Nosocomial infections are infections that are acquired in the hospital or acute care setting in relation to the original condition of the patient. Infections are said to be hospital-acquired if they surface within 48 hours after admission to the hospital unit or within 30 days after the patient has been discharged home. These infections are the most common complications experienced by patients admitted to the hospital, with about 10% of hospitalized patients acquiring some form of nosocomial infection.
There are several types of nosocomial infections such as ventilator associated pneumonia, urinary tract infection, bloodstream infection and surgical site infection. As modern medical practice becomes more advanced, the use of intravascular catheters have become a generic in the field and especially common in the Intensive Care Units where patients are critically ill (Lorente et al 2005).
These catheters serve as a means of access to administer high alert medications that need to be given via a large vein, for administering parenteral alimentation and may also serve as a tool to measure the central venous pressure (Byrnes & Coopersmith 2007) Blood stream infections resulting from a central venous access is not a common form of nosocomial infection although this type of infection is the most highly preventable among the different types of nosocomial infections.
As with any other type of infection, central venous catheter infections are associated with increased costs and expenditure in health care as patients acquiring this infection often have to increase their hospital stay. In addition, patients who acquire blood stream infections are more at risk of becoming critically ill as compared with patients who do not acquire this type of infection. Some factors that have been identified that contribute to blood stream infections are associated with the expertise and staffing ratio of health care workers to patients. The level of knowledge and training experience of urses also has an impact on the risks of the patient to acquire a blood stream infection (Robert et al 2000). Blood stream infections can be prevented through implementing practices that prevent the spread of infection, the most basic of which, is the observation of proper hand-washing techniques. Healthcare workers can also utilize proper personal protection equipments such as masks, gloves and gowns in order to minimize the risk of infection. Chlorhexidine was also found to be more effective in minimizing infection when used for cleaning the site before insertion of the central venous catheter (Chaiyakunapru et al 2002).
The location of the catheter also influences the risk of acquiring blood stream infections as catheters inserted in the jugular and femoral veins have the highest risk of becoming infected (Goetz et al 1998; Timsit 2003). Maintaining the integrity of the central venous catheter is also important in preventing infection from setting such as ensuring asepsis when changing the dressing, immediately removing the catheter after its purpose has been served and administering low molecular weight heparin to patients with this device (O’Grady et al 2002).
Equally important is the proper monitoring and surveillance of surgical site infections and the establishment of proper hospital guidelines and policies for the prevention of such infections which should be undertaken by the hospital management and implemented across all hospital units. Healthcare facilities should also emphasize practices that are geared towards the prevention of infection. This can be achieved through properly training healthcare workers and other hospital staff on ways to minimize the spread of infection and by implementing a surveillance system of all infections acquired in the hospital setting.