Is it Time to Move Beyond CLABSI?

When it comes to infection control in vascular access, central line-associated bloodstream infections (CLABSIs) certainly get the most attention. Yet the medical community is increasingly recognizing how infections associated with other types of vascular access devices are putting patients at risk.

Take peripheral IV (PIV) catheters, the most commonly used type of vascular access device. Nearly 90 percent of hospitalized patients require a PIV at some point during their stay, and PIV usage far outnumbers that of central vascular access devices (CVAD). PIVs, therefore, account for an infection rate that approaches the CVAD infection rate in absolute terms.

Yet there is currently no mandatory reporting system for bloodstream infections associated with PIVs in the U.S., making it one of the most underreported types of infections in vascular access. Epidemiologist Robert Garcia, an infection preventionist with 40 years of hospital experience, shares these concerns — and he has a plan to address this significant patient safety issue.

Mr. Garcia suggests a more robust approach to patient safety that focuses on hospital-onset bacteremia (HOB), rather than just CLABSIs. His recent white paper discusses the urgent patient safety need to expand infection control efforts to include all types of vascular access devices across care settings — and how next-generation antimicrobial dressings could significantly advance HOB prevention.

Mr. Garcia recently talked with Patient Safety & Quality Healthcare Editor-in-Chief Jay Kumar on PSHQ: The Podcast, a bi-weekly podcast covering the hottest topics in patient safety and quality.

Organizations are beginning to recognize this significant patient safety issue. Earlier this year, the ECRI Institute included PIV-related infections and other complications on its 2021 list of Top 10 Patient Safety Concerns. In fact, this is the second time ECRI has identified PIV infections as a major patient safety issue in recent years, noting in their 2019 patient safety report that “increased awareness of PIV-catheter-related infections, coupled with routine active surveillance and follow-up reporting, can help reduce the risk.”

In addition, the Infusion Nurses Society included some noticeable terminology updates in the 2021 Infusion Therapy Standards of Practice. They introduced the term “Catheter-Associated Bloodstream Infection” (CABSI) to refer to bloodstream infections associated with all types of vascular access devices, regardless of whether the infections stem from peripheral or central lines. By broadening the acronym, INS recognizes the importance of protecting patients from all catheter-related infections — not just CLABSIs.

> > > Download Robert Garcia’s white paper

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