SHEA, APIC Update CLABSI Guidelines
One goal is to revisit infection prevention at a critical moment
May 1, 2023
Two of the participating groups are the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America (SHEA). The latter is updating its compendium guidelines for preventing healthcare-associated infections, which first were published in 2008 and last updated in 2014.
The latest update is designed, in part, to reopen discussion at a pivotal moment when infection control practices need to be revisited and reinforced. Input was widespread, and the Infectious Diseases Society of America, the Joint Commission, and the American Hospital Association signed off on the document.
“The Compendium Expert Panel, made up of members with broad healthcare epidemiology and infection prevention expertise, reviewed the draft manuscript after consensus had been reached by writing panel members,” the guidelines state. “Following review and approval by the Expert Panel, the five partnering organizations, stakeholder organizations, and the Centers for Disease Control and Prevention reviewed the document.”
Other key points from the updated CLABSI guidance include:
- The subclavian vein now is considered the preferable site for central venous catheter insertion in intensive care patients to reduce infectious complications.
- Routine replacement of administration sets not used for blood, blood products, or lipid formulations can be performed at intervals of up to seven days. Previously, this interval was no longer than four days.
- Antimicrobial ointment for the catheter site, which is geared toward the population of hemodialysis patients, has been moved to “additional practices” given the focus on a specific population.
- Despite currently being supported by high-level evidence, antiseptic-containing caps remain an “additional practice” because they are not considered superior to manual disinfection, an essential practice.
- Previously considered an unresolved issue, the importance of infusion teams has been highlighted by listing it under “additional practices.”
REFERENCE
- Buetti N, Marschall J, Drees M, et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol 2022;43:553-569.
Chlorhexidine-containing dressings are now considered an “essential practice” for the prevention of central line-associated bloodstream infections in patients older than age 2 months, according to a consensus paper by five medical societies and associations.
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