The Five-Day Blues: A New Delineation for Late-Onset Central-Line Infections

The Hospitalist. 2012 January;2012(01):

January 4, 2012 | The Hospitalist

Bryn Nelson, PhD, is a freelance writer based in Seattle.

Reference

Davis J. Central-line associated bloodstream infection: comprehensive, data-driven prevention. Pa Patient Saf Advis. 2011;8:100-105.

Five Tips for Creating a Bundled Maintenance Plan for Central Lines

Few studies have focused on best practices for central-line maintenance. Even so, Dr. Ryder has identified a few important pointers:

1. Choose a needleless connector design that has minimal potential for bacterial transfer.

2. Reinforce the message that all injection ports, catheter hubs, and stopcocks are potential portals for bacteria.

3. Disinfect all potential portals before accessing the line. Dr. Ryder recommends either the passive disinfectant SwabCap as a cover for the needleless connector, or Site-Scrub, a product she’s worked on that acts as a more active disinfectant for catheter access sites.

4. Develop a policy for when needleless connectors should be replaced. One week, Dr. Ryder says, is clearly too long.

5. Consider using catheters with an intraluminal antimicrobial coating, which has been shown to reduce both biofilm and catheter thrombus formation.