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Central Line Blood Stream Infections

In a hospital, one of the most serious kinds of infections — called central line-associated bloodstream infections (CLABSI) — is caused by germs that enter the body through catheters or tubes inserted into large veins.

Central lines, also called central venous catheters, are often inserted in the neck, chest, arm or groin. These lifesaving catheters may be used to provide medications and fluids to severely ill patients and may remain in place for several weeks.

A CLABSI occurs when germs in or on the catheter enter the bloodstream. These infections can lead to serious complications, even death, especially for critically ill patients.

How does UCSF measure central line infections?

UCSF measures these infection rates according to the methods of the National Healthcare Safety Network (NHSN) of the Center for Disease Control and Prevention. The rate is the number of infections per 1,000 central line days, or the number of days patients have a central line in place. If two patients had a central line for five days each, that is a total of 10 central line days.

What is the central line infection rate at UCSF?

Lower is better when comparing these infection rates. UCSF's goal is to be below 1.25 central line infections per 1,000 central line days in critical care units. Individual hospital units compare their data with NHSN data. At UCSF, the rate has been decreasing steadily for more than four years.

Among adult patients, the rate of central line infections is 1.15, below UCSF's 1.25 goal.

central line bloodstream infection chart

How are these infections prevented?

To prevent infection, we treat the insertion of a central line as a surgical procedure. This means doctors and nurses thoroughly wash their hands before the procedure and put on surgical gowns and caps, masks and sterile gloves. The patient is covered from head to toe with sterile drapes. These measures result in lower infection rates.

When cleaning or removing a central line, we follow specific, sterile procedures that are closely monitored.

In addition, a committee of Infection Control employees, nurses and doctors meets regularly to review infection rates and examine our procedures. If a central line infection-associated blood stream infection occurs, this committee evaluates what, if anything, went wrong.

What can patients do?

Talk to your health-care team. Ask if team members follow UCSF standards for inserting and caring for a central line. Find out when the central line can be safely removed. If you don't see a doctor, nurse or technician clean his or her hands, ask him or her to do so before touching the central line.

    

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