from the editor
Getting Back to Basics for Vascular Access-Related Infection Prevention
In this special edition , we bring you the perspectives of experts in vascular access , infection prevention and risk management , to explore some of the most pertinent issues related to patient safety .
As DeVries ( 2019 ) reminds us , “ The goal of vascular access devices is to provide for the administration of the therapies required to help the patient recover while causing the least amount of damage to the patient ’ s vascular system … A monumental amount of attention has been devoted to preventing infections during the insertion phase of a vascular catheter ’ s life cycle . The very act of breaking the skin barrier and inserting a medical device directly through the vein wall and into the blood stream deserves special attention , as the patient ’ s natural infection prevention barriers have been disrupted .”
Millions of vascular access devices are inserted , maintained and removed daily in U . S . hospitals , making it one of the most ubiquitous medical procedures , yet as DeVries points out , it is one of the most critical ways that a patient may acquire an infection in the healthcare environment , and the processes and techniques involved demand extra care .
As a reminder of the essentials , we borrow from DeVries ( 2019 ) and provide the following evidence-based best practices checklist :
1 . The prevention of catheter-related BSIs is paramount to the preservation of vessel health .
2 . Adhering to the components of the central line bundle during a central line insertion procedure has proven to be an effective way to prevent catheter-related BSIs .
3 . The five components of the central line bundle include : ( a ) Hand hygiene ( b ) Maximal barrier precautions during insertion ( c ) Use of chlorhexidine as a skin antisepsis ( d ) Optimal catheter site selection with avoidance of the femoral vein for central venous access in adult patients ( e ) Daily review of catheter necessity with prompt removal of unnecessary catheters
4 . As an infection prevention strategy , catheters should be removed as soon as they are deemed no longer medically necessary .
5 . It is recommended that an observer be present during any central venous catheter ( CVC ) insertion procedure to ensure ANTT is maintained throughout the procedure .
6 . The use of a checklist to prevent central line-associated bloodstream infection is one of the top 10 strongly encouraged patient safety practices .
Until next time , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
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Reference :
DeVries M . ( 2019 ) Insertion Related Infection Prevention with Vascular Access Devices . In : Moureau N . ( ed ) Vessel Health and Preservation : The Right Approach for Vascular Access . Springer , Cham . https :// doi . org / 10.1007 / 978-3-030-03149-7 _ 10