The reduction and ultimate prevention of catheter-related bloodstream infections (CRBSIs) is a key step to improving overall inpatient outcomes. And specially trained vascular access clinicians are key to making that reality possible.

Bloodstream infections are a life-threatening challenge to the patient and a costly burden to the healthcare system increasing hospital stay, morbidity, mortality, and health services costs. The most recent estimate of their cost from the Agency for Healthcare Research and Quality ranges from $18,000 to $90,000.¹

Numerous studies^2-5 have linked complications associated with vascular access devices to the skill and knowledge not only of the individual performing the insertion but also of those responsible for the care and maintenance of the line. Further evidence has shown that specialized education in infection control practices can reduce such complications.^6-8 The value of a dedicated, fully trained team was a highlight of the PIV5Rights initiative where Steere et al showed that results with the vascular access specialist team reflected insertion first-stick proficiency at 96% success compared to traditional inserters at 33%.⁹ Steere et al also validated overall proficiency of the trained vascular access team providing daily maintenance of the line with 89% of catheters reaching completion of treatment.

One recently presented poster exemplifies the significance of having a properly staffed team of vascular access specialists in the quest to reduce CRBSIs. In her poster at the Association for Vascular Access Annual Scientific Meeting (AVA 2023, Portland, OR; Oct. 14-17, 2023), Molly Judge, BSN, RN, CRNI, VA-BC and colleagues shared data from a retrospective analysis of data collected at their 364-bed regional academic health center in the Midwest. Of note, this poster was recognized as third among the 10 posters voted the People’s Choice Award!

Their key finding was that CRBSIs could be prevented with a fully staffed vascular access team of certified specialists.

It all started in 2014 when their CRBSI cases skyrocketed after their vascular access team (VAT) had been cut to 1.5 FTEs, down from 2.5 FTEs. Based on their own data collection, half of CRBSIs were occurring in lines placed by the VAT. By 2017, VAT staffing had increased to 6 FTEs with Vascular Access Board Certification (VA-BC), and they had started 2-person PICC placement as well as VAT performing routine maintenance of all central lines.

Other changes included use of a subcutaneous anchor securement system (SASS)¹⁰ to prevent micro-pistoning and malposition of the catheter; and incorporating tissue adhesive at the insertion site to promote hemostasis and prevent the need for premature dressing changes.

Their data showed that there were no CRBSIs identified in the 3729 lines placed by members of their vascular access team since 2017; CRBSIs did occur in lines placed by other hospital staff.

The authors concluded: By maintaining an adequately staffed and certified VAT, patient harm related to vascular access therapy can be reduced and potentially even eliminated.

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