Website spotlight: Focusing on central line-associated bloodstream infections

Staff Development Weekly: Insight on Evidence-Based Practice in Education, June 17, 2011

A look at how new guidelines affect infection control in hospitals

In April, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee released a new set of guidelines to eliminate central line-associated bloodstream infections (CLABSI). The guidelines, titled Guidelines for the Prevention of Intravascular Catheter-Related Infections, replace the 2002 edition and are available on the CDC website.

Naomi O'Grady, MD, a senior staff physician at CCMD at the National Institutes of Health in Bethesda, MD, is the lead author of the new guidelines. "There's been a lot of new data coming out since 2002, either reinforcing recommendations that were made previously, leading to higher levels of evidence, or new data coming out that allows us to change certain recommendations," says O'Grady. "For example, this guideline recommends anything greater than 0.5% chlorhexidine rather than what we said previously, which was a minimum of 2%."

The guidelines reflect the idea that hospitals need to move past insertion techniques and an ICU focus.

"We know that catheter care and maintenance has a big impact on infections if they're not maintained correctly outside of the ICU setting," O'Grady says. "Although we have made a big impact in the ICU setting, I think there is still a lot of work to be done in the general medical wards and in the outpatient setting where patients often have permanent catheters for things like cancer chemotherapy and other long-term needs for IV access."

A significant change in the guidelines is the focus on catheter maintenance, says O'Grady.

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