The process you are referring to require sacrifice of the catheter
before a diagnosis is made. There is a better way. Draw blood
cultures from the catheter and from a peripheral site. There are 2
ways to assess these cultures
1. positive for catheter related infection if the colony count is
more than 5 times greater from the catheter than from the peripheral
site. OR
2. time to positivity - catheter is positive when the catheter sample
begins to grow bugs 2 hours before the peripheral sample.
Lynn
At 6:16 PM -0700 5/31/06, Jennifer Kettle wrote:
When culturing for suspected infusion-related infections is it
necessary to obtain both the catheter tip AND the catheter skin
segment for culture? I am still working to develop a standardized
care set for our computer system to help make the diagnosis of
suspected CRBSI easier as well as to encourage consistency. I am
also a member of the infection control committee here. The infection
control committee director (MD) does not feel that it is necessary
and compliance with our current policy to obtain the skin segment is
next to none anyhow. I am on the fence as I am having difficulty
interpreting the 2006 standards in regard to this. We are also in
the process of reviewing our current policy regarding this
procedure. Standard #58 under practice criteria E. states, "When
culturing a central vascular catheter segment, either the catheter
tip or a subcutaneous segment should be submitted for culture." Why
would one ever want to culture just the skin segment and not the
tip? Don't you need at least the tip for culture? Any input is
always appreciated. Thanks in advance. Jenny
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
