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Guidelines for Intravascular Catheter-Related Infections

Accreditation Monthly

April 14, 2010

The CDC released draft updated guidelines from the Hospital Infection Control Practices Advisory Committee (HICPAC) for the Prevention of Intravascular Catheter-Related Infections for public comment late in 2009. The paper is chock-full of interesting updated information for all types of catheters, and it's important to note that these guidelines will replace the 2002 version.

With an estimated 250,000 cases of CVC-associated bloodstream infections occurring annually, the recommendations provide for guidance related to areas such as site selection, skin preparation, dressing regimes, hand hygiene and aseptic technique for insertion, and avoiding routine replacements to prevent infections, as changing a catheter every seven days has not lowered CRBSI rates.

Although the final guidelines aren't out yet, noteworthy recommendations include when to replace IV tubing based on the current consensus of experts. Based on what is administered through the lines:

  • Blood—replace every 24 hours
  • Lipids—replace every 24 hours
  • Propofol—replace every six to 12 hours (per manufacturer)
  • Routine peripheral IVs—replace every 96 hours to seven days

However, if an IV is to remain in place more than six days, a midline catheter (PICC line) is still recommended.

By the way, it's no surprise to note that the paper also reports one of the factors of increased infection risk is reduced nursing levels. That's something to think about in consideration of your performance improvement initiatives related to infection prevention.

Laure Dudley, Senior Consultant 04/2010

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