SEE IF YOU CAN TELL FACT FROM FICTION. From cost savings to Candida, Clinical Mythbusters tackles questions you face every day. To get Clinical Mythbusters FREE every month, sign up now!
Simple hand washing and following full sterile barrier precautions alone are sufficient steps for minimizing catheter-related bloodstream infection (CRBSI).
False
As confirmed in a recent study, hand washing and full sterile barrier precautions can indeed reduce the rate of bloodstream infection—but not to the point where an institution should abandon other measures.
“Effect of a Second-Generation Venous Catheter Impregnated With Chlorhexidine and Silver Sulfadiazine on Central Catheter-Related Infections: A Randomized, Controlled Trial” by Mark E. Rupp, MD, et al. recorded a baseline rate of 3.3 infections per 1,000 catheter days (both definitive and possible bacteremia) when full sterile barrier precautions and a standardized dressing change protocol were followed. (1)
However, the study points out that the CDC recommends considering antiseptic-impregnated catheters in populations where bloodstream infection exceeds 3.3 per 1,000 catheter days, then goes on to add:
"The use of chlorhexidine for insertion-site preparation might further reduce catheter-associated infection. However, in the current study, the low rate of infection does not seem to reflect standard experience in intensive care units in the United States.
The CDC reported that rates of catheter-associated bloodstream infection range from 2.9 to 8.5 per 1,000 catheter days (mean rate, 4.9 per 1,000 catheter days) depending on the type of intensive care unit studied. Clearly, increased emphasis should be placed on appropriate catheter insertion and care.” (1)
REFERENCES:
(1) Rupp, M.E., Lisco, S.J., Lipsett, P.A., Perl, T.M., Keating, K., Civetta, J.M., Mermel, L.A., Lee, D., Dellinger, P.E., Donahue, M., Giles, D., Pfaller, M.A., Maki, D.G., Sherertz, R. “Effect of a Second-Generation Venous Catheter Impregnated With Chlorhexidine and Silver Sulfadiazine on Central Catheter-Related Infections: A Randomized, Controlled Trial.” Annals of Internal Medicine, Vol. 143, No. 8, October 18, 2005, pp. 570–581.
See the full list of mythbusters
Learn what's true and false about catheters and sign up for
our free bulletin on catheters and related subjects
Institute of Healthcare Improvement
5 million lives campaign
The 5 Million Lives Campaign is a voluntary initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008).
- IHI 5 Million Lives Website
- Overview
- Participants
- Implement the Central Line Bundle
- IHI Getting Started Kit: Prevent Ventilator-Associated Pneumonia How-to Guide
Center for Disease Control and Prevention (CDC)
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
