St. Joseph's Public Reporting
Answering your questions about Central Line Infections (CLI)
CLI occurs when a central venous catheter (or "line") placed into a patient's vein gets infected. This happens when bacteria grow in the line and spreads to the patient's blood stream.
Patients require a central line when blood, fluid replacement and/or nutrition need to be given to them intravenously. Central lines also allow health care providers to monitor fluid status and make determinations about the heart and blood.
- Redness, pain or swelling at or near the catheter site
- Pain or tenderness along the path of the catheter
- Drainage from the skin around the catheter
- Sudden fever or chills
Anyone who has a central line can get an infection. The risk is higher if you:
- Are in the intensive care unit (ICU)
- Have a serious underlying illness or debilitation
- Are receiving bone marrow or chemotherapy
- Have the line in for an extended time
Health care providers should take the following precautions to prevent CLI:
- Practice proper handwashing techniques. Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
- Wear sterile clothing – a mask, gloves and hair covering – when putting in the line. The patient should be covered with a sterile drape with a small hole where the line goes in.
- Clean the patient's skin with "chlorhexidine" (a type of soap) when the line is put in.
- Choose the most appropriate vein to insert the line.
- Check the line every day for infection.
- Replace the line as needed and not on a schedule.
- Remove the line as soon as it is no longer needed.
- Ask lots of questions. Find out why you need the line and where it will be placed. Learn what steps the hospital is taking to reduce the danger of infection.
- Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
- Try not to touch your line or dressing.
Treatment depends on the type of catheter, the severity of the infection and the patient's overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed.
St. Joseph's Public Reporting
As of April 30, 2009 the Ministry reports on its website:
- The number of CLI cases that developed in the ICU in each hospital site. Where the number is zero (0) or where the cases total five (5) or more associated with that hospital site, the number will be posted. If the cases are fewer than 5 (i.e., 1 to 4 cases), it will state "<5 cases".
- The CLI rate (per 1000 central line days) in each hospital site
The CLI rate is determined by the total number of newly diagnosed CLI cases in the ICU after at least 48 hours of receiving a central line, divided by the number of central line days in that month, multiplied by 1,000. Central line days are the total number of days a central line was used in ICU patients 18 years and older.
Hospital CLI rates provide only one measure of patient safety and quality of care.
The information gathered will assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Page last updated: April 30, 2010