Synnove Hvidevold Moe
Norway
CVC, CRBSI, Infections, procedures, evidence based
''5. Međunarodni kongres HDMSARIST-a'' i ''8. Međunarodni kongres WfCCN-a''
Šibenik, 12.-15. travnja 2012. godine
Background: CVC play an important role in the treatment of critically ill patients. Unfortunately complications such as intravascular catheter related bloodstream infections (CRBSI) often occur. Infections are a major problem in hospitals all over the world, and CRBSI is a serious complication with high mortality rate. There was a need in our hospital to create a new and standardized procedure based on the evidence based knowledge related to prevention of CRBSI in patients with CVC`s.
Aim: Develop a procedure for care and maintenance of CVC in patients at Oslo University Hospital to reduce the number of infections. The procedure aims to include hygienically aspects, care and maintenance.
Methods: A systematic study of literature, were all available evidence based knowledge relevant to our aim is critically summarized. AGREE has been used to evaluate both the available and relevant research and the procedure. An interdisciplinary group representing different specialities collaborated in the process.
Results: Use a non-touch technique or aseptic non-touch technique when handling the CVC. Never touch key parts. The CVC must be secured with sutures and transparent sterile dressing. CVC placement in centimeters should daily be documented in the patient record. The transparent sterile CVC dressing should not be changed more often than every 7th day, unless it is contaminated or loose. Control insertion site daily for signs of infections. Connectors and infusion lines should be changed every 3rd day, but daily be bathed in Chlorhexidine 5 mg/ml. When flushing the CVC, use press-pause technique. Lock the catheter with a positive pressure technique. Use heparin lock if the CVC is not daily in use.
Conclusion:This procedure aims to reduce the number of infections related to CVC. Based on available research, we developed a procedure which summaries the best care and management of CVC`s. To avoid CRBSI in CVC`s, updated evidence based guidelines must be implemented.