Central Venous Catheter Infections
Each year many Americans need a central venous catheter in order to receive medical treatment. In 2003, the number of Americans who received a central venous catheter was estimated to be around 5 million people.
A central venous catheter is a kind of tube that is placed into a patient’s vein and is used to provide long term medication. Typically, a central venous catheter is only used when medication needs to be routinely provided to the patient for at least several weeks, if not longer. Patients requiring chemotherapy, long term pain medication or antibiotics may use a central venous catheter.
The Risk of Infection
While central venous catheters provide some very important medical benefits for patients, they are not without risks. One of the most serious risks associated with the use of central venous catheters is infection. The New England Journal of Medicine reports that infections may occur in as many as 5 -26% of patients who have central venous catheters. The Centers for Disease Control and Prevention (CDC) estimate that more than 200,000 patients a year suffer from catheter related infections in the United States. This makes catheter related infections one of the most common type of health care related infections.
Infections can be life threatening. Patients with central venous catheters are typically in compromised health prior to an infection developing and may, therefore, have a more difficult time fighting off an infection. Serious infections, such as staph infections, can occur and it can be difficult to determine that the cause of the patient’s symptoms is an infection at the site of the central venous catheter.
For all of these reasons, it is important that medical professionals take all of the necessary steps to lower the risk of infection at the central venous catheter site.
Preventing Infections
According to a study published by the Mayo Clinic, more than 50% of catheter related infections are preventable. The techniques for prevention are not difficult and could save lives, prevent patient suffering and reduce the health care costs associated with the infection.
The CDC emphasizes five practices that could drastically reduce the likelihood of an infection developing at the central venous catheter site. Specifically, the CDC recommends:
- Educating and training the health care workers responsible for inserting and maintaining central venous catheters;
- Using "maximum sterile barrier precautions" when the central venous catheter is being inserted into the patient;
- Using a 2% chlorhexidine preparation to clean the skin at the central venous catheter site;
- Avoiding routine replacement of the central venous catheter line as a way to prevent infection. Each time the catheter is inserted and removed from the body, the potential exists for bacteria to enter the blood stream at the central venous catheter side. Therefore, replacing the catheter line to avoid infection is counterproductive; and,
- Using antispectic / antibiotic impregnated short term central venous catheters if the facility is still experiencing a high rate of infection despite adherence to the first four recommendations.
Other factors such as hand hygiene on the part of medical personnel, the materials used to make the central venous catheter and, proper care of the central venous catheter site also play a role in avoiding infection.
The Mayo Clinic report found that less than one half of all non-Veteran Administration Hospitals in the United States were following all of the recommended prevention strategies concurrently.
It is possible that if more US hospitals were to start following the easy to implement strategies to prevent central venous catheter infections that fewer patients would suffer and fewer patients would die from this very common complication.