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Central Line-Associated Bloodstream Infection

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1. Disinfection caps with isopropyl alcohol-impregnated sponges for needleless connectors to reduce central line-associated bloodstream infections

Disinfection caps with isopropyl alcohol-impregnated sponges for needleless connectors to reduce central line-associated bloodstream infections Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections HAYES, Inc. Record Status This is a bibliographic record (...) of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Disinfection caps with isopropyl alcohol–impregnated sponges for needleless connectors to reduce central lineassociated bloodstream infections. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016 Authors' conclusions Description of Technology: Isopropyl alcohol (IPA) impregnated disinfection caps have recently been introduced as an adjunct

2016 Health Technology Assessment (HTA) Database.

2. Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis

Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

3. Impact of multiple concurrent central lines on central-line-associated bloodstream infection rates. (PubMed)

Impact of multiple concurrent central lines on central-line-associated bloodstream infection rates. The current methodology for calculating central-line-associated bloodstream infection (CLABSI) rates, used for pay-for-performance measures, does not account for multiple concurrent central lines.To compare CLABSI rates using standard National Healthcare Safety Network (NHSN) denominators to rates accounting for multiple concurrent central lines.Descriptive analysis and retrospective cohort (...) analysis.We identified all adult patients with central lines at 2 academic medical centers over an 18-month period. CLABSI rates were calculated for intensive care units (ICUs) and non-ICUs using the standard NHSN methodology and denominator (a patient could only have 1 central-line day for a given patient day) and a modified denominator (number of central lines in 1 patient in 1 day count as number of line days). We also compared characteristics of patients with and without multiple concurrent central

2019 Infection control and hospital epidemiology

4. Quantitative Results of a National Intervention to Prevent Central Line-Associated Bloodstream Infection: A Pre-Post Observational Study. (PubMed)

Quantitative Results of a National Intervention to Prevent Central Line-Associated Bloodstream Infection: A Pre-Post Observational Study. Central line-associated bloodstream infection (CLABSI) remains prevalent in hospitals in the United States.To evaluate the impact of a multimodal intervention in hospitals with elevated rates of health care-associated infection.Pre-post observational evaluation of a prospective, national, clustered, nonrandomized initiative of 3 cohorts of hospitals.Acute (...) care, long-term acute care, and critical access hospitals, including intensive care units and medical/surgical wards.Target hospitals had a cumulative attributable difference above the first tertile of performance for Clostridioides difficile infection and another health care-associated infection (such as CLABSI). Some hospitals that did not meet these criteria also participated.A multimodal intervention consisting of recommendations and tools for prioritizing and implementing evidence-based

2019 Annals of Internal Medicine

5. Central lines coated with antibiotics reduce bloodstream infections in children

with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported elsewhere. Tis evidence is needed (...) are the implications? This high-quality trial showed that antibiotic coated central lines significantly reduced the risk of bloodstream infections for children in intensive care compared with standard and heparin coated central lines. Preventing healthcare-associated infections, including catheter-associated bloodstream infections, is an NHS priority so widespread use of antibiotic coated central lines in children’s intensive care units should form part of this. The researchers plan to publish a cost-effectiveness

2019 NIHR Dissemination Centre

6. Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units

Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units To investigate the procedural aspects in inserting central venous catheters that minimise central line-associated bloodstream infection rates in adult intensive care units through a structured literature review.In adult intensive care units, central line-associated bloodstream infections are a major cause of high mortality rates and increased in costs due (...) duplicates. Papers were scanned for titles and abstract to locate those relevant to the review question. After this, 250 papers were excluded for different reasons and a total of 52 papers were fully accessed to assess for eligibility. The final number of papers included was 10 articles.Many interventions can be implemented in the adult intensive care unit during the insertion of a central venous catheter to minimise central line-associated bloodstream infections rates. These include choosing

2017 EvidenceUpdates

7. Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures at a Level 3 Neonatal Intensive Care Unit<sup/>. (PubMed)

Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures at a Level 3 Neonatal Intensive Care Unit. Advances in neonatology led to survival of micro-preemies, who need central lines. Central line-associated bloodstream infection (CLABSI) causes prolonged hospitalization, morbidities, and mortality. Health care team education decreases CLABSIs. The objective was to decrease CLABSIs using evidence-based measures. The retrospective

2019 American Journal of Medical Quality

8. Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections (PubMed)

Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections The present study aimed to evaluate the effect of central line (CL) bundle compliance on central line-associated bloodstream infections (CLABSIs) in different departments of the same hospital, including the intensive care unit (ICU) and other departments.The four components of the CL bundle were hand hygiene, use of maximal sterile barrier precautions, chlorhexidine use, and selection of an appropriate (...) associated with CLABSIs.This study provides direct evidence that completing all CL bundle components perfectly is essential for preventing CLABSIs. Customized education should be provided, according to specific weaknesses of bundle performance.© Copyright: Yonsei University College of Medicine 2018.

