Prevention of Healthcare Associated Infections (Xenex Sponsored)

Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals

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Central Line-Associated Bloodstream Infections Key Points Î The risk of central line-associated bloodstream infection (CLABSI) in intensive care unit (ICU) patients is high. Î However, the majority of CLABSIs occur in patients in hospital units outside the ICU or in outpatients. Î Infection prevention and control efforts should include other vulnerable populations, such as patients receiving hemodialysis through catheters, intraoperative patients, and oncology patients. Î Besides central venous catheters (CVCs), peripheral arterial catheters also carry a risk of infection. Î Factors associated with increased risk: • Prolonged hospitalization before catheterization • Prolonged duration of catheterization • Heavy microbial colonization at the insertion site • Heavy microbial colonization of the catheter hub • Internal jugular catheterization • Femoral catheterization in adults • Neutropenia • Prematurity (ie, early gestational age) • Reduced nurse-to-patient ratio in the ICU • Total parenteral nutrition • Substandard catheter care (eg, excessive manipulation of the catheter) • Transfusion of blood products (in children) Î Factors associated with reduced risk: • Female sex • Antibiotic administration • Minocycline-rifampin-impregnated catheters Basic Practices for Preventing and Monitoring CLABSI: Recommended for All Acute Care Hospitals Before insertion: Î Provide easy access to an evidence-based list of indications for CVC use to minimize unnecessary CVC placement (III). Î Require education of HCPs involved in insertion, care, and maintenance of CVCs about CLABSI prevention (II). Î Bathe ICU patients over 2 months of age with a chlorhexidine preparation on a daily basis (I). 18

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