Central Venous Catheters: A Survey of ICU Practices

Abstract

Aim. This paper describes the current infection control practices for CVC care and compares these to evidence-based practice guidelines. Background. Intensive care patients with central venous catheters (CVCs) are at risk of catheter-related infection, which increases morbidity, mortality and health care costs. Infection control practices, including care of intravenous administration sets and catheter sites, are undertaken by nurses in an attempt to avoid infection. Although practice guidelines are available, infection control practices may vary between practitioners and institutions; however, current practice has not been formally surveyed. Method. A prospective, cross-sectional descriptive survey was carried out. Intensive care units (n = 14) in Australia were surveyed about their infection control policies for CVC care. Results were tabulated and compared with evidence-based practice guidelines. Results. A wide variety of responses was received about duration of administration set use for standard, parenteral nutrition and propofol (lipid-based anaesthetic) infusions; ad hoc administration set connection technique; dressing frequency, materials and solutions; and barrier precautions used during procedures. There was inconsistent adherence to the guidelines. Conclusion. There is variation in the infection control approach to CVC care. Greater adherence to existing Centers for Disease Control Guidelines would assist in the standardization of best practice and facilitate evidence-based care. What is already known about this topic Patients with central venous catheters are at risk of catheter-related infection, which increases morbidity, mortality and health care costs. Many nursing practices attempt to minimize infective risk, although not all are supported by evidence. The Centers for Disease Control provide evidence-based practice guidelines for the prevention of infection and care of central venous catheters. What this paper adds The state of current nursing practice with regards to infection control with central venous catheters. The level of adherence by nurses to the Centers for Disease Control practice guidelines. Recommendations for nursing practice, education and future research