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Hi All,
Here is an updated recommendation from the CDC on the use of CHG-Impregnated Dressings for Prevention of Intravascular Catheter-Related Infections.https://www.cdc.gov/infectioncontrol/guidelines/pdf/guidelines/c-i-dressings.pdf
Timothy R. Spencer, DipAppSc, BHSc, ICCert, RN, APRN, VA-BC
Global Vascular Access, LLC
E: tim.spencer68@icloud.com
M: +1 (623) 326 8889 (USA)
M: +61 409 463 428 (AU)
http://www.vascularaccess.com.au
http://orcid.org/0000-0002-3128-2034Sent from my iPhone
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Tim
Thats an interesting development from the CDC whereby they are now recommending the use of CHG-impregnated dressing (FDA-cleared) for short-term, non-tunnelled CVCs. Its an upgrade from their previous recommendation where those dressings were only recommended when the institutional CVC-related BSI rate was high.
I am curious at and when other US organisation like SHEA, APIC and INS will revise their positions.
Hopefully in the current review of the Australian NHMRC IC Guidelines the committee responsible for the review will follow this update.
As you know in Australia it is difficult to get a true sense of prospective CVC-related or even short term peripheral IV-related BSI given that the data is not available in the public domain. S. aureus BSI is sometimes used as a proxy measure however given the increasing pay for performance adoption in Australia I suspect Australian hospitals will now be looking for every additional measure to reduce CLABSI and vascular device-related BSI.
The estimated rates that any point prevalence survey will deduce will be difficult to validate and generalize especially when the sample size of next years national point prevalence surveys which will be collected from 20 public hospitals classified as either Principal Referral or Group A hospitals will be a gross underestimation of the true extent of the CLABSI burden.
Its such an important aspect of our work and that of the AVAS group I hope we can continue to respond appropriately to the problem. Part of that response should be careful consideration of new technologies and approaches to care.
Yours sincerely
Cath
Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.auFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
Sent: Monday, 13 November 2017 16:52
To: AICALIST@AICALIST.ORG.AU
Subject: Updated Recommendations on the Use of Chlorhexidine-Impregnated Dressings for Prevention of Intravascular Catheter-Related InfectionsHi All,
Here is an updated recommendation from the CDC on the use of CHG-Impregnated Dressings for Prevention of Intravascular Catheter-Related Infections.https://www.cdc.gov/infectioncontrol/guidelines/pdf/guidelines/c-i-dressings.pdf
Timothy R. Spencer, DipAppSc, BHSc, ICCert, RN, APRN, VA-BC
Global Vascular Access, LLC
M: +1 (623) 326 8889 (USA)
M: +61 409 463 428 (AU)
http://www.vascularaccess.com.au
http://orcid.org/0000-0002-3128-2034
Sent from my iPhone
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Thanks Tim
Having a quick look at the recommendations it covers central lines. In NSW the CEC CLABSI project (aseptic insertion, patient preparation, physician preparation etc) reduce CLABSI to close to zero and the probability of a central line associated BSI when the CLABSI insertion protocol is adhered to remains close to zero for the first 10 days after insertion without CHG-Impregnated Dressing. Thereafter it increase exponentially. This CEC lead project was rolled out to all ICUs by ANZICS and the last time I looked the ANZICS CLABSI data since the roll-out the average infection rate for ANZICS contributors is 0.44/ 1000 line-days. However, this aggregated rate hides an even more success story as this rate includes short and long dwell times each with different probabilities for infection. Our CEC project identified 75% of ICU patients have a LOS less than the 10 days (where the probability increases) and the minority of patients with a long stay actually contribute the majority of infections to a rate. The rate should be separated at 1-10 and >10 dwell days. So for central lines an additional infection prevention intervention such as CHG-impregnated dressing may not be cost effective for the majority of ICU patients with a short dwell time. Heres the rub who will have their central line in for more than 10 days if you can predict this then this the group who will benefit from such an intervention in ICU. Otherwise, giving it to 100% of ICU patients with a central line may not result in the best outcome according to cost-benefit.M-L
Professor Mary-Louise McLaws
Deputy President Academic Board
Professor of Epidemiology Healthcare Infection and Infectious Diseases Control
UNSW Global Water Institute lead for Water and Health
http://research.unsw.edu.au/people/professor-marylouise-mclaws
School of Public Health and Community Medicine/UNSW Medicine
UNSW SYDNEY NSW 2052 AUSTRALIA
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[cid:image001.png@01D2758A.1DD460C0]From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
Sent: Monday, 13 November 2017 5:52 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Updated Recommendations on the Use of Chlorhexidine-Impregnated Dressings for Prevention of Intravascular Catheter-Related InfectionsHi All,
Here is an updated recommendation from the CDC on the use of CHG-Impregnated Dressings for Prevention of Intravascular Catheter-Related Infections.https://www.cdc.gov/infectioncontrol/guidelines/pdf/guidelines/c-i-dressings.pdf
Timothy R. Spencer, DipAppSc, BHSc, ICCert, RN, APRN, VA-BC
Global Vascular Access, LLC
M: +1 (623) 326 8889 (USA)
M: +61 409 463 428 (AU)
http://www.vascularaccess.com.au
http://orcid.org/0000-0002-3128-2034
Sent from my iPhone
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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