In an attempt to reduce our CLABSI rate, my facility has prohibited us from drawing blood for routine blood work from central lines. We are only allowed to do so with an MD order, and the nursing supervisor on duty is supposed to be the one to do it.
Well, I looked around for research supporting this practice (ie: that reducing the number of blood draws from CVCs will reduce CLABSI rate) but I couldn't really find any literature on the matter. The only thing I found was this "project" published in the American Journal of Infection Control:
If you're unable to access the paper, you're not missing much ... here are the last two paragraphs:
Results: CLABSIs rates decreased housewide and central line utilization ratio is trending downward. Caregiverawareness increased along with better outcomes of preserving vital central lines.Lessons Learned: There are rare cases where a patient will be a candidate for a blood draw through a central linedue to physical factors (e.g., no access, emergency, etc.). In addition we identified opportunities to cluster labdraws and reduce unnecessary and/or redundant labs. Since we are also concurrently working on other preventionissues such as education, additional interventions also affected our decreased CLABSI rates. Overall the team feltthat no blood draw from a central line without a physician's order was a huge accomplishment and is possible forthe majority of patients.
In other words, there were too many confounding factors to tell us what role--if any--this particular policy played in the reduction of their CLABSI rate. Terrific.
All of the other research I found about CLABSIs and blood draws dealt with the contamination of blood cultures drawn from CVCs. Certainly an important issue, but not what I was looking for.
Now I can see how drawing blood from a line may increase the risk of infection but I find it a bit curious that seemingly no research exists on the matter. Does anyone else know of any research on this subject? Is anybody else working at a facility that prohibits routine blood work from being drawn from CVCs? I'd love to hear about it.
Just like with many other nursing stories and lore, such as "never do anything at all on the side of mastectomy, however long time passed since surgery because it might be UNSAFE" and "never do BP on the extremity with PICC line because it might be UNSAFE", this one has no credible evidence behind it. CLABSI are proven to be reduced by proper management of the line (aka aseptic dressing changes, ports cleaning, avoiding femoral lines, timely discontinuation/change, etc). Blood draws by themselves, when done correctly, are not confirmed to increase risk.
The OP's administration simply doesn't know which rope to pull and where to run, which is its' normal modus operandi.
Last edit by KatieMI on Jan 9