What is a Central Line?
A central venous catheter (or central line) is a catheter, or thin tube, that is placed into a patient’s large vein in the neck, chest, arm, or leg. The central line is often used to give critically ill patients the fluids, medications, and nutrients they need or to draw frequent blood samples. Central lines access a major vein near the heart and can be left in place for up to several months, if needed.*
*This differs from hospital to hospital and is decided based on each hospital’s protocol.
What Causes a CLABSI?
A CLABSI happens when bacteria or other germs enter the patient’s central line and get into the bloodstream, which can cause a serious infection. CLABSIs can be caused by many factors and can be prevented. Taking steps to maintain the cleanliness of a central line is critical, even steps as simple as practicing good hand hygiene.
Who is at Risk?
Although some patients are at higher risk for CLABSIs, any patient with a central line can develop an infection. CLABSIs tend to occur in patients receiving care in an intensive care unit (ICU), neonatal ICU (NICU), surgical ward, or specialty care area. These patients are usually at a higher risk due to the severity and complexity of their conditions.
How Can Hospitals Prevent CLABSIs?
Healthcare workers can prevent CLABSIs in several ways, starting with practicing good hand hygiene. Everyone who touches the central line for any reason needs to wash their hands with soap and water or an alcohol-based hand sanitizer. In addition, each time the central line is accessed, the cap being accessed (sometimes called “Scrub the Hub”) should be disinfected by the clinician.
The medical team inserting the lines should wear a mask, cap, and sterile gowns and gloves. The care team should make sure to fully cover the patient with a long sterile drape and use an antiseptic skin cleanser on the patient when the line is put in and when the dressing is changed.
How Can Patients Prevent CLABSIs?
After central line insertion, keep an eye on the dressing and the area around it. Don’t let the bandage or insertion site get loose, soiled, or wet, and don’t touch the central line and tubing. Make sure your care team is practicing good hand hygiene before touching the line, and the cap being accessed should be disinfected before any syringe or IV tubing is attached. Don’t be afraid to speak up if this is not being done.
If you have a fever, chills, or see that the area around your central line is sore or red, tell your medical team right away. Ask visitors to wash their hands before and after they visit, and make sure they don’t touch the central line or tubing.
If you or your loved one is getting ready for a hospital stay, research the hospital’s track record to learn about its CLABSI rate. Communicate expectations to the medical team.
If you have concerns, say so. Together, providers, patients, and families can help prevent CLABSIs, ensuring safer care and better outcomes.