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2018 Yonsei medical journal

9. Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children's hospital. (PubMed)

Impact of discontinuation of contact precautions on central-line associated bloodstream infections in an academic children's hospital. We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children's hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention

2019 Infection control and hospital epidemiology

10. Development of a Clinical Prediction Model for Central Line-Associated Bloodstream Infection in Children Presenting to the Emergency Department. (PubMed)

Development of a Clinical Prediction Model for Central Line-Associated Bloodstream Infection in Children Presenting to the Emergency Department. The majority of the children with a central line who present to the emergency department with fever or other signs of bacteremia do not have a central line-associated bloodstream infection (CLABSI). Our objective was to develop a clinical prediction model for CLABSI among this group of children in order to ultimately limit unnecessary hospital (...) admissions and antibiotic use.We performed a nested case-control study of children with a central line who presented to the emergency department of an urban, tertiary care children's hospital between January 2010 and March 2015 and were evaluated for CLABSI with a blood culture.The final multivariable model developed to predict CLABSI consisted of 12 factors: age younger than 5 years, black race, use of total parenteral nutrition, tunneled central venous catheter, double-lumen catheter, absence of other

2019 Pediatric Emergency Care

11. Effect of a Systemwide Approach to a Reduction in Central Line-Associated Bloodstream Infections. (PubMed)

Effect of a Systemwide Approach to a Reduction in Central Line-Associated Bloodstream Infections. Unit-based initiatives were deployed independently creating silos in practice variability across the system with little impact on reduction of central line-associated bloodstream infections (CLABSI).The goal was to decrease CLABSI systemwide by establishing standardized evidence-based practice (EBP) procedures to advance nursing practice.A new innovative method, the Ferrari Method for Practice

2019 Journal of Nursing Care Quality

12. Advances in the prevention and management of central-line-associated bloodstream infections: The role of chelator-based catheter locks. (PubMed)

Advances in the prevention and management of central-line-associated bloodstream infections: The role of chelator-based catheter locks. The proper functioning of central lines is imperative for the management of patients with cancer or on hemodialysis. However, these lifelines can become infected and can malfunction.Chelators such as citrate and EDTA have been widely studied alone or in combination with other antimicrobial agents in catheter lock solutions to prevent catheter-related (...) bloodstream infections and to maintain catheter patency. Given their anticoagulation, antiplatelet aggregation, antibiofilm, antimicrobial activity, safety profile, as well as their low cost, chelators have long been considered alternatives to heparin and a vital component of catheter lock solutions. In this review, we present a detailed summary of the properties of chelators and in vitro and in vivo studies of chelator-containing lock solutions.

2019 Infection control and hospital epidemiology

13. Chlorhexidine sensitivity in staphylococci isolated from patients with central line-associated bloodstream infection. (PubMed)

Chlorhexidine sensitivity in staphylococci isolated from patients with central line-associated bloodstream infection. Since 2011, 2% chlorhexidine in 70% isopropyl alcohol (2% chlorhexidine tincture) has been widely used in Korea. To investigate changes in chlorhexidine sensitivity of staphylococci causing central line-associated bloodstream infections, 264 blood culture isolates from adult patients treated in intensive care units of five university hospitals between 2008 and 2016 were analysed (...) . We observed no significant changes in chlorhexidine minimum inhibitory and bactericidal concentrations, or in the prevalence of resistance-associated genes before and after introduction of 2% chlorhexidine tincture. Thus, there was no evidence of increased resistance to chlorhexidine in staphylococci causing central line-associated bloodstream infections.Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

2019 Journal of Hospital Infection

14. Chlorhexidine Bathing to Prevent Central-line-associated Bloodstream Infections in Hematology Units: a Prospective Controlled Cohort Study. (PubMed)

