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Kimberly Joseph, Sameer Gupta, James Yon, Renee Partida, Lee Cartagena, John Kubasiak, Vanessa Buie, Jared Miller, Dorion Wiley, Kimberly Nagy, Frederic Starr, Andrew Dennis, Matthew Kaminsky, Faran Bokhari
BACKGROUND: Checklists have been advocated to improve quality outcomes/communication in the critical care setting, but results have been mixed. A new checklist process, "TRAUMA LIFE", was implemented in our Trauma Intensive Care Unit (TICU) to replace prior checklists. The purpose of this study was to evaluate the impact of the "TRAUMA LIFE" process implementation on quality metrics and on patient/family communication in the TICU. METHODS: "TRAUMA LIFE" was considered maturely implemented by 2016...
March 9, 2018: American Journal of Surgery
Gülçin Özalp Gerçeker, Seda Ardahan Sevgili, Figen Yardımcı
PURPOSE: To compare standardized flushing methods with aseptic non-touch technique; (1) Manually prepared syringes (2) Single-use prefilled flush syringes. METHOD: Forty-eight PHO patients with Hickman or Port catheters were recruited to participate in a prospective, randomized study. Standardized flushing methods with aseptic non-touch technique (ANTT) using single-use pre-filled flush syringes (intervention group) or manually prepared syringes (control group) also included the pulsatile technique, use of 10-mL syringe size with 0...
April 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Matthew Eisenberg, Michael C Monuteaux, Gillian Fell, Vera Goldberg, Mark Puder, Joel Hudgins
OBJECTIVES: To determine which factors confer the greatest risk of central line-associated bloodstream infection (CLABSI) in children with intestinal failure and fever presenting to an emergency department (ED), and to assess whether a low-risk group exists that may not require the standard treatment of admission for 48 hours on intravenous antibiotics pending culture results. STUDY DESIGN: This retrospective cohort study included children with intestinal failure and fever presenting to an ED over a 6-year period...
March 14, 2018: Journal of Pediatrics
Sami M Aloush, Faris A Alsaraireh
OBJECTIVE:  To assess nurses' compliance with central line associated bloodstream infection (CLABSI) prevention guidelines related to maintenance of the central line and the predictors of compliance. Method: This was an observational study that used a descriptive cross-sectional design. A sample of 171 intensive care unit (ICU) nurses were observed and their compliance was recorded on a structured observational sheet. The study was conducted in the ICUs of 15 hospitals located in 5 cities in Jordan...
March 2018: Saudi Medical Journal
Rowena L McMullan, Adrienne Gordon
BACKGROUND: Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants...
March 7, 2018: Cochrane Database of Systematic Reviews
Gabriela Fonseca, Marissa Burgermaster, Elaine Larson, David S Seres
BACKGROUND: Parenteral nutrition (PN) administered via central venous catheter has been identified as an independent risk factor for central line-associated bloodstream infections (CLABSIs). The aim of this study was to provide an updated description of the relationship between PN and CLABSI and assess temporal trends in CLABSI rates for individuals who received PN from 2009-2014, after the Centers for Medicare & Medicaid declared CLABSI a "never event." METHODS: Using data obtained from all adult patient discharges between January 1, 2009, and December 31, 2014, from 2 affiliated hospitals in a large health system in New York City, univariate and multivariate analyses were performed to examine the relationship between PN and CLABSIs as well as temporal trends...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Dia Byrne, Linda Penwarden
The purpose of this article is to share the efforts of one institution in reducing risk of central line-associated bloodstream infections (CLABSIs). The aim is to review alteplase use as a marker for peripherally inserted central catheter (PICC) occlusions, which may increase risk of CLABSIs. The discovery that alteplase use increased with the number of PICC lumens allowed for exploration of ordering and placement practices. Following education, placement of double-lumen PICCs decreased.
March 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Joshua P Parreco, Antonio E Hidalgo, Alejandro D Badilla, Omar Ilyas, Rishi Rattan
PURPOSE: The purpose of this study was to compare machine learning techniques for predicting central line-associated bloodstream infection (CLABSI). MATERIALS AND METHODS: The Multiparameter Intelligent Monitoring in Intensive Care III database was queried for all ICU admissions. The variables included six different severities of illness scores calculated on the first day of ICU admission with their components and comorbidities. The outcomes of interest were in-hospital mortality, central line placement, and CLABSI...
February 21, 2018: Journal of Critical Care
Philip J G M Voets
Many clinicians know from experience and medical epidemiological literature that the risk of central line-associated bloodstream infections (CLABSI) increases rapidly with a prolonged catheter dwell-time, but how this infection risk increases over time remains obscure. In this manuscript, a clinically useful rule of thumb is derived, stating that the risk of CLABSI increases in a quadratic fashion with the increase in catheter dwell-time. The proposed rule of thumb could be considered a quick and effortless clinical tool to rationally predict the pattern of CLABSI risk with an increasing catheter dwell-time...
