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hospitals can have serious consequences. AHRQ, which has sponsored hundreds of patient safety research and implementation projects, offers these 10 Evidence-Based Tips to Prevent Adverse Events (AHRQ, 2009a) from occurring in the hospital setting. These healthcare “tips” are a result of safety research. 1. Prevent central line associated blood stream infections. Central venous catheters or central line catheters, are placed into large veins in a patient's neck, chest, or groin to administer medication or fluids or to collect blood samples. Their placement disrupts skin integrity, allowing for potential infections. An infection can then cause bacteremia and hemodynamic changes and organ dysfunction can occur (IHI, 2008). Each year, an estimated 250,000 cases of central line-associated blood stream infection (CLABSI) occur in U.S. hospitals, and an estimated 30,000 to 62,000 patients who get the infections die as a result, according to CDC (AHRQ, 2009). Among patients in an intensive care unit (ICU), 48% have central venous catheters (IHI, 2008). The case fatality rate for catheter related blood stream infections is almost 20% (IHI, 2008). The site with the highest occurrence of infection is the femoral artery, especially in obese patients (IHI, 2008). The subclavian site has a lower risk of infection than the internal jugular vein (IHI, 2007). Risks and benefits for site selection must be weighed for each patient. In addition to the high human cost of central venous catheter infections, the financial burden is high as well. According to the Institute for Healthcare Improvement (2008), the attributable cost per bloodstream infection is up to $29,000 per case. The total financial burden attributable to HAIs is estimated to be between $28 billion to $33 billion each year (AHRQ, 2009).
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