as of this date our nursing staff draw blood samples from CVC's. Our Infection Control physician wants this to stop. We will see as the discussion continues.
We looked at this recently to determine what effect blood draws had on infection risk. The only literature we could locate [and we were looking at pediatric studies] referred to efficacy of drawing labs from lines and other line care and the risk of infection was really only a side effect reported. The literature we found reported that drawing labs from 3 French and larger catheters was efficacious, and that entering the line for 1.4 lab draws per day did not increase the risk of infection. What we gleaned from this project is that we could "enter" a line no more than once per day to obtain labs. Each entry for labs, however, involved more than one line access. [enter, draw discard, enter, draw specimen, enter, flush or hook up infusion]
Anne Marie Frey RN, BSN, CRNI, VA-BC Clinical Expert Vascular Access Service: I.V. Team The Children's Hospital of Philadelphia [email protected]
Anne Marie, I just went through the literature on blood sampling from CVADs to revise the phlebotomy standard. Apparently, you found some that I did not. Can you post your list of references? Thanks Lynn
I too would like some more information on why this should be limited. In my opinion, most patients have a CVC for a reason, although I understand it is not always due to limitied venous access but need for multiple access. Our parent institution would like blood draws from these lines to be very limited due to their recent increase in CLABSI's. Our facility has zero CLABSIs. I feel that is punishing the patient for what is poor technique and an issue with staff education but medical staff is staunch in their endeavors to persue this. I need some literature to support or disagree with this process so I know where to stand and how to proceed. Any info would be greatly appreciated. As you can surmise, I am not in agreement with limiting blood draws but I want to do the best for the patient. Thank you!
as of this date our nursing staff draw blood samples from CVC's. Our Infection Control physician wants this to stop. We will see as the discussion continues.
We looked at this recently to determine what effect blood draws had on infection risk. The only literature we could locate [and we were looking at pediatric studies] referred to efficacy of drawing labs from lines and other line care and the risk of infection was really only a side effect reported. The literature we found reported that drawing labs from 3 French and larger catheters was efficacious, and that entering the line for 1.4 lab draws per day did not increase the risk of infection. What we gleaned from this project is that we could "enter" a line no more than once per day to obtain labs. Each entry for labs, however, involved more than one line access. [enter, draw discard, enter, draw specimen, enter, flush or hook up infusion]
Anne Marie Frey RN, BSN, CRNI, VA-BC Clinical Expert Vascular Access Service: I.V. Team The Children's Hospital of Philadelphia [email protected]
Anne Marie, I just went through the literature on blood sampling from CVADs to revise the phlebotomy standard. Apparently, you found some that I did not. Can you post your list of references? Thanks Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I too would like some more information on why this should be limited. In my opinion, most patients have a CVC for a reason, although I understand it is not always due to limitied venous access but need for multiple access. Our parent institution would like blood draws from these lines to be very limited due to their recent increase in CLABSI's. Our facility has zero CLABSIs. I feel that is punishing the patient for what is poor technique and an issue with staff education but medical staff is staunch in their endeavors to persue this. I need some literature to support or disagree with this process so I know where to stand and how to proceed. Any info would be greatly appreciated. As you can surmise, I am not in agreement with limiting blood draws but I want to do the best for the patient. Thank you!