I was honored to serve on the committee to revise this document, originally written in 2008. Many aspects of catheter insertion and maintenance are now supported by stronger evidence such a routine bathing with chlorhexidine and nurse-to-patient ratios in ICU. Other aspects of care not previously addressed are included such as a recommendation for a vigorous mechanical scrub of a needleless connector for a minimum of 5 seconds. Other highlighted information remains unanswered by evidence including a statement about no evidence for using a needleless connector in an infusion system set up for continuous infusion of fluids.
There is a new section on examples of implementation strategies, based on the 4 components of implementation science – engage, educate, execute, and evaluate. I was actually surprised at the number of studies about education for central venous catheter insertion. Over the past 10 years, we have seen an enormous amount of consideration and resources dedicated to reducing bloodstream infections caused by central venous catheters. You could be feeling
overwhelmed but don’t ignore this information yet. Vascular catheter associated infection continues to be listed as a hospital acquired condition, meaning that your hospital receives no payment to treat this complication. Additionally, the Center for Medicare and Medicaid Services continue to expand their application of value-based purchasing as a result of the Affordable Care Act. In 2012, a CMS report used many forms of data analysis to reveal that patients with a vascular catheter associated infection have a 33% increased risk of being re-admitted as an inpatient. And hospital readmission is another cause of reduced payments to hospitals. So now is definitely not the time to let down your guard.
On July 24th, I will lead a discussion of the changes in this updated document and address any questions you may have about the contents. This is a video conference presentation scheduled to begin at 1 pm ET. This presentation will be repeated on August 21st at 3 pm ET. Visit here to register for the video conference. Download the final document above and be prepared to discuss your questions and concerns about its content.