What You Need to Know About Central Line Infections (CLI)
Patients who need frequent intravenous (IV) medications, blood, fluid replacement and/or nutrition may have a central venous catheter (or "line") placed into one of their veins. This line can stay in place for days and even weeks.
Catheter-related bloodstream infections (CR-BSI)
Lines are often very helpful. But sometimes they cause infections when bacteria grow in the line and spreads to the patient's bloodstream. This is called a "catheter-related bloodstream infection" (CR-BSI). It is very serious and 20 percent (or 1 out of 5) of patients who get CR-BSI die from it.
A bundle of 5 care steps to prevent CR-BSI
Doctors and nurses can help prevent CR-BSI by using a bundle of 5 "care steps." Hospitals find that when all 5 of these steps are done that there are almost no cases of CR-BSI. The bundle of care steps are:
- Using proper hand hygiene. Everyone who touches the central line must wash their hands with soap and water or an alcohol cleanser.
- Wearing maximal barrier precautions. The person who inserts the line should be in sterile clothing – wearing a mask, gloves, and hair covering. The patient should be fully covered with a sterile drape, except for a very small hole where the line goes in.
- Cleaning the patient's skin with "chlorhexidine" (a type of soap) when the line is put in.
- Finding the best vein to insert the line. Often, this is the subclavian vein (in the chest) which is not as likely to get an infection as veins in the arm or leg.
- Checking the line for infection each day. The line should be taken out when it is no longer needed and not on a schedule.
How patients and family members can help
- Watch the hospital staff to make sure they wash their hands before and after working with the patient. Do not be afraid to remind them to wash their hands!
- Ask the doctors and nurses lots of questions before you agree to a line. Questions can include: Which vein will you use to put in the line? How will you clean the skin when the line goes in? What steps are you taking to lower the risk of infection?
- Make sure the doctors and nurses check the line every day for signs of infection. They should only replace the line when needed and not on a schedule.
Learn more about central line infections as they relate to the 100,000 Lives Campaign at www.ihi.org.
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