Central Line-Associated Blood Stream Infections (CLABSI)

The use of intravenous (IV) catheters is common in both inpatient and outpatient care. In the United States, it is estimated that almost 300 million catheters are used each year; nearly 3 million of these are central venous catheters (CVCs), also known as central lines. The use of CVCs is an integral part of modern health care throughout the world, allowing for the administration of intravenous fluids, blood products, medications, and intravenous nutrition, as well as providing access for hemodialysis and hemodynamic monitoring. However, the use of CVCs is associated with the risk of bloodstream infection caused by microorganisms that can colonize the external surface of the device or fluids that are administered through the line. These serious infections, termed central line–associated bloodstream infections, or CLABSIs, are associated with increased illness and health care costs, and even death. It is now recognized that CLABSIs are serious but largely preventable when evidence-based guidelines are followed for the insertion and maintenance of CVCs.

It has been estimated that 80,000 CLABSIs occur in ICUs in the United States each year; however, if patients outside ICUs are also included, the estimate increases to 250,000 cases of CLABSI each year.

Naval Medical Center Portsmouth views CLABSIs as preventable. Physicians, nurses, and Pharmacists collaborate to identify patients at risk. We have implemented evidence-based guidelines during insertion and maintenance of central lines to minimize the risk of infection.

Our evidence-based practices include:

• Use of a subclavian vein site unless medically contraindicated.
• Standard skin prep and barrier protection (dressings)
• Use of standard central line insertion kit
• Emphasis on the importance of compliance with Hand Hygiene practices
• Daily review of the continued necessity for the central line Hand hygiene compliance monitored.

For those patients who arrive with infections we use a team approach to aggressively treat them.