Effects of Peripherally Inserted Central Catheter Team on Catheter Related Blood Stream Infections

Purpose:
After having identified a significant incidence of catheter related blood stream infections (CRBSI), the goal of the study was to identify causes and methodologies that can be utilized in the acute care setting to reduce the number of CRSBI.

Background/Significance:
The Hospital had been having opportunities for improvement in the area of CRSBI. There had been a great deal of education provided for the Nurses providing care for those patients but the problem persisted at an approximate rate of 14 infections during the year up to July of 2009 with little or no improvement in outcomes. In view of the fact that this could extend patient stay and compromise patient ability to recover from their disease process it was considered prudent to explore alternatives.

Methods:
Data was collected in the following areas: Total number of CRBSI Total number of central venous catheter insertions Historical data was collected to assess insertion techniques, infection control processes utilized during insertion and follow up care after insertion. Nursing activities associated with catheter care and management was collected and analyzed. There were opportunities for improvement in care post insertion and an educational program was developed and presented for all nurses. There was no significant difference in CRSBI after the education that include sterile procedure and dressing change practice was presented. Data was collected via the patient care module in Meditech.

Results:
A team of 5 nurses completed an on-line study program on PICC line insertion and they continued their training with an RN trainer from a PICC line training specialty company. The training period lasted for 1 week, at the end of which two of the nurses from the PICC team successfully completed the training with the number of required successful insertions to attain certification. Since the inception of the PICC team, CRBSI have diminished to 0. To date, the PICC team has had over 400 successful PICC line insertions. Radiology continues to serve as a resource for difficult insertions, specifically those situations involving difficulty advancing the catheter to the appropriate location.

Conclusions and Implications for Practice:
There has been: A reduction of hospital length of stay as patients can continue IV therapy outside of the acute care setting Provision of a reliable infusion device with minimal complications. Diminished number of venipunctures for lab draws, etc. Increased level of patient satisfaction