News & Commentary

Anti-Infection Rules Ignored by Hospitals

More than half of clinicians do not follow the CDC’s recommendations for infection control while inserting arterial catheters (ACs) into ICU patients, according to a study in Critical Care Medicine. Researchers at Rhode Island Hospital found that 56% of 1,029 clinicians surveyed do not follow the federal agency’s guidelines, and that increases the risk of bloodstream infections.

Survey participants included physicians, nurse practitioners, physician assistants, nurses, and respiratory therapists. The precautions include the use of sterile gloves, a surgical cap, a surgical mask, and a small sterile drape.

Central venous catheters (CVC) have been a focus of infection control efforts in hospitals. “There is a growing body of evidence that ACs pose an infectious risk that is comparable to CVCs,” the study states.

CVCs are placed in large veins in the neck, chest or groin. ACs are thin and usually placed in arteries to help monitor blood pressure and get blood samples.

The CDC issued new intra­vascular catheter guidelines in 2011, and researchers note that “it is unknown whether critical care clinicians in the United States are aware of or in compliance with” those guidelines. The answers seem to be “maybe” and “no.”

“Clinicians significantly underestimated the infectious risk posed by arterial catheters, and support for mandatory use of full barrier precautions was low,” the study states.

The majority of respondents under­estimated the risk of infection associated with ACs by a factor of 10.

Just why that’s the case, however, is a bit of a mystery and “could not be determined from the data in this study.” Level of training did not seem to matter, either.

There were no differences between attending physicians, fellows, and the combined group, which consisted of nurse practitioners and physician assistants.

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