In a prior question to the list serve about sending catheter tips for culture, it was suggested that catheter tips should not be cultured because of contamination with removal or that the biofilm is in the intraluminal portion of the catheter.
The new guidelines suggest that it should be done. Is this to be the new standard?
http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=15033
I think there is confusion among many people about the differences between central line associated BSI (CLABSI) and catheter related BSI (CRBSI). CLABSI is a surveillance definition for data collection, tracking and trending. It can allow overestimates of the actual number of infections and culturing the catheter is not recommended. CRBSI is a clinical definition used for diagnosis and treatment of the patient and blood cultures from the catheter and peripheral veins and catheter cultures if the catheter is removed are methods used to confirm the diagnosis. So 2 different processes for 2 different purposes. The guidlines you found are for diagnosis and treatment of CRBSI. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn said it very well and the hospitals reporting CLA-BSI are doing themselves a injury in a public reporting community as they are reporting infections that may not be infections
Catheter tip culturing is useless as organisms such as the staph skin contaminants re-grow back immediately on the skin and in the layers of the skin. Therefore when you pull the tip you should not be surprised to culture staph even in a catheter that is not infected
I have no idea why hospitals insist on reporting CLA-BSI which is not even accurrate
Kathy Kokotis RN BS MBA
Bard Access Systems
Healthcare organizations that participate in the CDC's National Healthcare Safety Network (this replaced the old NNIS system) are required to report CLABSI according to their surveillance definitions. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861