Chlorhexidine Bathing to Prevent Central-line-associated Bloodstream Infections in Hematology Units: a Prospective Controlled Cohort Study. Patients with hematological malignancies hospitalized for myelosuppressive chemotherapy are at high risk of life-threatening healthcare-associated infections, despite the use of oral prophylactic antibiotics. Chlorhexidine (CHG) bathing decreases incidence of bloodstream infections at intensive care units, but its effect has been understudied in patients (...) with hematological malignancies at non-critical-care units.Adults with hematological malignancies hospitalized for cytotoxic chemotherapy at non-critical-care units were offered daily 2% CHG bathing. We compared outcomes of patients chose to take CHG bathing (CHG group) and that of those chose not to take (usual care group). The primary outcome was gram-positive cocci, skin-flora-related, or central-line-associated bloodstream infection. The negative-control outcome was gut-origin bacteremia. Outcomes were

2019 Clinical Infectious Diseases

15. A systematic review of central-line-associated bloodstream infection (CLABSI) diagnostic reliability and error. (PubMed)

A systematic review of central-line-associated bloodstream infection (CLABSI) diagnostic reliability and error. To establish the reliability of the application of National Health and Safety Network (NHSN) central-line-associated bloodstream infection (CLABSI) criteria within established reporting systems internationally.Diagnostic-test accuracy systematic review.We conducted a search of Medline, SCOPUS, the Cochrane Library, CINAHL (EbscoHost), and PubMed (NCBI). Cohort studies were eligible (...) for inclusion if they compared publicly reported CLABSI rates and were conducted by independent and expertly trained reviewers using NHSN/Centers for Disease Control (or equivalent) criteria. Two independent reviewers screened, extracted data, and assessed risk of bias using the QUADAS 2 tool. Sensitivity, specificity, negative and positive predictive values were analyzed.A systematic search identified 1,259 publications; 9 studies were eligible for inclusion (n = 7,160 central lines). Publicly reported

2019 Infection control and hospital epidemiology

16. Lecture-based education versus simulation in educating student nurses about central line-associated bloodstream infection-prevention guidelines. (PubMed)

Lecture-based education versus simulation in educating student nurses about central line-associated bloodstream infection-prevention guidelines. The Center for Disease Control and Prevention published central line-associated bloodstream infection-prevention guidelines to prevent complications and improve the quality of care; however, it is not known whether student nurses receive education about these guidelines or what is the best approach to this education. This study aimed to assess student (...) nurses' knowledge of central line-associated bloodstream infection-prevention guidelines and to compare the effectiveness of simulation versus classroom lecturing in educating them with these prevention guidelines. It used a two-arm randomized controlled trial design with pre-post tests. It was conducted at two public universities in Jordan, with a total of 131 fourth-year student nurses as participants. The participants were randomly assigned to the experimental group (receiving classroom lectures

2019 Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing Controlled trial quality: uncertain

17. Central lines coated with antibiotics reduce bloodstream infections in children

with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines could reduce bloodstream infections in paediatric intensive care units. The researchers say cost-effectiveness, based on six-month hospital resource data, will be reported elsewhere. Tis evidence is needed (...) are the implications? This high-quality trial showed that antibiotic coated central lines significantly reduced the risk of bloodstream infections for children in intensive care compared with standard and heparin coated central lines. Preventing healthcare-associated infections, including catheter-associated bloodstream infections, is an NHS priority so widespread use of antibiotic coated central lines in children’s intensive care units should form part of this. The researchers plan to publish a cost-effectiveness

2018 NIHR Dissemination Centre

18. Centers for medicare and medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement. (PubMed)

Centers for medicare and medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement. In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). We sought to understand why this policy did not impact central line-associated bloodstream infection (...) (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.Retrospective cohort study.Acute-care hospitals in the United States.ParticipantsFee-for-service Medicare patients discharged January 1, 2007, through December 31, 2011.Using inpatient Medicare claims data, we analyzed billing practices before and after the HAC policy was implemented, including the use and POA designation of codes for CLABSI or CAUTI. For the 3-year period following policy implementation, we determined the impact

2018 Infection control and hospital epidemiology

19. The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center. (PubMed)

The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center. The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. However, our rates

2018 Infection control and hospital epidemiology

20. Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. (PubMed)

Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. To identify, describe, and evaluate interventions to reduce unnecessary central venous catheter (CVC) use to prevent central-line-associated bloodstream infections (CLABSIs) in adults.Systematic review.The review has been registered in PROSPERO, an international prospective register of systematic reviews. We searched PubMed, EMBASE (...) , the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health (CINAHL) from inception until August 28, 2018, to collect experimental and observational studies. We included all studies that implemented interventions to reduce unnecessary CVC use, defined as interventions aimed at improving appropriateness, awareness of device presence, or prompt removal of devices.In total, 1,892 unique citations were identified. Among them, 1 study (7.1

2018 Infection control and hospital epidemiology

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