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CDC, NIH Revise Bloodstream Infection Prevention Guidelines

John Commins, for HealthLeaders Media, April 5, 2011

Educating and training healthcare personnel and maintaining safety protocols are the key areas of emphasis in updated federal guidelines designed to prevent catheter-related bloodstream infections.

"Catheter-related bloodstream infections—like many infections in healthcare—are now seen as largely preventable," said Naomi O'Grady, MD, medical director of procedures, vascular access, and conscious sedation services at the National Institutes of Health Clinical Center Critical Care Medicine Department, and lead author of the study: Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011.

"Implementation of these critical infection control guidelines is an important benchmark of healthcare quality and patient safety," O'Grady said in a media release.

The guidelines were created by NIH, the Centers for Disease Control and Prevention, and the Healthcare Infection Control Practices Advisory Committee, in consultation with 14 other healthcare professional organizations.

In addition to training for healthcare personnel and fortifying sterile barriers during catheter insertion, the guidelines also call for: using 'maximal sterile barrier precautions' during central venous catheter insertion; cleaning skin with the antibacterial scrub chlorhexidine: using a > 0.5% chlorhexidine skin preparation with alcohol for antisepsis; avoiding routine replacement of central venous catheters as a strategy to prevent infection; and using antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine impregnated sponge dressings if the rate of infection is not decreasing using the first four strategies fail, the guidelines said.

The guidelines, which replace the 2002 edition, also recommend using "bundled strategies" and documenting and reporting rates of compliance with all components of the bundle as benchmarks for quality assurance and performance improvement. The report was published Friday in Clinical Infectious Diseases, and is available on CDC's HICPAC website. The guidelines will also be included in a special supplement to the American Journal of Infection Control.

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