Blood Stream Infections (BSI) in your unit - page 2

by traumasurgRN 7,629 Views | 16 Comments

We have recently had a spike in the number of BSI's in our Trauma unit. We have implemented several changes to reduce the bsi's but we have not seen much of a change. Currently, we bathe all patients with a central line in... Read More


  1. 0
    Quote from Sun0408
    My current trauma unit hasn't had a BSI in more than a year. We wash all pts with soap and water daily. The dressing to all central lines are changed 24 hours post insertion and a bio batch is applied at the insertion site. Dressing are then changed PRN or q7 days. Caps are changed after all blood draws, q7days and we us clori-prep to access all ports. The caps on our lines are clear so you can "see" the inside. I am sorry, I do not know the name of them to provide a link for you. We also piggy back most of our fluids in so we don't have the access the ports as often. Any one of us can change the dressing, so we don't do anything usual there but follow sterile technique.

    In addition to the things we normally do, all TLC's are changed to PICC's after 7 days. Any groin line is removed after 24 hours or sooner..

    I am in the process of leaving my current unit to go to another trauma unit who is also having an increase in BSI, I have a sample of our bio patch and caps as well as our infection control data to show them. Im not sure if your unit has a lot of new nurses; that could be contributing to the increase. Might be something to look into.
    My unit pretty much utilizes all of these practices and each year we have zero BSIs. We don't use chloriprep to access ports, though, just an alcohol swab.
  2. 0
    "Scrub the hub" for 15 seconds with alcohol, change IV tubing and caps q4days unless it's propofol (q12 hours), change central line dressings q7days unless there is a gauze over the insertion site then the gauze must be removed within 24 hours.

    How is your units hand washing compliance?

    How do you draw cultures? Assuming you know they aren't coming back just contaminated.
  3. 0
    Quote from Bec7074
    "Scrub the hub" for 15 seconds with alcohol, change IV tubing and caps q4days unless it's propofol (q12 hours), change central line dressings q7days unless there is a gauze over the insertion site then the gauze must be removed within 24 hours.

    How is your units hand washing compliance?

    How do you draw cultures? Assuming you know they aren't coming back just contaminated.
    Our cultures are drawn sterile, chlorohexidine, sterile towels sterile gloves, sterile field. That was decided after too much contamination. So far it has been working great.
  4. 0
    My SICU has had 2 CLABSIs in the past 12 months and both have been traced back to insertion.

    We implement Curos caps and Bio-patch dressings. We use sterile technique when changing the dressings.

    Also one thing to watch out for is the "hubbing out" of the lines, be sure to the remind the physician to leave you enough exposed catheter to place the bio-patch.

    I wish I could say we change all lines q7days and all femoral lines after the initial 24h but we do not and we still have an almost 0% infection rate.
  5. 0
    Does anyone know what the bio-patches are inoculated with?
  6. 1
    Quote from Nolander
    Does anyone know what the bio-patches are inoculated with?
    I believe it's chlorhexadine.
    Esme12 likes this.
  7. 0
    We do pretty much everything people have already said (sterile drsg change w/chlorhexadine scrub, biopatch, etc). We also just got swab caps, which are impregnanted with alcohol. They screw onto unused claves so scrubbing with an alcohol swab doesn't need to be done. They have to be changed every time they are taken off.
    I wish we had a policy to d/c fem lines! They are so gross- once I had a pt have a large bm and the open claves were in the poop! Gross!


Top