huskins, E. Colantuoni, G. Yenokyan, M. Moss, T. B. Rice, D. Ridling, D. Campbell, R. J. Brilli, , Reducing PICU Central Line–Associated Bloodstream Infections: 3-Year Results Pediatrics. ,vol. 128, ,(2011) , 10.1542/PEDS.2010-3675
Olivier Mimoz, Stéphanie Villeminey, Stéphanie Ragot, Claire Dahyot-Fizelier, Leila Laksiri, Franck Petitpas, Bertrand Debaene, Chlorhexidine-Based Antiseptic Solution vs Alcohol-Based Povidone-Iodine for Central Venous Catheter Care JAMA Internal Medicine. ,vol. 167, pp. 2066- 2072 ,(2007) , 10.1001/ARCHINTE.167.19.2066
Michael W. Climo, Deborah S. Yokoe, David K. Warren, Trish M. Perl, Maureen Bolon, Loreen A. Herwaldt, Robert A. Weinstein, Kent A. Sepkowitz, John A. Jernigan, Kakotan Sanogo, Edward S. Wong, Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection The New England Journal of Medicine. ,vol. 368, pp. 533- 542 ,(2013) , 10.1056/NEJMOA1113849
Dennis G Maki, Carol E Weise, Harold W Sarafin, None, A semiquantitative culture method for identifying intravenous-catheter-related infection. The New England Journal of Medicine. ,vol. 296, pp. 1305- 1309 ,(1977) , 10.1056/NEJM197706092962301