While Most Central Line Bloodstream Infections Decline, Kidney Dialysis Bucks The Trend

by U.S. Medicine

April 12, 2011

WASHINGTON, DC—With a decline in the number of central line associate bloodstream infections in intensive care units, the focus is turning to an area where such infections are burgeoning – kidney dialysis clinics.

bloodstream1.jpgThe CDC reported last month that there were 58% fewer central line associated bloodstream infections in 2009 than there were in 2001 in intensive care unit patients. This represents about 27,000 lives saved and about $1.8 billion in cumulative health care costs avoided, according to CDC Director Thomas R. Frieden, MD, MPH.

Still, the report found that about 60,000 bloodstream infections in patients with central lines occurred in non-ICU health care settings, such as hospital wards and kidney dialysis clinics. About 37,000 of these infections occurred in hemodialysis outpatients with central lines.

“We have a long way to go, especially in hemodialysis,” said Frieden. “The number of patients on dialysis is expected to double in the next 10 years as more people with diabetes develop renal failure, and it’s more important we make it safer.”

Frieden emphasized that it is important for providers to only use central lines and similar devices when essential. “If patients begin the planning process early as their kidney failure gradually goes downhill, it’s possible to start dialysis without using a central line,” he said. “In many parts of the world, that’s the norm. But in the U.S., unfortunately, that’s the exception.”

Regional and statewide projects, such as the Pittsburgh Regional Healthcare Initiative and the Michigan Keystone Project, have demonstrated roughly 70% reductions in rates of these infections in intensive-care units, the report stated.

MTFs adhere to the Institute for Healthcare Improvement’s Central Line bundles for the prevention of central line infections. MTFs are accredited by The Joint Commission (TJC) and according to MHS officials are in full compliance with TJC’s National Patient Safety Goal #7 that relates to the necessary implementation of best practices or evidence-based guidelines to prevent infection for short- and long-term central venous catheters (CVC) and peripherally inserted central catheter (PICC) lines.

HHS has set a national goal for a 50% reduction in central line associated bloodstream infections by 2013. CDC monitors progress in reducing these infections through the National Healthcare Safety Network.

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