Intravenous news: Twelve infection preventionists who have improved the health and well-being of patients, healthcare workers, and the public will be honored as Heroes of Infection Prevention by the Association for Professionals in Infection Control and Epidemiology (APIC).

Since 2005, when the Heroes of Infection Prevention program was introduced, APIC has recognized more than 60 members and groups for their exceptional work in the infection prevention field. In addition to recognizing the outstanding work of 12 infection preventionists, APIC will select a Heroes Implementation Research Scholar to identify the five most successful infection prevention programs of the last six years. The scholar will visit the selected facilities, interview staff, summarize findings, and share these success stories with the broader U.S. and international healthcare community.

“Our goal is to improve patient outcomes by advocating for the adoption of best practices in infection prevention,” said Michelle Farber, RN, CIC, APIC 2012 president. “This year’s initiative provides the opportunity to highlight outstanding work by infection preventionists who have been recognized for their dedication to patient safety so that best practices can be replicated in more healthcare settings.”

The deadline for nominations is February 15, 2012.

Click here for the nomination form.

Intravenous products:  PR-USA.net report “Medical Device Development Group, specialists in the commercialization of medical devices, has announced a joint venture with Moffitt Cancer Center. The new organization, called Tampa Medical Innovations (TaMI), will commercialize medical device inventions envisioned by the Moffitt medical team.

The lead product is an IV closure system designed to eliminate blood loss during IV insertion and reduce the potential for blood-borne pathogen exposure. “The process of connecting intravenous fluid tubing to a catheter that has been inserted into a vein basically requires three hands,” explained Tariq Chaudhry, M.D., the inventive anesthesiologist at Moffitt. “The Stat-Clip system is a break-through technology that solves a long-standing issue in the practice of IV therapy by eliminating blood exposure between establishment of patency and connection of the IV line.”

There are approximately 176 million IV procedures performed annually in the United States, and each has the potential for cross contamination and blood-borne pathogen exposure, two key sources for infection.

“We are delighted to join with Medical Device Development Group to bring important new inventions to market,” said Haskell Adler, PhD, MBA, Senior Licensing Manager at Moffitt. “We believe that this venture is the best way to accelerate commercialization and get these innovations into routine use worldwide.”

“Some of the best innovations come from doctors and nurses whose daily patient care leads them to see a need and find a solution,” said Bill Knab, CEO of TaMI. “Our goal with TaMI is to transform these inventions into products that will improve patient care and simplify medical procedures.”

TaMI is currently seeking first-round funding to accelerate the development of the Stat-Clip system as well as other medical innovations from Moffitt.”

Click here for the full press release.

Intravenous news: Another three intravenous policy links have been recommended by visitors to the IV policy website. The new guidelines are:

• Position statement: Use of safety devices and sharps injury prevention
• Strategies to prevent Central Line–Associated Bloodstream Infections in acute care hospitals
• Guidelines for the prevention of intravascular catheter–related infections
• Safe injection, infusion, and medication vial practices in health care
• Guide to the elimination of Catheter-Related Bloodstream Infections

Intravenous news: Twelve new links to a variety of infusion therapy and vascular access guidelines have been added to the IVpolicy website. The new guidelines are:

• The use of Seldinger or Modified Seldinger Technique, in combination with real-time imaging modalities for Peripherally Inserted Central Catheter and Midline placements by clinicians.
• The use of ultrasound guidance by Registered Nurses for central venous catheter insertion.
• Preservation of peripheral veins in patients with chronic kidney disease.
• Cannulation of the internal and external jugular veins by Registered Nurses and other qualified healthcare professionals.
• Vascular Access Society guidelines.
• Peripheral intravenous cannulation learning programme handbook.
• Venepuncture learning programme handbook.
• Policy and guideline for Nurses and Midwives undertaking cannulation in children.
• Policy and guideline for Nurses and Midwives undertaking venepuncture in children.
• Policy and guideline for Nurses and Midwives undertaking cannulation in adults.
• Policy and guideline for Nurses and Midwives undertaking venepuncture in adults.
• Guiding framework for education, training and competence validation in venepuncture and cannulation.

Visit www.ivpolicy.com for links to the full guidelines.

Intravenous products: Nurses and physicians with an interest in IV management can now keep their knowledge up to date by following a new Facebook page for 3M™ Tegaderm™ IV Solutions. With news and information about events, clinical papers, product innovations and best practice from across Europe, this fan page is a must for healthcare professionals working in infection prevention, vascular access and IV management.

Visit www.ivdressing.com for the full press release.

Intravenous literature: Reyes, J.A., Habash, M.L. and Taylor, R.P. (2012) Femoral central venous catheters are not associated with higher rates of infection in the pediatric critical care population. AJIC: American Journal of Infection Control. 40(1), p.43-47.

Abstract:

Background: Adult data show a difference in central venous catheter (CVC) infection rates between 3 major sites: subclavian (SC), internal jugular (IJ), and femoral veins. We hypothesized that in patients in pediatric intensive care units (PICUs), there is no difference in rates of CVC infection among these three sites, but specifically the femoral compared to all other sites.

Methods: In this retrospective cohort study, data from January 1999 to January 2008 were collected prospectively for internal review and quality assurance. All PICU patients with a CVC were enrolled. The rate of CVC infection was determined using Cox regression survival analysis to account for various durations of CVC placement at the various sites, then adjusted for severity of illness, number of lumens, and patient age. Mortality was compared in patients with a CVC infection versus those without.

