Does anyone do pre-admission blood cultures on patients (either direct admit or through ER) with central lines? Now that there is no reimbursement with CLABSI's - trying to avoid "blame".
We do not, but it would seem reasonable, especially since we send u/a (with cx as necessary) when inserting foleys and many ICU's are doing nasal swabs on admission to the unit.
Nancy our faciltiy has a protocol called "present on admission" checklist. This covers anyone arriving to our hospital and is a screen for possible UTI's and CRBSI's. For instance, for central lines we have three boxes to assess. 1. central line on admission, 2. Redness, burning, pain at insertion site, and 3. has fever and a central line. If any box is checked we can then send blood cultures x 2 or for our UTI box send urine for culture as part of our protocol if any box is checked in that assessment. This checklist also includes a skin/wound assessment. It only takes a second to fill out and is part of the chart. Audits can be easily done on this form as well.
We do not, but it would seem reasonable, especially since we send u/a (with cx as necessary) when inserting foleys and many ICU's are doing nasal swabs on admission to the unit.
Keely Ralston RN-BC, VA-BC, CPUI, RCIS
Nancy our faciltiy has a protocol called "present on admission" checklist. This covers anyone arriving to our hospital and is a screen for possible UTI's and CRBSI's. For instance, for central lines we have three boxes to assess. 1. central line on admission, 2. Redness, burning, pain at insertion site, and 3. has fever and a central line. If any box is checked we can then send blood cultures x 2 or for our UTI box send urine for culture as part of our protocol if any box is checked in that assessment. This checklist also includes a skin/wound assessment. It only takes a second to fill out and is part of the chart. Audits can be easily done on this form as well.
Frank