Central Line Associated Bloodstream Infection (CLABSI)

Vascular Access

Inserting a central line is a common procedure performed at UPMC Children's Hospital of Pittsburgh

A central line, or catheter, is a temporary intravenous (IV) line inserted into a vein to provide medication, fluids, nutrients, or even to take blood samples. It is often used to avoid multiple needle sticks, preserve veins, and for more stable long-term access. The nursing staff is educated on the latest techniques and care of IV lines, reducing potential complications. Whether for medical purposes or for treatment, our nurses and staff are committed to excellent central line care.

A central line is a long, flexible catheter used to deliver fluids or medications over a prolonged length of time, usually several weeks or more. These catheters are often placed in the arm, leg, neck, or chest. A catheter is placed through the skin and into a large vein, and then leads into a larger vein terminating near the heart.

Caring for Your Child’s Central Line

Our physicians, staff, and vascular access nurses educate parents and patients about caring for the IV line and how to avoid infections or complications, while in the home setting. While in the hospital, the bedside nurses or vascular access team, will perform this care. 

Central Line Associated Bloodstream Infection (CLABSI)

What is a central line-associated bloodstream infection?

A central line-associated bloodstream infection, or CLABSI, is presence of bacteria in the bloodstream that may have been introduced through a central line device. It is diagnosed by sending a sample of the patient’s blood to the Microbiology Laboratory to be cultured. Symptoms of a CLABSI include fever (or low body temperature for small infants).

How does a CLABSI happen?

A bloodstream infection can occur when bacteria is introduced in the blood via the central line. 

How often are central line infections reported at Children’s?

In 2018, we reported one central line infection for every 614 days that patients have a central line in our hospital.

How do we prevent CLABSIs at Children’s Hospital?

Here at UPMC Children's Hospital of Pittsburgh, we take precautions when inserting and caring for the line: 

Insertion

  • We take the maximum sterile barrier precautions. This means that staff will wear a sterile gown and gloves, and a cap and mask as they would in an operating room.
  • We have Vascular Access nurses, ICU physicians, surgeons, advanced practice providers, and interventional radiologist are all specially trained with the most current insertion practices
  • We thoroughly clean the insertion site with chlorhexidine (CHG) or povidone- iodine/ 70% isopropyl alcohol solution
  • We use sterile, prepackaged insertion trays that have all of the supplies that are needed.

Care and Maintenance

  • We change dressings every 7 days unless and when it is soiled, wet, or non-occlusive (loose) and every 2 days if there is gauze over the insertion site.
  • Every day, we discuss whether the central line is necessary. If it is no longer needed, we will remove it to decrease the chance of infection.
  • We scrub all access ports with an alcohol swab for at least 15 seconds and allow to dry for 3-5 seconds before injecting medications or flushing.
  • We change the medication tubing according to evidence-based practice in relation to what type of medication is going through the line.
  • We change the end injection caps according to evidence-based practice.
  • Additionally, we use a chlorhexidine (CHG) disc that is applied to the insertion site unless contraindicated.
  • We have also implemented alcohol caps on the ends of our line and on all open ports to reduce exposure of contaminates.
  • We require daily linen changes unless otherwise contraindicated.
  • We require daily bathing with soap and water or chlorhexidine (CHG) wipes. The CHG wipes are the preferred method to prevent infections.