to a dSIR of 0.58 , which outperformed the national CDC NHSN CLABSI dSIR of 0.69 for 2019 . The pandemic likely affected both the care of the line for COVID-19 and non – COVID-19 hospitalized patients . Qualitative feedback from infection prevention teams reported changes to routine CLABSI prevention practices in ICUs , such as less universal decolonization , alterations in line care due to intravenous pumps placed in hallways , line and dressing integrity gaps related to prone positioning of patients , opportunities in scrub-the-hub compliance , and increases in line draws for blood cultures .”
Another variable potentially impacting CLABSI outcomes , the researchers add , includes staffing changes responding to increased patient volume on the units , such as the help of traveling clinicians not as familiar with standard unit prevention practices . Lastly , during the pre-COVID-19 period , “ line rounds ” were a routine practice , ensuring that proper device selection , utilization , and bedside practices were being followed . The teams reported that many of those rounds stopped during the COVID-19 pandemic period due to competing priorities . They explain , “ Prior to the COVID-19 pandemic , we had implemented system-wide initiatives to reduce CLABSI risk , from standardizing policies of insertion and maintenance , to optimizing placement and maintenance kits and hardwiring competencies . The gaps and events may be even more pronounced in other acute-care facilities .”
Experts like Cawcutt recognize the impact of the COVID-19 pandemic on HAI prevention practices .
“ There ’ s definitely a breaking point from the COVID
pandemic ,” she says . “ Before the pandemic we knew what to do , it is actually ensuring that we can maintain the correct protocol ; however , with new staff , new faculty , new trainees , new healthcare providers , new IPs , they may not understand all the critical components of central line decision-making , including whether to insert one , how to insert one , and then making sure we ’ re taking it out as soon as possible . COVID has completely shifted that workflow ; between workforce shortages , workforce turnover and supply chain issues , hospitals were overwhelmed .”
Cawcutt continues , “ Any aspect of the changed workflows and shortages from COVID would cause protocols to fall apart , and I think every organization must step back and analyze their rates and assess what is still being done well and what still needs improvement and how do we address that . Hospitals need to ask themselves , what are the processes where we saw some deterioration ? For example , if staff couldn ’ t get their hands on securement devices , you could have an entire cohort of fellows , residents and trainees who have come and gone , and they were never taught to place them . There ’ s no easy answer anymore because every organization experienced the pandemic with different pieces of this and some groups were able to maintain some protocols better than others based on the way their workflow was pre-pandemic or based on the supply chains or how overwhelmed their systems became . So , I think everyone must essentially start over and re-assess where they are , what they are doing well . So often we forget the first point of prevention is when someone decides the central line is needed .
less IV restart , one less inconvenienced patient
IV Safety Release Valve
Fewer Needlesticks • Longer Dwell Time • Less Time on IV Restarts • Retain the Continuity of Care • Reduced Risk of Central Line Placement • No Specialty Training
E-mail : nursing @ linearsciences . com
Moureau , N ., PICC Excellence , Greenville MUMC , AVATAR . ( 2018 ). Accidental Intravenous Catheter Dislodgement : Incidence and Perception of Safety at the Bedside . ( 2018 )