Intravenous literature: Zingg, W., Walder, B. and Pittet, D. (2011) Prevention of catheter-related infection: toward zero risk? Current Opinion in Infectious Diseases. 24(4), p.377-84.
PURPOSE OF REVIEW: This review identifies important findings in the recent literature related to the prevention of central line-associated bloodstream infection (CLABSI).
RECENT FINDINGS: CLABSI rates obtained through surveillance programs have decreased in recent years. Reasons for this are multifactorial: bundle interventions for practice change; technology; and pressure from benchmarking and public reporting. Many studies on the successful use of bundle strategies have been published in the past 2 years, whereas technology has somewhat disappeared from the literature. Success stories made CLABSI prevention the example of healthcare-associated infection prevention. The overwhelming success of practice change together with emerging public awareness confronts hospitals with serious implementation challenges. Fortunately, a number of implementation guidance articles were published recently, which allow hospitals to detect and overcome implementation barriers.
SUMMARY: The efforts made for CLABSI prevention exemplify not only the complexity of the problem but also the creativity and – most recently – success. Although ‘zero’ risk may not seem a realistic goal, the number of hospitals approaching this idealistic threshold is growing. The evidence is now clear that CLABSI can be reduced most effectively by ‘state-of-the-art’ insertion technique and catheter care. The question today is not ‘what to do’ but ‘how to do it’.