Results: A total of 4,512 patients with a CVC were enrolled. No site was associated with an increased risk of infection compared with the other sites, with hazard ratios of 0.951 (95% confidence interval [CI], 0.612-1.478) for the SC site, 0.956 (95% CI, 0.593-1.541) for the IJ site, and 1.120 (95% CI, 0.753-1.665) for the femoral site. No significant association between mortality and presence of CVC infection was found when adjusted for age, severity of illness, and duration of CVC placement. An association was found between the presence of a CVC infection and prolonged PICU length of stay (3.98 days longer; P < .001).

Conclusion: Femoral CVCs are not associated with higher rates of infection in the PICU. In addition, the presence of CVC infection does not affect mortality, but is associated with longer PICU admission.

Intravenous literature: Jett, G.A. (2012) A call for consideration of needlestick injury data in evaluating staffing effectiveness. AJIC: American Journal of Infection Control. 40(1), p.81.

Extract:

“Dr Larson, I applaud the effort to promote improved understanding of contributing factors to occupational injuries and bloodborne pathogen exposures that Patrician, Prior, Fridman, and Loan discussed in their June 2011 article. As the authors posit, the impact of staffing on the prevalence of needlesticks and other injuries among nurses has received limited attention to date. In my experience in occupational health nursing and infection prevention, the primary targets of needlestick injury follow-up investigations are typically individual behavioral factors and the use of engineered safety devices. This approach is an appropriate initial step but fails to determine potential root causes for the injury event. Other research has demonstrated scheduling and work factors such as extended-hour shifts, sequential shifts with inadequate time away from work, and night or weekend shifts to significantly increase the risk of needlestick injuries. We must place significantly greater attention on the multifactorial contributors to needlestick injuries. This includes consideration of workforce injuries and exposure event data in evaluating staffing effectiveness in health care organizations. Infection preventionists, occupational health nurses, and health care leaders should incorporate nursing workload indicators into their analysis of injury data to better understand and decrease the prevalence of needlestick injuries.”

Intravenous literature: Patrician, P.A., Pryor, E., Fridman, M. and Loan, L. (2012) Response to “A call for consideration of needlestick injury data in evaluating staffing effectiveness”. AJIC: American Journal of Infection Control. 40(1), p.81.

Extract:

“Mr Jett, my coauthors and I thank you for your thoughtful letter concerning our June 2011 paper on the association of needlestick injuries among inpatient staff nurses and nurse staffing. We particularly applaud your regard for the multifactorial nature of needlestick injuries. Despite advances in needleless devices, needlestick injuries continue to occur, and, as our data show, contaminated needles are still a serious threat to the occupational safety of nursing personnel, not to mention others who work in hospitals (eg, housekeeping staff) whom we did not study. Just as with the patient safety movement, we need to seriously consider not only the actions of the individual nurses but the systems in which they provide nursing care, or the context of their respective work environments, if we are to better understand the multifactorial nature of such adverse events.”

Intravenous literature: Safdar, N., Mittelstadt, K., Jacobs, E.A. and Gaines, M.E. (2012) Patient awareness of the risks of central venous catheters in the outpatient setting. AJIC: American Journal of Infection Control. 40(1), p.87-88.

Extract:

“Bloodstream infection remains the most common life-threatening complication of central venous access. Central venous catheters (CVCs) are the most frequent cause of nosocomial bloodstream infection with 250,000 to 500,000 episodes occurring in the United States annually. In the last several years, widespread implementation of evidence-based interventions to prevent central line-associated bloodstream infection (CLABSI) in the intensive care unit has been undertaken with commensurate reduction in CLABSI rates. Nonetheless, CLABSI remains one of the most important life-threatening complications of central venous access. Patient education regarding CVC insertion and risk of CLABSI has been recommended, as outlined in the 2011 Patient Safety goals from the Joint Commission. However, data on patient education regarding CLABSI are scant. We undertook a survey to assess patients’ awareness of the risk and consequences of CLABSI at the University of Wisconsin hospital, a 592-bed acute care tertiary referral hospital.”

Intravenous literature: Rotz, S. and Sopirala, M.M. (2012) Assessment beyond central line bundle: Audits for line necessity in infected central lines in a surgical intensive care unit. AJIC: American Journal of Infection Control. 40(1), p.88-89.

Extract:

“Central line-associated bloodstream infection (CLABSI) is a major health care burden in the intensive care unit (ICU) setting. Many risk factors associated with central lines have been studied with mixed results. Although it has long been accepted that increased duration of a central line leads to higher infection rates, little attention beyond central line bundle is paid to the factors contributing to CLABSI development. Recently, more attention has focused on reminding staff to remove lines that are not medically necessary using a daily goals checklist. Audits of line necessity with feedback to staff may have a desirable impact on staff behavior but are not routinely performed. We performed a retrospective audit of patients with CLABSI in a surgical ICU at a large academic teaching center to assess the burden of infected lines that were left in longer than medically necessary. To determine medical necessity, we established criteria for conditions requiring a central line as follows: irritant and vesicant medication use, total parenteral nutrition administration, dialysis, and hemodynamic instability (defined as use of a vasopressor or inotrope, mean arterial pressure < 60 or heart rate > 100). If no documented indication could be found in the paper or electronic medical record for greater than 48 hours, it was assumed that the line was unnecessary.”