Nursing Research and Evidence-Based Practice, Children's Health, Children's Medical Center, Dallas, TX.
Critical Care Services, Children's Health, Children's Medical Center, Dallas, TX.
Br J Nurs. 2021 Oct 28;30(19):S24-S29. doi: 10.12968/bjon.2021.30.19.S24.
Healthcare organizations have prioritized patient safety and quality improvement efforts to reduce central line-associated bloodstream infections (CLABSIs). Implementation of central venous catheter (CVC) insertion and maintenance bundles have significantly reduced infection rates. Nevertheless, CLABSIs continue to be a significant cause of mortality and morbidity in hospitals, and further efforts are necessary to improve CVC care practices. A hospital-wide committee at a tertiary care pediatric hospital identified gaps in our CVC maintenance practices resulting from CVC contamination events from a patient's body fluids. A lack of published literature on the topic resulted in the need to create an institutional clinical practice guideline (CPG) to develop guidance to mitigate potential CLASBIs from CVC contamination. Utilization of the CVC CPG in all inpatient units and other reduction strategies resulted in a steady decline in our CLABSI rates, particularly in those related to CVC contamination events. Case reports illustrate the effectiveness of the CPG.
医疗机构已将患者安全和质量改进工作列为优先事项，以降低中心静脉导管相关血流感染（CLABSI）的发生率。实施中心静脉导管（CVC）插入和维护套件已显著降低了感染率。然而，CLABSI 仍然是医院中导致死亡率和发病率的重要原因，需要进一步努力改善 CVC 护理实践。一家三级儿科医院的全院委员会发现，由于患者体液导致的 CVC 污染事件，我们的 CVC 维护实践存在差距。由于缺乏关于该主题的已发表文献，因此需要创建机构临床实践指南（CPG）来制定指导意见，以减轻潜在的 CLASBIs 从 CVC 污染。在所有住院病房和其他降低策略中使用 CVC CPG 导致我们的 CLABSI 率稳步下降，特别是与 CVC 污染事件相关的 CLABSI 率。病例报告说明了 CPG 的有效性。
