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preventing CABSI

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We are doing a quality improvement program in our NICU to decrease our Catheter Associated Blood Stream Infection rate. I would love any information from other units about how you do line changes and how often, closed medication systems, sterile versus clean, etc. Please respond directly by email if possible; it is sometimes hard to follow these threads for this old nurse! ldenton@unch.unc.edu

Also does everyone filter their intralipids? And what type of filter is used? We have separated our HAL from the IL and find that the filters on the lipids are clogging up.

Thanks for any help you can offer.

NJNICUCCRN

Specializes in NICU. Has 23 years experience.

we do NOT filter lipids for the reason that they DO clog the filters. we change lines every 3rd day with clean technique but are switching to sterile changes. We do filter our meds.

NeoNurseTX, RN

Specializes in NICU Level III.

sterile line changes q24 hrs for everything but PIVs. IL and HAL are separated, IL are filtered through I THINK a 1.2 micrometer filter. looks like these but we have some tubing length on ours http://www.obex.co.nz/Shared/Products/Images/HiRes/Lipipor%20NEO.jpg

anything running with a fluid w/ dextrose in it is changed q24. the tubing for something w/o dextrose (really just PAL or UAC fluids) is changed q72 but the fluid is changed q24 and new fluid is pulled through then.

we rarely ever have cabsi's and we sometimes have >100 babies.

EmilyPeruana

Specializes in NICU. Has 3 years experience.

we do NOT filter lipids.

we do filter tpn.

we clean all ports with CHG prior to administering meds or flushing. we clean the port with CHG 5-6x 360*, waiting for it to dry is annoying, but we've broken our own BSI records.

we replace lipids tubing/buretrol qd, replace tpn and entire line/port system/main port on picc/broviac/uvc q3d.

we do entire line changes with 2 people - 1 sterile, 1 clean.

clean person connects lines and flushes through ports of our "3-way manifold "(or 4-way)....sterile person sets up everything and connects entire setup to the cvc...

has worked for us so far.

feel free to email me.

americana_emilia@hotmail.com