Central venous catheters, usually called CVCs, are extremely important for patients in any type of intensive care unit. It is because of their crucial role in the care of these patients that their troublesome risk of catheter-related bloodstream infections, sometimes referred to as CR-BSIs, has developed into such a problem. There are approximately 80,000 CR-BSIs diagnosed each year in the United States alone. These infections lead to nearly 28,000 patient deaths in intensive care units. Not only is this a dreadful loss of life; it is also incredibly expensive. Extra care and treatment for a patient suffering from a CR-BSI can cost an average of $45,000. In fact, these infections can cost as much as $2.3 billion for the United States each year (Pronovost et al., 2007). One reason CR-BSIs are having such a major effect in our intensive care units is that they affect patients of every age group. You can find patients suffering from a CR-BSI in absolutely any life stage, as they occur as early in life as the neonatal stage. Patients in the intensive care unit are extremely vulnerable to infection because of the weakened state of their immune systems while dealing with their current health problems.
Studies have shown that over half of catheter-related infections could be avoided. As they are slowly realizing that CR-BSIs have become a major issue in today’s health care system, health care providers are beginning to take steps to lower the risk of contracting them. The Center for Disease Control and the Agency for Healthcare Research and Quality have provided suggestions of ways to prevent CR-BSIs. One strongly recommended option is the use of maximal barrier precautions (Krein et al., 2005). These precautions, also known as maximal sterile barriers, require that the person inserting the CVC wear a head cap, face mask, sterile body gown, and sterile gloves. They also require the use of a full-size sterile drape around the insertion site. Previously, the only precautions taken when dealing with the insertion of CVCs were the use of sterile gloves and a small regional sterile drape. The maximal sterile barriers procedure is much more time consuming than the original method, so we must find how well these strict techniques work in comparison to previous techniques (Hu, Veenstra, Lipsky, & Saint, 2004). If there is little or no improvement, there would seem to be no reason behind spending the extra time and money on the maximal sterile barriers. There are four criteria for comparison that should play a large role in the decision between the two techniques: infection rates, cost effectiveness, likelihood of those implementing maximal sterile barriers also using other safety precautions, and survival rate and/or mortality rate.
The implementation of maximal sterile barriers to replace the older, more lenient techniques can significantly lower infection rates. The improved infection rates have been consistent for different age groups,...