Catheter-related infections and their prevention
WHY THIS ARTICLE
This is not really an article but a sort of guide, published with the aim of improving care practices, especially in relation to what is necessary to prevent hospital-acquired infections and, among these, catheter-associated infections, the so-called CLABSI. It does so by illustrating strategies, techniques and tactics for their prevention, emphasizing with great authority the need to revert to an approach based on the concept of ‘bundle’ and the need, in order to promote its adoption, to use procedural kits because they are a useful tool to reduce the risk of CLABSI. They work by reducing dissimilarities in implantation and management techniques used by healthcare providers. Just a few words about the Joint Commission: The Joint Commission is one of the largest and most prestigious accrediting bodies in the world. The Joint Commission is one of the largest and most prestigious accreditation bodies in the world. It carries out a voluntary accreditation process through which a third party certifies and guarantees that a healthcare organization meets specific standards. It was born in the USA in 1951 with the aim of improving the quality of health care in American hospitals. This is a voluntary accreditation process through which a third party, independent and non-governmental body certifies and guarantees that a healthcare organization complies with specific standards (divided into two large blocks, those centered on the patient and those on the organization) that tend towards continuous improvement in structures, processes and results: there are accreditation programs for practically all the structures that operate in the world of healthcare (outpatient clinics, hospitals, laboratories, rehabilitation centers, nursing homes, etc.) so much so that recently the Policlinico Gemelli underwent this accreditation.
The use of central venous catheters (CVCs) is an integral part of modern health care throughout the world, allowing for the administration of intravenous fluids, blood products, medications, and parenteral nutrition, as well as providing access for hemodialysis and hemodynamic monitoring. However, their use is associated with the risk of bloodstream infection caused by microorganisms that colonize the external surface of the device or the fluid pathway when the device is inserted or manipulated after insertion. These serious infections, termed central line–associated bloodstream infections, or CLABSIs, are associated with increased morbidity, mortality, and health care costs. It is now recognized that CLABSIs are largely preventable when evidence- based guidelines are followed for the insertion and maintenance of CVCs.
This monograph includes information about the following:
• The types of central venous catheters and risk factors for and pathogenesis of CLABSIs
• The evidence-based guidelines, position papers, patient safety initiatives, and published literature on CLABSI and its prevention
• CLABSI prevention strategies, techniques and technologies, and barriers to best practices
• CLABSI surveillance, benchmarking, and public reporting
• The economic aspects of CLABSIs and their prevention, including the current approaches to developing a business case for infection prevention resources