|The following article features coverage from the Oncology Nursing Society (ONS) 2019 Annual Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.
ANAHEIM, CA — Central line-associated bloodstream infections (CLABSIs) are preventable. Including chlorhexidine gluconate (CHG)-impregnated dressing in a standardized central line bundle resulted in a 100% decrease in CLABSIs, according to results of a nurse-led intervention presented at the Oncology Nursing Society (ONS) 44th Annual Congress.
Central venous catheter bloodstream infections are linked to increased morbidity and mortality; therefore, preventing CLABSIs can decrease complications and lower health care costs. Medication-impregnated dressing products reduce the incidence of catheter-related bloodstream infections relative to all other dressing types. CHG-impregnated dressings had a significant reduction in the incidence of CLABSI.
Our oncology unit is a 26-bed solid oncology inpatient unit that cares for patients with cancer admitted for chemotherapy, symptom management, oncology emergencies, and neutropenic surveillance, reported Samantha Thomas, BSN, RN, OCN®, of UCLA Medical Center in Santa Monica, California. The unit cares for patients with port-a-caths (PACs), peripherally inserted central catheters (PICCs), and hemodialysis/plasmapheresis central lines. The nursing staff has a direct and critical role in preventing CLABSIs.
CHG-impregnated dressings were not standard in the central line bundle, and the unit experienced 13 CLABSI cases between July 2016 and July 2017. In addition, the CLABSI rate was above the national benchmark expectations in 8 of 13 months.
The increase in the unit’s CLABSI rates inspired the nursing team led by Ms Thomas to push for a change in clinical practice that would improve the quality of care for their oncology patients. The team designed and conducted a trial on the oncology unit from August 2017 to December 2017. For the trial, unit nursing staff were instructed in placement and management of CHG-impregnated dressings, which were to be used on all central lines on the unit for the trial period.
The number of CLABSIs on the unit during the trial period was 0; a 100% decrease in infections that outperformed the national benchmark. The success of the trial led to system-wide implementation of including a CHG-impregnated dressing in the central line bundle.
Thomas S, Jakel P, Kulangara J, Cordero F. Prevention of central line-associated bloodstream infections in the oncology population. Oral presentation at: ONS 44th Annual Congress; April 11-14, 2019; Anaheim, CA.