Healthcare institutes today are facing a major problem with centrally-line- associated bloodstream infections (CLABSIs). CLABSIs occur commonly and are the most potentially preventable source if morbidity. This research was conducted to see how central line bundles could be use to eliminate CLABSIs. According to the Sutter Roseville medical center (SRMC), they have seven years of zero CLABSIs, by using a broader approach of the central line buddle rather then the conventional buddle required by the CDC (Harnage, 2012).
The SRMC’s, central line buddle is ease to use and failure proof as shown in figure 1 of the article (Harnage). This article explained how various component of the central line buddle were modified to achieve zero infection of CLABSIs by the SRMC. The most important point of this approach was elimination of infection through central lines. The success of this approach was base on the protocol implemented on dressing change, catheter flushing and daily checking of all central lines. Dressing changes were done only when the site was messes but with the protocol is done every 7 days and as needed, also the catheter lines were been flushed with normal saline then with heparin using a positive pressure flush, but now flushing is done every 8 hours when not in use or before and after medication administration with 10ml of normal saline using a push and pause technique. Remember these lines can not be use if there is no blood return and the potency checked.
For this protocol to be effective, education and training was mandated for the register nurses, that is a one -on -one bedside training. The register nurses are the once using this line on a daily bases so training them on the use of this line were a major past in the infection control process. An aspect in the dressing change kit in was also nurse friendly in that all the supplies needed for the dressing change were place in a single package. By putting everything together it helped the nurse to easily access everything they need, because due to the many tasks the nurse needs to do, they may be tempted to bypass or skip entirely preventive practices that are too time consuming.
The nurses also had to document on a daily base on the patient flow sheet how the site and dressing on the line look, thus making the nurses take responsibility and accountabit of the site. The main problem with this approach was that it wasn’t cost effective. But according on research, CLABSIs cost from $21300 and $35000 to treat, thus avoiding infections can save most healthcare institute hundreds of thousands of pounds annually (Harnage).
I will like everyone who reads this article to implement it because is a patient first culture approach and we as healthcare provide are there to provide care to patient and do no harm. With that say, my clinical group for NURS 210 at Grace Fairview have since this practice and protocol and have also participated in it implementation. So from experience I will follow the approach and encourage my register nurses colleague to do same because the benefits out weight the disadvantages.
Harnage, S. (2012) Seven years of zero central – line – associate bloodstream infections.
British Journal of Nursing, 2012 (IVTHERAPY SUPPLEMENT),Vol 21, No 21