Central Venous Catheter-Related Infections
CVC-Associated Infections Per 1,000 Catheter Line Days
Central venous catheters (CVC) — including tunneled and non-tunneled central lines, peripherally inserted central catheters (PICC) and ports — are used to administer medications, intravenous fluids or nutritional supplements, and can be used to monitor central venous pressure. They also are used to obtain blood samples that are needed to monitor sick children and reduce the number of times patients must undergo needlesticks. While CVCs offer many benefits, they also place patients at risk for blood stream infection.
Our work to reduce CVC-associated blood stream infections began in 2003 in collaboration with 10 local hospitals. This collaboration received the Joint Commission's 2005 Codman Award for effective use of performance measurement to improve the quality and safety of health care.
| |
March 2008 |
Catheter Associated – Bloodstream Infections: How often do patients acquire an infection as a result of a central venous catheter (CVC)?
(Average number of hospital-wide CVC related infections per 1,000 catheter line days)
View our performance over time. (.pdf, 22k) |
1.3 |
Over the years Cincinnati Children's has worked on reducing central line infections, we've achieved and sustained a significant shift.
We began a new initiative in September 2006, with the goal of further reducing CVC-associated blood stream infection rates across the institution to less than or equal to 1.0 per 1,000 central line days.
The improvement team is focused on hospital-wide implementation of both a catheter insertion and a catheter maintenance bundle. This is the first time we have focused not only on insertion but also on the care and maintenance of catheters.
Insertion Procedures
The standardized procedure for maintaining a sterile environment when inserting a central line now includes:
- Hand washing before the procedure
- Cleaning the insertion site with a chlorhexidine solution
- Using maximum sterile barriers, including a sterile drape to cover the patient and bed, and a mask, sterile gown and gloves for the physician
An insertion checklist helps assure that no step is omitted, and staff are empowered to stop the procedure if sterility is not maintained.
Maintenance Procedures
Care and maintenance of the CVC may be the most important part of preventing central line infection in children. Our new bundle of standardized practices when accessing the central line and during CVC dressing changes includes:
- Chlorhexidine scrub each time the catheter is entered
- Standardized dressing change kits and catheter hub change kits
These kits include, in one package, all the equipment needed to complete dressing change or hub change procedures. As a result, the nurse can complete the task more efficiently and is less likely to forget or omit important steps that might impact the sterility of the procedure.
We also have launched a hand hygiene campaign highlighting this very basic yet essential procedure. Patients, parents, family members and personnel are encouraged to monitor hand hygiene practices and remind physicians and nurses who seem to have forgotten to wash their hands.
Back to Top
We Want Your Feedback
We would like to know what you think of the information presented here. Please send us an email to let us know if you found this web page helpful and easy to understand, or if you there's any additional information you need but couldn't find (childrens-quality@cchmc.org).
Back to Top
Last updated May 2008.
