Blood Stream Infections (BSI) in your unitRegister Today!
- by traumasurgRN May 28, '12We 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 Hibiclens with disposable wipes, we have a trained team to perform dressing changes on the lines, and we have of course been following standards like scrubbing the hub for 15 seconds. What are some methods that some of y'all have been using to prevent bsi's?
- May 28, '12 by Esme12Welcome to AN and the new trauma forums!!! AN is the largest online nursing community.
I have seen some recent studies heavily linked to the hubs on certain tubing system with residual blood in the hub of the line being heavily to BSI.
What type of tubing do you use? It was heavily linked to the "clave" type systems.
http://www.zerobsi.com/bsi/pdf/11_09...usion_elec.pdfLast edit by Esme12 on May 28, '12
- May 28, '12 by Sun0408My 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.
- May 28, '12 by traumasurgRNOur unit does have several new nurses, including myself. Our director and educational department have been trying several different methods, but the BSI's are still popping up. I am not sure if we use a Bio patch on our lines or not. I like the idea of using Chlori-prep to access the port. Do you use Chlori-prep wipes or the chlori-prep scrubbers?
- May 29, '12 by Sun0408We use the wipes before accessing the ports and the sticks to clean to site at each dressing change. The bio patch is a round disk that goes over the cath at the insertion site.
- Jul 31, '12 by ada0679The docs need to change the lines every 7 days
- Oct 14, '12 by breeziRNQuote from traumasurgRNHow do you not know if your unit uses the Bio patch...Our unit does have several new nurses, including myself. Our director and educational department have been trying several different methods, but the BSI's are still popping up. I am not sure if we use a Bio patch on our lines or not. I like the idea of using Chlori-prep to access the port. Do you use Chlori-prep wipes or the chlori-prep scrubbers?
- Oct 20, '12 by NicuGalMost line infections are caused by people improperly accessing the line or less than sterile technique putting them in. Our SICU changes all dressings that are done on the ER and places bio discs as soon as they can.
- Nov 5, '12 by CVCURNWe use Curos caps on all our central lines in combo with the clear caps and ever since making the change hospital-wide we haven't had a single CLAB in over a year. Those Curos caps are life-changers, but they are approximately $0.25 a piece ($60 a box) and they are one-time use. We also do the general strict sterile technique with dressing changes Q 7 days and the tegaderms we use on our dressing changes have a chlorahexidine-impregnated gel in the center that is placed directly over the catheter insertion site.