CDC updates bloodstream infection prevention guidelines

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Updated guidelines for preventing bloodstream infections are now available for clinicians who insert IV catheters, as well as those in charge of infection control and surveillance in the hospital, outpatient and home healthcare settings.

The release of the first updated guidelines since 2002, coincide with a new requirement enacted this year in which hospitals that accept Medicare patients must report central-line associated blood stream infections to the Centers for Medicare and Medicaid Services. Facilities that do not comply risk losing 2% of their Medicare payments.

“Catheter-related bloodstream infections — like many infections in health care — are now seen as largely preventable,” guideline coauthor, Naomi O'Grady, MD, of the critical care medicine department at the National Institutes of Health Clinical Center in Bethesda, MD, said in a press release. “Implementation of these critical infection control guidelines is an important benchmark of heath care quality and patient safety.”

O'Grady represented one of 15 different medical organizations, including the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America, involved in the Healthcare Infection Control Practices Advisory Committee (HICPAC) – the workgroup responsible for revising the recommendations.

As many as 250,000 blood-stream infections occur each year, background information in the guidelines state. However, between 2001 and 2009 prevention efforts reduced the number of central-line associated blood stream infections in ICU patients by 58%, saved an estimated 3,000 to 6,000 lives and reduced extra medical costs by $414 million.

The working group attributed this success to five, evidence-based prevention strategies, emphasized in the new recommendations:

  • Education and training for clinicians who insert and maintain catheters;
  • Instituting maximal sterile barrier precautions while inserting IV catheters;
  • Preparing the catheter site with an antiseptic cholorhexidine solution >0.5% prior to insertion;
  • Avoiding routine central venous catheter replacement to prevent infection;
  • Use of short-term central venous catheters and sponge dressing that contain antiseptics and antibiotics if infection rates do not decrease.

“Education and reinforcement of care and maintenance protocols among staff is key. We all have a role to play in protecting patients from these infections,” O'Grady said.

Clinicians can access the full guidelines on the CDC'S HICPAC website.

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