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New Catheter Placement Guidelines for Nurses Aimed at Reducing CLABSI

Nurses are well positioned to stop dangerous and costly bloodstream infections caused by the improper placement of catheters in large veins in the neck, chest or groin, according to guidelines released by the Joint Commission.

Central line-associated bloodstream infections, or CLABSI, needlessly afflict thousands of patients each year, lengthening hospital stays, boosting hospital readmission rates, and driving up the cost of care.

"These devastating bloodstream infections don't need to happen," says Patricia Stone, PhD, MPH, RN, FAAN, Centennial Professor of Health Policy in Nursing, Columbia University School of Nursing, New York City and a contributor on the new guidelines.

Catheters deliver life-saving medicines and nutrients to some of the most vulnerable patients - including premature babies in intensive care units, adults recovering from major trauma and surgery, and frail elderly patients in long-term care settings. Without proper insertion, utilization, and maintenance, catheters can also transmit deadly infections to the bloodstream.

Nurses, using their infection control training, play a vital role in creating a culture of patient safety, Stone says. "Nurses are on the front lines and can take advantage of their constant contact with patients and other caregivers to explain infection-control techniques and help health facilities develop and enforce standards of care that have been proven effective against CLABSI."

Nurses often help organize and implement effective prevention techniques including catheter insertion checklists, regular replacement of dressings, and proper handwashing techniques. With their background in education, nurses have the knowledge to inform patients and colleagues about evidence-based practices to reduce CLABSI.

Each year in the U.S., there are an estimated 100,000 deaths from health care-associated infections, and one third of the fatalities are from CLABSI, according to The Joint Commission.

Healthcare-associated infections create approximately $33 billion in excess medical costs for U.S. hospitals every year, yet it isn't clear how to ensure that best-practices for prevention are followed, Stone says. She discovered this in a review of programs in place at acute care hospitals that was presented earlier this year at IDWeek, a conference dedicated to research in prevention, diagnosis, treatment and epidemiology of infectious disease. While most hospitals have infection prevention policies, adherence can be haphazard, putting patients at risk, she found.

"These infections drive up health costs, wasting resources that could be spent meeting so many other patient needs," Stone says. "The Joint Commission's guidelines underscore the value of investing in nurses and making sure caregivers at the bedside have all the resources they need to keep patients 

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