Intra-vascular device management
- Recommendations for the prevention of infection in intra-vascular device (IVD) (DOCX, 356KB)
- The importance of reducing harm to patients
- IVD specific information
There are close to 200, 000 healthcare associated infections (HAIs) in Australian acute facilities each year. Intravenous (IV) catheters cause over 3,500 cases of blood stream infections (BSIs) every year in Australia. BSI infections are associated with mortality of over ten per cent and in many cases also significant morbidity. These events are potentially preventable through correct IVD management.
Correct use and management of intravascular devices minimises the risks of transmission of infection to inpatients. The Australian Commission on Safety and Quality in Healthcare (ACSQHC) Standard 3: Preventing and Controlling Healthcare Associated Infections requires the development and implementation of:
- a system for use and management of invasive devices based on the current National Health and Medical Research Council’s and ASCQHC Australian guidelines for the prevention and control of infections in health care
- protocols for invasive device procedures regularly performed within the organisation.
The IVD management guideline and resources do not cover the insertion and management of arterial, pulmonary artery, intrathecal, epidural or intraosseous catheters, or pressure monitoring devices.
Australian Commission on Safety and Quality in Health Care initiatives
The ACSQHC introduced mandatory reporting of healthcare associated Staphylococcus aureus blood stream infections in 2011. Currently, only infections associated with care provided by acute care public hospitals are required to be monitored and reported for inclusion in the National Health Care Agreements reporting system.
IVD Management guideline supports the principles of the ACSQHC National Surveillance Initiative For guidance regarding the surveillance for Staphylococcus aureus bacteraemia (SAB) and Central Line Associated Bloodstream Infections (CLABSI) the ACSQHC has developed two implementation guides. The guides are designed to support and standardise surveillance activities in line with national definitions for SAB and CLABSI.
The importance of reducing harm to patients
Healthcare facilities provide vital services to our community; however, there is growing awareness of the potential for adverse events in these settings. Of those adverse events, there are around 200, 000 healthcare associated infections (HAIs) in Australian acute facilities each year. Unlike some adverse events that are difficult to predict or prevent, HAIs are considered to be potentially preventable.
HAIs impact morbidity and mortality outcomes can be personally devastating to patients and their families and are associated with longer lengths of stay and higher costs. There is regular public reporting of the performance of hospitals in relation to their HAI rates. Some HAIs attract penalties under current funding arrangements. An effective infection prevention and control program can address and reduce HAIs; however, it must be multi-faceted.
In Australia intravenous (IV) catheters cause over 3,500 cases of blood stream infections (BSIs) every year. These infections are associated with mortality of over ten per cent and in many cases also significant morbidity. A large proportion of these are preventable through the correct intravascular device management.
 Cruickshank M & Ferguson J (eds) (2008) Reducing harm to patients from health care associated infection: the role of surveillance. Australian Commission for Safety and Quality in Health Care.
Bloodstream infection investigation checklist
An investigation should be undertaken of all episodes of healthcare associated intravascular device-related Staphylococcus aureus bloodstream infection (BSI).
- Establish the S. aureus BSI meets the criteria for investigation.
- Investigate the episode using an investigation checklist to identify factors that may have contributed to the BSI.
- Undertake an event analysis.
- Develop an action plan and report outcomes in accordance with local governance processes.
IVD specific information
Links to Appendices 1–6
- Appendix 1: Tunnelled CV specific information
- Appendix 2: PICC specific information
- Appendix 3: Percutaneous CVC specific information
- Appendix 4: PORT or Port-a-cath specific information (Totally Implanted Central Venous Access Port)
- Appendix 5: Haemodialysis catheter specific information
- Appendix 6: Peripheral intravenous catheter specific information
Link to investigation checklist to be completed
- Appendix 7: Staphylococcus aureus bloodstream infection investigation checklist (DOCX, 540KB)
Australia. Australian Commission on Safety and Quality in Healthcare. Australian Guidelines for the Prevention and Control of Infection in Healthcare: 2019 [cited November 2019]