Infection prevention and central venous catheters: evidence round-up

By Sarah Chapman // November 27, 2015//Evidently Cochrane Blog

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Image source: evidentlycochrane.net

After the fascinating discussion we had, over 60 of us in a #WeNurses tweetchat, about the latest evidence on when to re-site peripheral venous catheters and whether it is reflected in current practice (catch up on it in this blog if you missed it), I’m turning my attention to central venous catheters (CVCs).

Infection prevention is of huge importance when it comes to vascular access devices. Micro-organisms can get into the bloodstream through the point where the skin has been penetrated and along the outer surface of the catheter, or internally through the catheter and its connectors. Minor infections at the entry site or in device connectors can lead to more serious bloodstream infections. The possible consequences include the whole gamut of infection-related miseries for the patient, including pain, anxiety, delayed treatments and a longer stay in hospital as well as greater demands on resources.

In the UK, the epic3 National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections should be informing practice, though I know from our tweetchat that some Trusts have policies that deviate from the recommendations. These guidelines draw on several Cochrane reviews and we also have some new and updated evidence since their publication in 2013. Here’s a round-up of Cochrane evidence. Does your practice reflect it?

Carry on reading via the Evidently Cochrane Blog

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Infection prevention and control: lessons from acute care in England

Latest Health News

November 2015 | The Health Foundation

Infection control has been high on the political agenda and on the agenda of the NHS in England in recent years. There have been many successes, not least the reduction in MRSA bloodstream infections and cases of Clostridium difficile infection. However, other health care associated infections that have not been monitored as rigorously are growing in incidence. New infections, including the growing number of more resistant strains of bacteria, are in danger of spreading. As a result, infection control needs to remain central to the work of the NHS.

This learning report is based on the findings of a large research study that identified and consolidated published evidence about infection prevention and control initiatives. The researchers synthesised this with findings from qualitative case studies in two large NHS hospitals, including the perspectives of service users.

via Infection prevention and control: lessons from acute care in England | The…

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Antibiotic prescribing is higher in deprived areas of England | The BMJ

Latest Health News

BMJ 2015;351:h6117

Prescribing of antibiotics has fallen steadily over the past five years in England, but the gap in prescribing levels between the least and most deprived areas is widening, a new analysis indicates.

The charity Antibiotic Research UK and the data analysis company EXASOL used prescribing data released by the government’s Health and Social Care Information Centre on the number of antibiotic prescriptions written by GPs and subsequently dispensed between August 2010 and July 2015. From the data they produced a “heat map” showing the hotspots of antibiotic prescribing in England:

Exasol-Infographic_FINAL-121115-881x1235

via Antibiotic prescribing is higher in deprived areas of England | The BMJ.

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Model for Improvement reduced surgical site infections

An improvement collaborative implemented a care bundle to reduce surgical site infections amongst children. Over a two year period they used the Model for Improvement to develop and implement change. Organisations were encouraged to adopt all or part of the bundle. Support was provided through webinars, discussion boards, targeted messages to leaders and in-person training. Within six months, 97% of organisations were using the bundle reliably. There was a 21% reduction in surgical site infection rates, from an average of 2.5 per 100 procedures to 1.8 per 100 procedures. The reduction was sustained over the 15 month follow-up period.

Schaffzin JK, et al. Surgical site infection reduction by the Solutions for Patient Safety Hospital Engagement Network. Pediatrics. Nov;136(5)1353-60 2015.