Central line surveillance across all hospital settings

central catheter

“Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings” Martínez-Morel et al (2014).

Trends over time of State-mandated CLABSI reporting

clabsi

“Most states with HAI laws required reporting of central line-associated bloodstream infections in adult intensive care units (92%), and about half required reporting of methicillin-resistant Staphylococcus aureus and Clostridium difficile infections (54% and 51%, respectively)” Herzig et al (2014).

Survey of neonatal peripherally inserted central catheter practices

neonatal picc

“The goal of this secondary analysis of results from a national survey of peripherally inserted central catheters (PICCs) practices in neonates was to determine whether demographics and types of training were associated with differing radiographic confirmation practices of these catheters” Sharpe (2014).

Citrate locking to reduce long-term central line complications

ava 2015

“This study shows that locking with TSC in patients with hematological malignancies significantly reduced the incidence of CVC-BSI with gram-negative rods. However, the incidence of CVC-BSI with coagulase-negative staphylococcus or CVC-related thrombosis was not reduced by TSC locking” Boersma et al (2014).

On-demand temperature-sensitive polymer for central venous catheters

clabsi

“Here we compare the ad libitum release of chlorhexidine and silver-sulfadiazine from a central venous catheter with their release from a new, on-demand release coating consisting of a temperature-sensitive copolymer of styrene and n-butyl (meth)acrylate” Sjollema et al (2014).

Confusion associated with persistent left-sided superior vena cava

picc tip

“A persistent left-sided superior vena cava (PLSVC) is a rare, often asymptomatic, venous anomaly that may be first diagnosed during central venous catheterization. During chest radiograph interpretation, a PLSVC can be confused with inadvertent arterial catheterization” Mackey and Dargin (2014).

Method to overcome difficult peripheral venous access

opat

“A preliminary observational study was undertaken to evaluate the risk of failure of ultrasound-guided peripheral intravenous catheterization of a deep arm vein for a maximum of 7 days, after peripheral intravenous (PIV) cannulation failure” Meyer et al (2014).

Alternative views for imaging the subclavian vein with ultrasound

ultrasound cvc insertion

“Ultrasound guidance for central line placement in the subclavian vein (SCV) is more efficient and safer than landmark-based technique. The supraclavicular (SC) approach is an alternative to the infraclavicular (IC) approach, but the research is sparse. The objective was to determine which approach provides the best view” Stachura et al (2014).

43% reduction in CLABSI cases per 1000 central line-days

hand hygiene

“The three initial areas of focus were (1) health care-associated infections-ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI); (2) sepsis mortality; and (3) perinatal care-reduction of elective deliveries prior to 39 weeks of gestation” Wang et al (2014).

Shielding parenteral nutrition solutions from light

parenteral nutrition

“This study did not show significant beneficial effects of photoprotection. Since the decreased rate of BPD/death found with all-in-one PN relates to a center-dependent variable, this warrants further investigation” Laborie et al (2014).

Central line care standards in blood and marrow transplant

PICC

“Survey results indicate nationwide differences in catheter site selection, educational strategies, dressing strategies, delegation of dressing changes, and volumes of flushing and locking solutions used to manage catheter patency. Variability in practice coincides with gaps in the evidence identified in practice recommendations” Keeler (2014).

Report illustrates extravasation injury from a midline catheter

needlestick

“Midlines are mainly used for patients not receiving vesicant drugs, and are generally inserted without radiological guidance. They are believed to be safe, but we present the first ever-documented oxaliplatin extravasation injury from a midline catheter” masters et al (2014).

Associations with fever and Central Line-Associated Bloodstream Infections

clabsi rca

“We hypothesized that plasma immunoglobulins against flagellin (FLiC) and lipopolysaccharide (LPS) would be able to differentiate CLABSIs from nonbacterial febrile episodes and that levels would increase with infection and decline following appropriate antibiotic treatment” Galloway et al (2014).

Effective strategy for reducing CLABSI rates outside the ICU

intravenous infusion

“A multipronged approach blending both the adaptive and technical aspects of care including front line engagement, education, execution of best practices, and evaluation of both process and outcome measures may provide an effective strategy for reducing CLABSI rates outside the ICU” Dumyati et al (2014).