Associations between vascular access devices and bloodstream infections: An 18-month review at a large academic hospitalCampbell, Julie (2021) Associations between vascular access devices and bloodstream infections: An 18-month review at a large academic hospital. Master Essay, University of Pittsburgh.
AbstractBackground: Hospital-associated infections (HAIs), used interchangeably with healthcare- acquired infections (HCAIs), are newly acquired infections that are contracted within a hospital environment or health care setting. These infections can occur as a result of complications with peripherally inserted central catheters (PICC), midline catheters (MC), or peripheral intravenous catheters (PIVs), all of which are vascular access devices required for the delivery of fluids, and medication therapies to hospitalized individuals. Identifying the factors associated with venous access device complications, positive blood culture outcomes and the emergence of healthcare-acquired infections is of clear public health significance. In this review, the electronic clinical data of patients experiencing concurrent vascular access device complications and bloodstream infections was analyzed to understand factors that need to be addressed to prevent or reduce incidence of future hospital associated infections. Methods: Electronic medical records from platforms TheraDocTM, RISKMASTER and Cerner PowerChart were used to conduct a retrospective, review of clinical data over an 18-month time period from January 1, 2019 thru June 30, 2021. Findings helped to elucidate associations between vascular access device complications and bloodstream infections. Spreadsheet software and statistical software were used for analysis. Results: Investigation of 1237 positive blood culture patient profiles and 905 IV line complication patient profiles revealed 55 patients that met the inclusion criteria of having concurrent IV line complications and positive blood culture outcomes within the 18-month study interval. Approximately 83% of patients reviewed had an infiltration vascular access device (VAD) complication, 10% had insertion site issues, and 5% had phlebitis. Infiltration outcomes were significantly associated with the peripheral intravenous line (PIV) access device, had the greatest harm score risk, and most frequent association with prevalent hospital-associated infection causative pathogens. Conclusions: Our findings suggest that the majority of vascular access device complications and associated bloodstream infections result from peripheral intravascular (PIV) lines. Measures should be taken to increase mitigation efforts by focusing resources towards the development and implementation of PLABSI prevention bundles to help reduce and prevent the emergence of vascular access device related healthcare-associated infections. Share
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