Reducing infections associated with central venous catheters

The Effect of Nursing Interventions on Catheter-related Bloodstream Infections in Patients Receiving Total Parenteral Nutrition Through Peripherally Inserted Central Catheter Lines

Background: Catheter-related blood-stream infection (CRBSI) is a serious and costly complication associated with central venous catheters. Nursing interventions that focus on decreasing bacterial colonization at the insertion site could decrease infection rates. Method: This retrospective study examined CRBSI in patients requiring peripherally inserted central catheters (PICCs) for total parenteral nutrition. One hundred and ninety-two patients with 235 catheters and an average dwell time of 11.5 days participated. Nursing interventions included a chlorhexidine-impregnated sponge dressing and a double skin scrub prior to insertion. Conclusion: The results of the study show that the interventions did not reduce CRBSI in the target population but the double skin scrub did decrease CRBSI in the general PICC population.

Hand hygiene: promoting compliance among nurses and health workers

Around 10% of hospital patients acquire a healthcare-associated infection and it has been estimated that around one-third of these could be prevented. This article discusses the causal link between hand hygiene and infection and the reasons why healthcare workers (HCW) fail to comply with hand-hygiene policies. The action of hand hygiene is discussed in terms of the removal of transient micro-organisms and the agents used. Reasons for non-compliance and some measures for achieving compliance, such as education and patient empowerment, are discussed alongside the difficulties that these present. In order to move forward, it is suggested that the problem has to be managed through cultural change, making it easier for HCWs to comply by improving hand-cleansing facilities and materials and providing feedback to personnel on local infection rates so that high-priority areas can be targeted. This may be facilitated by locally based action research.