Running Head: CLABSI PREVENTION

CLABSI Prevention
Tyler Nickels
Ferris Sate University

CLABSI PREVENTION

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Abstract

This paper is about the proper care for central lines and how to prevent central lineassociated blood stream infections (CLABSI). The risk for infection while having a
central line is great if care is not properly done. The technique to provide care is
explained along with other factors that help to limit the occurrences of CLABSI. Central
line infections relate to Jean Watsons Nursing Theory. Knowing how to care for central
line will establish better quality of care for nurses and improve patient safety.

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CLABSI Prevention

CLABSI are among the most deadly of heathcare-associated infections (HIAs),

resulting in a mortality of 12% to 15% (Dumont, 2012). It is scary to think as many
patients in the hospitals have central lines. Preventing CLABSI is crucial for patients with
central lines. It starts with the nurse and their education of how to prevent central line
infections. Most hospitals have their own policy of how to properly care for a patient with
central line. Implementing proper education is what prevents central line infections and
will reduce the amount of nuisance for the hospital and patient. Dumont states that, the
average cost per case is upwards of $26,000 (2012). The hospital then pays for the
infection services, as it was acquired while staying in the hospital.
Policies and Procedures
There are many policies and recommendations set in place to prevent any
infection development while having a central line. The CDC recommends these laws,
leading to the hospital developing policies for appropriate care of central lines, and this is
monitored by the Joint Commission (Dumont, 2012). In 2009, The University of
Maryland Medical Center (UMMC) developed the White Paper to help prevent CLABSI.
The White Paper emphasized best practices aimed at reducing CLABSI
and included the following: practicing appropriate hand hygiene, use of
chlorhexidine for skin antisepsis, use of maximal sterile barrier
precautions during insertion, avoidance of the femoral vein as an
access site, and prompt removal of unnecessary catheters. A checklist
was required for all central line insertions in the ICU (Thom, 2013).
This White Paper stems off what the Institution for Healthcare

CLABSI PREVENTION

Improvement (IHI) developed in 2005, called a bundle approach

(Dumont, 2012). Some of the steps in proper care of central lines are
what nursing students have learned in dressing a central line site. The
procedure includes having the patients head turned the opposite
direction, having both, the patient and nurse wear a mask, along with
aseptic technique throughout (Lynn, 2011, pg. 813-815). Since these
changes in care for central lines were established the number of
incidents of CLABSI in the intensive care unit (ICU) have been reduced
from an estimated 43,000 in 2001 to 18,000 in 2009- a 58% reduction.
The CDC estimates that this reduction represents 3,000 to 6,000 lives
saved (Dumont, 2012). These values were gathered from ICU settings
of hospitals, where majority of central lines are in place. It is very
exciting to see that the numbers have improved over the years.
Ideally, it would be great to see zero CLABSIs reported, but it is still
optimistic to see how the reduction has progressed. For nurses and
hospitals, it is important to keep any caregivers updated on education
for prevention of CLABSI. Doing this does not just save the hospital
money from required additional care toward the patient, but also
saving lives and improving quality of nursing care.
Nursing Theory
Preventing CLABSIs follows that of Jean Watsons Nursing Theory.
In 1979 Jean Watson developed her central theme, nursing is
concerned with promoting and restoring health, preventing illness, and

CLABSI PREVENTION

caring for the sick (Taylor, 2011, p.75). Watsons theory directly
relates to CLABSI prevention regarding to preventing illness. Causing
an infection to a patient can lead to many types of illnesses, possibly
death. When a patient becomes septic, it can be hard to predetermine,
making it difficult to treat. Thus, emphasizing the severity CLABSI can
cause to someone. In applying Jean Watsons theory to clinical
practice, clinical nursing care is holistic to promote humanism, health,
and quality of living. Caring is universal and is practiced through
interpersonal relationships (Taylor, 2011, pg. 75). To promote health
and quality of life to the patient, as Jean Watsons theory in clinical
setting states, is imperative for the nurse to know how to properly care
for central lines. Knowledge deficit is a major concern in nursing and
can have a significant impact on the patient.
Conclusion
Preventing CLABSIs is a very important role for a nurse caring
for patients who have central lines. It can truly be a life or death
determining factor. It starts with the proper education of the nurse and
the hospital assuring education is up to date for nurses. With the help
of IHI developing a guideline of recommendations for central line
placement and care, it reduced the number of reported CLABSIs. It has
helped to improve patient safety as well as providing better nursing
care.

CLABSI PREVENTION

References
Dumont, C., Nesselrodt, D. (2012). Preventing central-line associated
bloodstream infections CLABSI. Nursing, 42(6), 41-46. Lippincott
Williams & Wilkins, Inc. doi: 10.1097/01.nurse.0000414623.31647.f5
Lynn, P. (2011). Taylors Clinical Nursing Skills: A Nursing Process Approach (3rd ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of
nursing: The art and science of nursing care (7th ed.). Philadelphia,
PA: Lippincott Williams & Wilkins.
Thom, K., Li, S., Custer, M., Preas, M., Rew, C., Cafeo, C., Leekha, S.,
Caffo, B., Scalea, T., Lissauer, E. (2013). Successful
implementation of a unit-based quality nurse to reduce central

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line-associated bloodstream infections. American Journal of

Infection Control, 42(2), 139-143. doi:10.1016/j.ajic.2013.08.006

APA Rubric (150 Points)

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Peer Review Checklist

Submits peer review checklist and signature

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Proper APA format: Title page, Typeface, Running head &

page numbers, Margins, Indents, & Spacing, Headings,
Abbreviations
Subject matter and Body of Paper
Evidence of scholarly writing and research. Paper is written
concisely and coherently. Critical thinking is evident. Key
elements of assignments covered
Content is comprehensive/accurate/persuasive
Displays an understanding of relevant theory
Major points supported by specific details/examples
Research is adequate/timely

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Nursing Theory
Addresses, defines and relates at least one pertinent Nursing
Theory to the safety/quality topic of the paper
Writer compares/contrasts/integrates theory/subject matter with
work environment/experience
At an appropriate level, the writer analyzes and synthesizes
theory/practice to develop new ideas and ways of
conceptualizing and performing

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In text Citations and Quotes

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References (minimum of 3 appropriate APA scholarly

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Reference page cited in proper APA format

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139