Ask the Expert: Central Line-Associated Bloodstream Infection (CLABSI)

A Central Line-Associated Bloodstream Infection (CLABSI) poses significant risks to a patient’s health, making it essential to understand and implement effective prevention strategies.

In this Ask the Expert, we spoke to Medline Canada's Lia Anderson, a Clinical Specialist, RN and CVAA member, to explore best practices for creating and maintaining a safety culture in healthcare settings to mitigate these risks.

Q:What is a Central Line-Associated Bloodstream Infection (CLABSI)?

A central line-associated bloodstream infection (CLABSI) is a severe infection that occurs when bacteria or viruses enter the patient's central line and bloodstream. The mortality rate is relatively high, and the cost to treat is significant, adding additional strain to Canada's healthcare system. Creating and maintaining a culture of safety focuses on the prevention aspect of care rather than the treatment aspect.

Q: What are the common symptoms of CLABSI that healthcare professionals should be aware of?

Two categories of symptoms could be discussed: localized and systemic. A localized infection would occur when the catheter is inserted into the skin. This area needs to be monitored for symptoms such as pain or swelling. CLABSI, on the other hand, refers to a systemic infection that involves the whole body because the infection is in the bloodstream itself. The symptoms are very different, including fever, chills and lethargy. Sometimes, if the infection goes on long enough without treatment, it can present as an altered mental state of the patient. Monitoring the patient for early symptoms is essential.

Q: Can you explain the leading causes of CLABSI and the common symptoms that healthcare professionals should know?

For CLABSI to occur, the bacteria needs to enter the bloodstream. Infection prevention must be at the forefront of daily wound care; though a routine practice, the importance of sterile or aseptic techniques cannot be minimized.

Q: What are the best central line insertion and maintenance practices to prevent CLABSI and ensure patient safety?

So, with initial central line insertion, many aspects of the patient's care need to be considered to optimize its lifespan. Healthcare providers can reference the Canadian Vascular Access Association’s (CVAA) Guidelines, promoting best practices in the prevention of CLABSI. The insertion aspect includes aseptic technique, avoiding the contamination of microorganisms while inserting the ideal catheter in the optimal location. It's also essential to utilize the correct skin products to prepare and protect at the insertion site to minimize skin breakdown.

Q: How does effective CLABSI prevention impact patient outcomes and hospital performance?

CLABSI has a significant clinical impact on our healthcare providers and financial resources, including prolonged hospital stays that reduce bed availability. Prevention or early intervention not only lessens the risk of complications but also promotes a healthy environment. The strain on our healthcare resources is at an all-time high. Avoiding additional costs due to prolonged hospitalization benefits both financial and human resources.

Q: What learning education programs or resources does Medline provide to address CLABSI prevention?

Medline has several educational programs available to all healthcare facilities. Our Vascular Access Health Solutions program is a holistic solution to build CLABSI prevention awareness. Our team of clinicians look at the present processes within a facility to evaluate what is working and explore opportunities to improve. With an understanding of our customer’s goals, Medline will work with the facility to implement educational and training programs to provide best-practice guidance. 

Learn More:

To learn more about Medline's Vascular Access Health Solutions program, please visit medline.ca/en/vascular-access or speak to your Medline Clinical Support Clinician.