February 22, 2018: Journal of Theoretical Biology
Tracy N Zembles, Linda S Flannery, Anna R Huppler
PURPOSE: The development and implementation of an antimicrobial lock therapy guideline at a large pediatric hospital are described. SUMMARY: Central venous access devices (CVADs) are essential in the medical management of patients requiring long-term total parenteral nutrition, chemotherapy, or hemodialysis. However, the use of a CVAD carries a significant risk of the development of central line-associated bloodstream infection (CLABSI). Antimicrobial lock therapy is indicated for patients with CLABSIs who have no signs of exit site or tunnel infection and for whom catheter salvage is a goal...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Steven S Spires, Peter F Rebeiro, Mickie Miller, Katie Koss, Patty W Wright, Thomas R Talbot
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services...
February 15, 2018: Infection Control and Hospital Epidemiology
Victor Daniel Rosenthal, Javier Desse, Diego Marcelo Maurizi, Gustavo Jorge Chaparro, Pablo Wenceslao Orellano, Viviana Chediack, Rafael Cabrera, Daniel Golschmid, Cristina Graciela Silva, Julio Cesar Vimercati, Juan Pablo Stagnaro, Ivanna Perez, María Laura Spadaro, Adriana Miriam Montanini, Dina Pedersen, Teresa Laura Paniccia, Ana María Ríos Aguilera, Raul Cermesoni, Juan Ignacio Mele, Ernesto Alda, Analía Edith Paldoro, Agustín Román Ortta, Bettina Cooke, María Cecilia García, Mora Nair Obed, Cecilia Verónica Domínguez, Pablo Alejandro Saúl, María Cecilia Rodríguez Del Valle, Alberto Claudio Bianchi, Gustavo Alvarez, Ricardo Pérez, Carolina Oyola
OBJECTIVE To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017. DESIGN This prospective, pre-post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions...
February 12, 2018: Infection Control and Hospital Epidemiology
Gulay Yazici, Hulya Bulut
BACKGROUND: Healthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates. OBJECTIVES: To evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections. MATERIALS AND METHOD: This quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter...
February 2018: Applied Nursing Research: ANR
Maziar M Nourian, Angelina L Schwartz, Austin Stevens, Eric R Scaife, Brian T Bucher
BACKGROUND: The optimal time to reinsert central venous catheters (tCVC) after a documented central line associated blood stream infection (CLABSI) is unclear. The goal of this study is to identify risk factors for children who develop persistent bacteremia after tCVC removal due to CLABSI. METHODS: We performed a retrospective cohort study from a tertiary children's hospital. Children who underwent removal of a tCVC due to CLABSI were included in our analysis. Our primary outcome was persistent bacteremia after tCVC removal defined by a persistently positive blood culture...
December 24, 2017: Journal of Pediatric Surgery
Yasser B Abulhasan, Susan P Rachel, Marc-Olivier Châtillon-Angle, Najayeb Alabdulraheem, Ian Schiller, Nandini Dendukuri, Mark R Angle, Charles Frenette
BACKGROUND: Healthcare-associated infections (HAIs) occur frequently in neurological intensive care units (neuro-ICUs); however, data differentiating associations with various diagnostic categories and resulting burdens are limited. This prospective cohort study reported incidence rates, pathogen distribution, and patient-related outcomes of HAIs in a neuro-ICU population from April 2010 to March 2016. METHODS: Laboratory results and specific clinical indicators were used to categorize infections as per National Healthcare Safety Network nosocomial infection surveillance definitions...
January 25, 2018: American Journal of Infection Control
David Paje, Anna Conlon, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: The guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated duration of use is =5 days. However, short-term PICC use is common in hospitals. We sought to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term PICCs. METHODS: Between January 2014 and June 2016, trained abstractors at 52 Michigan Hospital Medicine Safety (HMS) Consortium sites collected data from medical records of adults that received PICCs during hospitalization...
February 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Jessica L Seidelman, Sarah S Lewis, Kirk Huslage, Nancy Strittholt, Sheila Vereen, Chris Sova, Bonnie Taylor, Desiree Bonadonna, David Ranney, Utlara Nag, Mani Daneshmand, Deverick J Anderson, Daniel J Sexton, Becky A Smith
No abstract text is available yet for this article.
January 24, 2018: Infection Control and Hospital Epidemiology
Charles R Hong, David Zurakowski, Brenna S Fullerton, Katelyn Ariagno, Tom Jaksic, Nilesh M Mehta
BACKGROUND: We aimed to describe nutrient intake and growth in infants with gastroschisis and identify factors associated with impaired growth. METHODS: Retrospective study of neonates who underwent gastroschisis repair from 2010 to 2015. Nutrient intake and weight-for-age z scores (WAZ) were recorded. RESULTS: Data from 60 eligible infants with median (Q1, Q3) gestational age of 36 weeks (35, 37) and birth weight 2418 g (2098, 2665) were analyzed...
January 8, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Anne Marie Chaftari, Ray Hachem, Sammy Raad, Ying Jiang, Elizabeth Natividad, Patrick Chaftari, Issam Raad
We evaluated the rate of central venous catheter (CVC) removal in 283 cancer patients with bloodstream infections (BSIs). Removal of CVCs occurred unnecessarily in 57% of patients with non-central-line-associated BSI (non-CLABSI), which was equivalent to the rate of CVC removal in patients with CLABSIs. Physician education and safe interventions to salvage the vascular access are warranted. Infect Control Hosp Epidemiol 2018;39:222-225.
February 2018: Infection Control and Hospital Epidemiology
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
March 2018: European Journal of Pediatrics
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