Is there a way to prove or deduce by whom the CRBSIs was caused? Is there a time frame from the date of placement of CVC to the time of culture that would definitively show that placement caused an infection?
Forum topic
Thu, 06/23/2011 - 15:14
#1
Need some understanding on CRBSIs
The only thing I know of is the published information about biofilm. CRBSI comes from the biofilm. There is more biofilm on the extraluminal side of the catheter within the first week after insertion. This probably indicates that the infection during this period is coming from the skin, probably during insertion or due to inadequate stabilization and/or dressing. After the first week, there is more biofilm on the intraluminal walls, indicating that the organisms are entering from the catheter hub and all of the manipulation done to it. 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
Thank you so much :-)
Mark
No timeframe exists for intraluminal versus extraluminal insertions at this point. Insertion related infections also have no time frame as the bacterial may have entered at the time of insertion but not exhibit an issue until a much later time frame. Having said that we have seen a very large decrease since bundles in early onset infections in the ICU especially with Staph. These were likely a result of implementation of the bundle for insertion.
Kathy Kokotis RN BS MBS
Bard Access Systems
Our facility has adopted 72 hours as the time frame for which we would classify an infection r/t insertion after that it would be associated with care/maintenance. If I recall correctly our Director of Infection/Control based this on information from SHEA.
There is no official number published by SHEA or any other organization that I have found in any guidelines.
It is likely your MD is providing an anecdotal recommendation.
kathy