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The Joint Commission Update for Infection Control
Implement best practices to prevent CA-BSIs
Checklist on insertion, feedback rates to staff
The Joint Commission new 2009 national patient safety goal to prevent central line-associated bloodstream infections (CA-BSIs; NPSG.07.04.01) calls for use of use of a common-sense — but once controversial — checklist to ensure a standardized protocol is followed for central venous catheter insertion.
The practice has gone from being banned to endorsed, as a federal agency temporarily blocked such efforts as possibly violating human research protocols. The issue has been resolved to the point of garnering the endorsement and encouraged use by all parties, but you might want to run it by your institutional review board to get a waiver of informed consent.
The new Joint Commission patient safety goal is to "implement best practices or evidence-based guidelines to prevent central line-associated bloodstream infections." The requirement covers short- and long-term central venous catheters and peripherally inserted central catheter (PICC) lines. The requirement has a one-year phase-in period that includes defined expectations for planning, development, and testing ("milestones") at three, six, and nine months in 2009, with the expectation of full implementation by Jan. 1, 2010. Here are the key dates and requirements:
That means as of New Year's Day 2010, hospitals must do the following unless they want to draw the ire of Joint Commission surveyors: