The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) updated the Guidelines for the Prevention of Intravascular Catheter-Related Infections in late 2011. This resource is available as a PDF on the CDC website at http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf, It also will be published online in the March 30, 2012 advance access issue of Clinical Infectious Diseases and in an upcoming print supplement to the American Journal of Infection Control.
The updated recommendations replace previous guidelines published in 2002 by the CDC and were formulated by a working group led by the Society of Critical Care Medicine. In addition to the CDC and HICPAC, also collaborating on this project were the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, Surgical Infection Society, American College of Chest Physicians, American Thoracic Society, American Society of Critical Care Anesthesiologists, Infusion Nurses Society, Oncology Nursing Society, American Society for Parenteral and Enteral Nutrition, Society of Interventional Radiology, American Academy of Pediatrics, and Pediatric Infectious Diseases Society. These organizations are well respected, so clinicians can consider the updated Guidelines to be an authoritative resource.
The 83-page document is filled with evidence-based and best practice recommendations. Major areas of emphasis include 1) educating and training healthcare personnel who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a > 0.5% chlorhexidine skin preparation with alcohol for antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine impregnated sponge dressings if the rate of infection is not decreasing despite adherence to other strategies. The guidelines also emphasize performance improvement by implementing bundled strategies, and documenting and reporting rates of compliance with all components of the bundle as benchmarks for quality assurance and performance improvement.
All clinicians, regardless of their workplace, need to take a look at the revised guidelines for preventing IV catheter-related infection and compare the guidelines to their own practice and institutional policies. The updated guidelines are a fabulous, one-stop resource that clinicians everywhere should adopt and implement in practice.