Infection Control Today

MAY 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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" Surveillance for peripheral devices has been part of the INS standards for years but has not yet become a standard component of infection prevention team ef orts. 14 ICT May 2019 F or 25 years, I have been in infection prevention and watched our fi eld grow and shift into so much more than it was when I fi rst started. My passion is at the intersection of hospital epidemiology, vascular access and patient safety. I have been fortunate, throughout my career, to create a program that allows me to explore the impact on our patients and strive to see those focuses align. I have studied, published, presented and mentored to ensure every patient who entrusts us with their care has all of their invasive vascular access devices treated with the respect they deserve – knowing that any line can truly be our patient's life line. This year has already been a monumental step forward in raising awareness. International tennis phenomenon Andy Murray shared a photo of himself with his peripheral IV device post operatively and it raised a tremendous amount of questions. The Association for Vascular Access (AVA) came across this social media post and used it as a teaching tool – annotating the photo to point out aspects that may have been out of alignment with what we would expect to see in our hospitals ( asp?page=AndyMurray). It was followed by a podcast with an international panel discussing the potential to do better with our peripheral vascular access devices around the globe. This sparked a spirited conversation about differences in practice, assessing competency and ensuring programs have plans for measuring performance on all vascular access devices. Ramzy Nasrallah, CEO of the Association for Vascular Access (AVA) and AVA Foundation, explains it this way: "When we annotated the Andy Murray Instagram photo, where he had what appeared to be two PIVCs in the same vein covered by non-occlusive dressings on a hairy arm that should have been clipped, the overwhelming defense from anesthesiologists was, 'But we always do it this way.' And the overwhelming reply from nurses involved in the care and maintenance of those devices was, 'Yes, we know.'" That is not the only "big news." Every year, ECRI Institute publishes a Top 10 Patient Safety Concerns list ( As a patient safety organization, it reviews the available data and consults with a broad group of experts when formulating the list. It is a document that can start conversations within our leadership teams and help increase focus on risk reduction opportunities that may not be receiving the necessary level of attention. For 2019, one of the items that made the list is bloodstream infections from peripherally inserted IV lines. They are not referring to PICCs (peripherally inserted central catheters) with that statement, they are talking about the ubiquitous short peripheral catheters that almost every patient receives as part of their care. My organization has proactively followed these infections as well as monitored process measures (dressing integrity, CHG sponge usage, administration set management, alcohol impregnated caps, site selection, etc. as well as hand hygiene and overall device utilization) for years, but we will still be using this publication to reinforce all the efforts to continually improve outcomes with every invasive device used for patient care. If you have not already seen the executive summary, it can be a great tool for expanding conversations with patient safety and the executive team. For surveillance, many programs have not yet expanded their scope to include outcome (or process) data beyond central line associated bloodstream infections (CLABSI). Surveillance for peripheral devices has been part of the INS standards for years but has not yet become a standard component of infection prevention team efforts. 1 There is signifi cant optimism that may soon change. Earlier this year, the Centers for Disease Control and Prevention (CDC) issued a call for comments on a proposal to potentially expand National Healthcare Safety Network (NHSN) surveillance protocols to include all hospital onset bacteremia ( Are We There Yet? More Than Just Central Lines By Michelle DeVries, MPH, CIC, VA-BC feature

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