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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
[Management of intravascular catheters for prevention of perioperative cross infections]
Takashi Okubo1, Eiko Ohara, Akishige Nakamura
1Department of Surgery, NTT West Co. Tokai Hospital, Nagoya, Japan.
Insights
Preventing intravascular catheter infections requires hospital-wide systems, focusing on aseptic techniques during line connections and managing specific components like stopcocks. Exploring alternatives to central venous catheters for nutrition is crucial.
Area of Science:
- Healthcare-associated Infections
- Infection Control
- Medical Device Safety
Context:
- Bloodstream infections from intravascular catheters are a significant nosocomial infection.
- Current prevention strategies often focus on individual infections rather than comprehensive hospital systems.
- Catheter site contamination during infusion and connection is a primary cause.
Purpose:
- To highlight the importance of systemic prevention of catheter-related bloodstream infections (CRBSIs).
- To identify key areas of vulnerability in current catheter management practices.
- To advocate for improved aseptic techniques and alternative nutritional support methods.
Summary:
- Nosocomial bloodstream infections linked to intravascular catheters necessitate robust, hospital-wide prevention systems.
- Key contamination risks include aseptic technique lapses during transfusion line connections, particularly with three-way stopcocks and hub management.
- Optimizing transfusion line exchange frequency, fat emulsion injection, and blood preparation are critical.
- Exploring nutritional management strategies that avoid central venous catheter insertion is paramount.
Impact:
- Implementing comprehensive prevention strategies can reduce the incidence of CRBSIs.
- Improved management of catheter components and procedures can enhance patient safety.
- Reducing reliance on central venous catheters may lower infection risks and healthcare costs.
Abstract:
Bloodstream infection derived from an intravascular catheter occupies an important position among the various types of nosocomial infection. It is therefore necessary to establish a system for preventing catheter infection not only as measures for each separate infection, but also for the entire hospital. Catheter infections are mainly caused by contamination of the connecting part of a transfusion line during the infusion of drug solution as well as by contamination of the part of the catheter inserted. Consequently, the greatest possible care should be taken in the preparation of aseptic transfusion and the prevention of contamination when connecting a transfusion line. In particular, there are problems with three-way stopcocks, management of hubs, frequency of transfusion line exchange, fat emulsion injection method, and blood preparation. It is most important to consider effective nutritional management methods that do not require the insertion of a central venous catheter.
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