Sometimes when patients are admitted to the hospital, they can get infections. These are called health care-associated infections.
When a patient requires long-term access to medication or fluids through an IV, a central line is put in place. A central line blood stream infection can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. The bacteria can come from a variety of places (e.g. skin, wounds, environment, etc.), though it most often comes from the patient's skin.
Hospitals follow best practices on how to prevent bacteria from entering into a central line. Patients in the ICU often require a central line since they are seriously ill, and will require a lot of medication, for a long period of time.
• Redness, pain or swelling at or near the catheter site
• Pain or tenderness along the path of the catheter
• Drainage from the skin around the catheter
• Sudden fever or chills
Anyone who has a central line can get an infection. The risk is higher if you:
• Are in the intensive care unit (ICU)
• Have a serious underlying illness or debilitation
• Are receiving bone marrow or chemotherapy
• Have the line in for an extended time.
If a CLI is suspected, the central line is often removed and sent to the laboratory for testing. Once a diagnosis of CLI is confirmed, the patient may be treated with one or more antibiotics.
CLIs account for 90% of catheter related infections (see the Safer Healthcare Now! document
.). Prevention interventions, such as the use of insertion and maintenance bundles can decrease infection rates.
North York General Hospital's Critical Care Unit (CrCU) utilizes insertion bundles for all new central lines inserted in the CrCU. Insertion bundles encompass four aspects:
optimal catheter site selection where there is a lower risk of infection
aggressive hand hygiene habits
the use of chlorhexidine 2% with 70% alcohol skin antiseptic
maximum barrier precautions by all staff involved with the catheter insertion including wearing a cap, mask, gown and gloves.
Once a central line is in place, staff complete a maintenance bundle on a daily basis to determine whether the patient still requires the central line and whether there are any signs and symptoms of infection that would warrant early removal.
Patients should always follow instructions given to them by your health care team.
Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.