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| ==Central Line Related Blood Stream Infection (CLR-BSI)== | | {{PreICD10 dx |
| | | NewDxArticle = Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) |
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| | {{DX tag |Infection | Medical Problem| Central Line Related Blood stream Infections | See: [[UPL]] (Universal Pathogen List) | 8600 - Central Line Related Blood stream Infections | No | 0 | '''''Critical Care and Medicine''''' |Currently Collected | Code added Jan 1996|}} |
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| '''The Case for Preventing Central Venous Catheter related Bloodstream Infections.'''
| | == Criteria == |
| *●Central Venous Catheters (CVCs) are being used increasingly in the inpatient and outpatient setting to provide long-term venous access. CVCs disrupt the integrity of the skin, making infection with bacteria and/or fungi possible. Infection may spread to the bloodstream and hemodynamic changes and organ dysfunction (severe sepsis) may ensue, possibly leading to death. Approximately 90% of the catheter-related bloodstream infections (CR-BSIs) occur with CVC.
| | Have been moved to [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)]] in prep for ICD10, please see there. |
| *● Forty-eight percent of intensive care unit (ICU) patients in the U.S. have central venous catheters, accounting for 15 million central-venous-catheter-days per year in U.S.-based ICUs. Studies of catheter-related bloodstream infections that control for the underlying severity of illness suggest that mortality attributable to these infections is between 4% and 20%. Thus, it is estimated that 500 to 4000 U.S. patients die annually due to bloodstream infections.
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| *●In addition, nosocomial bloodstream infections prolong hospitalization by a mean of 7 days.Attributable cost per bloodstream infection is estimated to be between US $3,700 and $29,000. There are no equivalent Canadian figures for burden of illness. (as per literature).
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| *'''Purpose'''
| | == Related Articles == |
| **To identify the incidence of Central Venous Line Related Infections within the WRHA ICU's.
| | {{Related Articles}} |
| **The monitoring of the incidence over time will identify the magnitude of the problem within a specific area or unit and will enable comparisons between selected ICU's across Canada (Canadian Collaborative - Safer Health Care Now).
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| **This should lead to the review of practices occuring at the time of insertion as well as the care processes relating to the maintenance of the catheter dressings.
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| *'''GOAL'''
| | [[Category: Central lines (old)]] |
| **Eliminate this preventable patient harm.
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| *'''Criteria'''
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| Laboratory confirmed bloodstream infection must meet at least '''one''' of the following criteria and have occurred in the ICU or within 48 hours of leaving the ICU:
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| **'''Criterion 1:'''
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| Patient has a recognized pathogen cultured from '''one or more''' blood cultures and the organism cultured from '''blood is not related''' to an '''infection at another site'''.
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| **'''Criterion 2:'''
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| Patient has at least '''one''' of the following signs or symptoms:
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| *fever (>38 C)
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| '''OR'''
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| *chills
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| '''OR'''
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| *hypotension
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| '''OR'''
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| *Signs of infection of catheter insertion site/tunnel
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| '''PLUS'''
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| *at least one of the following (A or B) below:
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| a.) Common skin commensal (comtaminant) is cultured from '''two or more''' blood cultures drawn on separate occasions. (e.g. diphtheriods, Bacillus sp., Propionibacterium sp., coagulase-negative staphylococci, or micrococci).
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| '''OR'''
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| b.) Common skin commensal (comtaminant) is cultured from at least '''one''' blood cultures from a patient with an intravascular line. (e.g. diphtheriods, Bacillus sp., Propionibacterium sp., coagulase-negative staphylococci, or micrococci).
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| '''AND'''
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| physician institutes appropriate antimicrobial therapy.
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| {{Discussion}}
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| #need to attached or link the rest of the teaching package for this project. [[User:TOstryzniuk|TOstryzniuk]] 18:48, 2 July 2008 (CDT)
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| [[User:TOstryzniuk|TOstryzniuk]] 19:42, 26 June 2008 (CDT)
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| [[Category: Data Collection Guide]]
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| [[Category: Diagnosis Coding]]
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| [[Category: Questions]]
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