Prevention and Management of Central Line Associated Bloodstream Infection (CLABSI)

Running head: CASE STUDY
Jim Karas Case Study
Name of the Student
Name of the University
Author Note

1CASE STUDY
Introduction
The case study suggests that Jim Karas was admitted to the hospital and some of his
presenting complaints was hypotension, delirium, infection, breathing difficulty, and
agitation. The CVAD infection had developed central venous catheter insertion in left
internal jugular vein. This essay will elaborate on the underlying factors that might have
played an important role in the onset of CVAD in the patient Jim Karas. This will be
supported by scientific evidences that will help in the recognition of measures that can be
implemented for averting clinical complications in the patient.
Central Line Associated Bloodstream Infection (CLABSI) prevention and management
Central venous access device (CVAD) refers to a wide range of catheters that are
primarily introduced and placed in the veins, with the aim of administering targeted therapies
to the circulating bloodstream. The catheters are placed in a way that the end is present
outside the human body (Hadaway, 2012). In contrast, surgical placement of ports underneath
the skin are typically gained access to by means of special needles (Cotogni & Pittiruti,
2014). Jim Karas, was admitted hospital, following his comatose state inside a car. His initial
complaints were that of insentience and difficulty in breathing. A detailed medical
assessment led to the diagnosis of hypotension, followed by administration of ventilation
masks. Jim was subjected to treatment by oropharyngeal airway (OPA) and intravenous (IV)
cannula. Despite demonstrating symptoms of hypertension, following mechanical ventilation,
the medications were not immediately stopped. Other noticeable effects were heart rate
elevation and an increase in body temperature (38.8 °C). There is mounting evidence for the
fact that a range of intrinsic risk factors are responsible for governing the likelihood of a
person getting affected by bloodstream associated infections such as, age, gender, and other
comorbidities (Rinke et al. 2013). Nonetheless, according to Chopra et al. (2013) a plethora

2CASE STUDY
of extrinsic factors namely, parenteral nutrition that encompasses administration of
carbohydrate, protein, fat, electrolytes, minerals, and vitamins, microbe colonization at
catheter insertion site, and absence of sterile barriers for the catheter insertion also control the
onset of infections. Additionally, extended hospitalization prior to multi-lumen CVC and
insertion procedures also increases complication risks.
The Centre for Disease Control and Prevention has formulated guidelines the need to
be followed before catheter insertion procedures, in order to prevent the patients from
acquiring the infections. According to the guidelines, the hub and access port must be
scrubbed with antiseptics, prior to insertion. The guidelines also emphasise on the use of
sterile equipment for port and catheter access, dressing changes with glove usage, hand
hygiene, soiled dressing replacement, and maintenance of sterile and/or aseptic conditions.
Recent evidences suggest that use of the intravenous technique, Aseptic Non-Touch
Technique (ANTT) consists of hassle-free management of sterile instrument that are in
contact with port access regions, helps in management of aseptic conditions (Mutalib et al.
2015). There is also a need to show adherence to the clinical steps that are associated with
hygiene and dressing policies, for preventing infections. It has also been confirmed by
evidences that central line procedures should be applied while establishing aseptic condition
during insertion of catheters (Conley, 2016). Sterile glove selection plays an important role
under these circumstances. Often the professionals fail to demonstrate accurate practice that
contributes to the incidence of healthcare associated or nosocomial infections.
The complications observed upon admitting Jim to the hospital can be effectively
managed by following certain procedures such as, hand hygiene maintenance, sterile glove
usage during catheter insertion, and dry period maintenance between catheter insertion
periods. Adherence to the aforementioned procedures are imperative for enhancing rapid
wound healing, thereby lowering chances of HAIs. Furthermore, it is vital to scrub the hub