LOVELY PROFESSIONAL UNIVERSITY

DEPARTMENT OF MANAGEMENT

A STUDY ON CENTRAL LINE ASSOCIATED BLOODSTREAM

INFECTIONS SPECIFICALLY RELATED TO CENTRAL
VENOUS CATHETERS, THEIR DRESSINGS, PERIPHERAL
VENOUS CANNULATION AND COLLECTION OF BLOOD
SAMPLES.

Submitted to Lovely Professional University

In partial fulfillment of the requirements for the award of degree of

MASTER OF BUSINESS ADMINISTRATION

(HOSPITAL AND HEALTHCARE MANAGEMENT)

Submitted by: Supervisor:

Navjot Gill Dr. Alka Kohli
Registration No.10907210 Designation: Manager
(Quality
Assurance) SPS Apollo Hospital

INDEX
S. NO. TOPICS

1. Introduction

2. Executive summary

3. Objective of study

4. Methodology

5. Central venous catheters

6. Indications for central line catheters

7. Central peripheral catheters

8. Blood sample collection

9. Central line blood stream infections

10. Data analysis and interpretation

11. Findings

12. Recommendations

13. References

CENTRAL LINE BLOOD STREAM INFECTIONS:

Catheter-related bloodstream infections (CR-BSIs) are defined as bacteremia/fungemia in
a patient with an intravascular catheter with at least one positive blood culture obtained
from a peripheral vein, clinical manifestations of infection (i.e., fever, chills, and/or
hypotension), and no apparent source for the bloodstream infection except the catheter.
Bloodstream infections are considered to be associated with a central line if the line was
in use during the 48-hour period before the development of the bloodstream infection. If
the time interval between the onset of infection and device use is greater than 48 hours,
there should be compelling evidence that the infection is related to the central line.
Central line blood stream infections other than associated with insertion of CVC are also
related to insertion of peripheral cannula and collection of blood samples. Any break in
the skin carries a risk of infection. Although IV insertion is an aseptic procedure, skin-
dwelling organisms such as Coagulase-negative staphylococcus or Candida albicans
may enter through the insertion site around the catheter, or bacteria may be accidentally
introduced inside the catheter from contaminated equipment. Moisture introduced to
unprotected IV sites through washing or bathing substantially increases the infection
risks. For these procedures there are standard aseptic precautions while doing these
procedures.

SCOPE OF BLOOD STREAM INFECTIONS

Infection of IV sites is usually local, causing easily visible swelling, redness, and fever. If
bacteria do not remain in one area but spread through the bloodstream, the infection is
called septicemia and can be rapid and life-threatening. An infected central IV poses a
higher risk of septicemia, as it can deliver bacteria directly into the central circulation.

OBJECTIVE OF STUDY:
Objective of my study is to find out the percentage of various parameters during process
of central venous catheter insertion, peripheral cannulation and collection of blood
samples which are being done in various areas of SPS Apollo Hospital which are being
led by hospital management to keep a check on central line blood stream infections.

SCOPE OF STUDY:
Due to time constraint it was very difficult to cover the entire hospital so I decided to
cover ICUs and emergency ward for CVC insertion and their dressings and wards and
ICUs for sample collection and peripheral cannulation. The study is carried out in SPS
Apollo Hospital Ludhiana only.

2.10 METHODOLOGY
I carried out my study in SPS Apollo Hospital. For my study I made Checklist for
procedures of Central line catheter insertion, dressing of central line, peripheral venous
cannulation and blood sample collection based on aseptic procedures. Then I took
observations for all checklists randomly from various areas of hospital (ICU, emergency,
general and private wards) for one month. After collecting data for one month it was
analyzed and interpreted. Analysis and data interpretation is given below in detail.