CLABSI Prevention in the ICU-a New Approach

Abstract The Center for Disease Control and Prevention (CDC) emphasizes that the primary cause of preventable deaths and disabilities among hospitalized patients in the United States are hospital-acquired infections (HAIs). Based on the CDC surgical site infection monitoring, common infections include central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia, and catheter-associated urinary tract infections. This paper primarily focuses on the problem of CLABSI, with an aim to reduce the net occurrences of CLABSIs in the intensive care unit (ICU) through the interventional use of SecurePortIV skin adhesive during the insertion of central lines. Although few researchers have examined the implication of policy change and other care alternatives, the focus on the effects of increasing utilization of the SecurePortIV skin adhesive has rarely been subjected into practice. As such, this study is anticipated to gain momentum across ICUs. Baseline questionnaire audit data for the intensivists (N = 7) revealed that 90% of the time the SecurePortIV skin adhesive was not being used. The same survey sent to the peripherally-inserted central catheter (PICC) team (N = 4) revealed 10% of the time the SecurePortIV skin adhesive was not being used. Six-month post-implementation questionnaires were sent to the intensivists and the PICC team. Results revealed that 90% of the intensivists (N = 7) adopted utilization of the SecurePortIV skin adhesive at all central venous catheter (CVC) insertions and 100% of the PICC team (N = 4) adopted utilization of the SecurePortIV skin adhesive with all central line insertions and dressing changes. Health systems need to optimize practices of utilizing CVCs as a means of reducing the incidences of CLABSI. The research considered adhesive as a reliable barrier alternative that could help prevent the catheter colonization and possible sepsis potentiation resulting in bloodstream infections. Baseline dressing changes for central line audit data for the PICC team revealed (N = 39) to completion of pilot project (N = 19) significant decrease number in central line dressing changes. Reducing the risks associated with the use of CVCs is a significant step towards preventing HAIs. Considering that since 2008, Medicare and Medicaid Services resolved not to reimburse hospital costs associated with CLABSI treatment, there is an increased need to change hospital focus towards evidence-based strategies that could eradicate CLABSI. During the time of the study, there were no CLABSIs. It is recommended that monthly questionnaire audits are completed in order to monitor compliance of SecurePortIV skin adhesive. It is also recommended that CLABSI champions and leaders continue education to all new nursing staff in order to achieve 100% compliance rate