Quote from studenthawk24
I am working on a project to reduce catheter associated bloodstream infections. Rather than just focusing on central lines, I am also looking at arterial lines.
What precautions does your hospital take when placing art lines?
How often do you change the dressing and tubing?
What type of dressing do you use?
Any information would be helpful.
I am a nurse practitioner in the ICU and while I do place arterial catheters, I do not provide catheter maintenance and do not know the details on how often the dressings and lines are changed by the bedside nurses. However, I have worked in two different hospital systems and in one, the provider who inserts the catheter utilizes full barrier protection in terms of donning sterile gown, mask, gloves, and hats as well as using an arterial line kit that contains a sterile drape and chlorhexidine swabs regardless of cathere site insertion (i.e., femoral, radial). In the other hospital, the full barrier protection is only utilized when inserting femoral arterial catheters. Radial catheters are inserted using an Arrow Radial Artery Catheterization Set, the site is swabbed with Chlorhexidine, and the inserter wears sterile gloves and a mask with no requirement for sterile gown.
More importantly, the reason why I posted is to give you kudos for being astute in adding arterial lines in your project. Recent efforts in preventing Catheter-Related Bloodstream Infections (CRBSI's) have largely focused on central venous catheters (CVC's). However, recent studies do show that arterial catheters have similar rates of infection as CVC's. See the studies below:
1. Koh, DBC et al. Prospective study of peripheral arterial catheter infection and comparison with concurrently sited central venous catheters. Critical Care Medicine. Volume 36(2), February 2008, pp 397-402.
2. Traore, O et al. Prospective study of arterial and central venous catheter colonization and of arterial- and central venous catheter–related bacteremia in intensive care units. Critical Care Medicine. Volume 33(6), June 2005, pp 1276-1280.
There is also a study below that showed that rates of infection among arterial cathers vary depending on insertion site with those inserted in the femoral artery having the greatest risk of infection. I'm sure you and I agree as to why that is so.
1. Lorente, L et al. Arterial catheter-related infection of 2,949 catheters. Critical Care. Volume 10(3), May 2006.
In light of the above studies (and I'm sure you'll find more if you do a search), I wouldn't be surprised if future CDC guidelines pay the same attention to arterial catheters as they do CVC's.