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Abstract
This paper provides comprehensive information pertaining to the incidence of bloodstream complications that are associated with central venous catheters (CVCs) in hemodialysis adult patients. It focuses on the effects of bloodstream-related complications and central venous catheters (CVCs). The study adopted the topic since intravascular catheters complications are becoming indispensable in the modern world particularly in the intensive care units (ICUs). This is essential since catheters remain the leading cause of healthcare bloodstream infections. They put patients at risk of attracting local and systemic infections that include local site infections, CRBSI, and endocarditic. As noted, the paper covers various issues that are set with an aim of providing in-depth information to various stakeholders on bloodstream infections. Firstly, it covers risk factors of catheter-related issues and bloodstream infections where long-term threatening illnesses such as lung cancer and other local health issues have been cited. Other risk factors include loss of life, poor blood flow, cell functioning, and contamination of the bloodstream. Clinical and cost impacts are also highlighted in the study where difficulty in blood sampling, infusion medication, and high cost of treatment are cited. Other areas that are covered include management and treatment of the complications and key preventive measures.
Introduction
Incidences of bloodstream infections that are associated with venous catheters have been increasing especially in the modern world. The increase that is attributable to inferior medical practices has been common among adults who suffer from hemodialysis complications. The use of catheters has been presenting more challenges to patients than expected by medical practitioners. Their use puts more patients at risk of contracting chronic diseases that are expensive to treat despite having the capacity of making vital vascular tissues accessible. Severe risks that it exposes most patients to include local site infections, metastatic infections, lung, and brain abscess. Conversely, intravascular catheters are more indispensable in the intensive care units (ICUs) as reported in various empirical studies. This is evident since over 32% of total patients who suffer from intravascular-related complications are affected at the ICU centers (Boeckh, 2008).
This is because the complications expose patients to risk for attracting local and systemic infections such as CRBSI and endocarditic when receiving treatment at the ICU centers. In the US, central venous catheters CVCs have been established as the leading cause of healthcare complications that affect most individuals, especially adults. They are deeply associated with bloodstream infections (BSIs) that are implicated immensely as the major causes of life-threatening illnesses. The infections that are associated with CVCs are categorized as central line-associated bloodstream infection (CLABSI) that causes pneumonia and urinary tracks.
Risk factors
As noted, central venous catheters CVCs are intravascular hemodialysis complications that commonly affect patients in various settings.
They expose patients to severe health complications that cause many risks (Kaye, 2011). Firstly, they are the leading causes of Medicare complications that are associated with bloodstream infections (BSI). This is apparent since intravascular catheters produce toxic liquid-like substances that contaminate blood in the human body. This affects effective blood flow and the distribution of oxygen to the whole body to aid the execution of various functions. Similarly, catheters affect the functionality of body cells, especially those that fight diseases (Boeckh, 2008).
Secondly, CVC and bloodstream intravascular tissues are being implicated as the major causes of long-term and life-threatening diseases that include pneumonia, lung, and brain abscess. In particular, their use especially in ICUs puts patients at risk of contracting local and systemic infections such as CRBSI, endocarditic, and others. Consequently, CVCs may affect the implementation of maxima sterile barrier precautionary measures when the antimicrobial catheters procedures are not adhered to effectively. Other risk factors that the use of CVCs presents include loss of life, chlorhexidine cleansing, and antimicrobial management difficulties. Loss of life is a key risk factor that is caused when the bloodstream is contaminated (Kaye, 2011). This occurs since for the human body to function appropriately, blood that flows in the veins must be pure. The human bloodstream is essential because it transports blood that carries nutrients and oxygen that the body requires for effectiveness.
Clinical impact of the infections
According to Mokrzycki & Lock (2011), incidences of bloodstream infections have far-reaching clinical effects that require effective mitigation by relevant officials. This is essential in ensuring that medical officials do not compromise quality when giving clinical assistance. Firstly, bloodstream infections affect the blood sampling process and infusion of medication that remains key clinical activities. This is evident since the infections lead to blood contamination, thus reducing individuals capacity to infuse the medicine. It makes bloodstream or body cells accept and absorb the medicine. They also make body cells that are integral in facilitating the distribution of medicine to be weak. This compromises the execution of critical clinical treatment activities since the activities are required to be executed in patients with strong cells.
Notably, medical officials have indicated that a large number of patients who are admitted to ICU die because of inactive body cells and the inability of the body to accept medication due to bloodstream infections. They cite that blood sampling and transfer is becoming very difficult among patients who suffer from bloodstream complications. Blood infusion is another major challenge that clinical officials face when they provide Medicare services to individuals who suffer from bloodstream complications (Mokrzycki & Lock, 2011). Variably, the incidences cause difficulties when clinical officers perform hemodynamic measurements on patients. The infections make it cumbersome for clinical officials to establish the type of disease that one suffers from to enable the prescription of the right kind of medication. It also affects the isolation process of organisms from the catheter and the peripheral blood of hemodialysis patients.
The cost impact of the infections
Bloodstream infections cause immense economic complications to patients and clinical officers (Safdar, 2011). Firstly, the infections expose patients to severe pain that compromises their ability to be productive. Secondly, treating bloodstream-related infections requires vast resources. This is because the medication processes and drugs that are used to mitigate the effects of the complications are so expensive. Indeed, the infections present a substantial economic burden especially when it comes to treating CLABSI that remains a common health complication among adults. The heavy cost burden is because hemodialysis patients are hospitalized normally for many days to facilitate their full recovery.
The minimum number of days that a patient can take in a hospital is seven whereby the cost required for each day amounts to $37,000 in most settings. This translates to a substantial figure if the Medicare process of a patient is undertaken in a hospital. Apart from monetary cost, another big challenge is the loss of time since the medication process takes along. Consequently, the infections present cost implications to service providers who are under obligation to deliver quality services (Dellinger & Parrillo, 2008). This is apparent since holistic treatment of the complications requires quality service providers who are expensive to hire and relevant Medicare equipment that is very expensive. For instance, the service providers must have effective therapeutic equipment, lung, and brain abscess testers including sterile barriers.
Management and treatment of the infections
Effective management and treatment of bloodstream infections that are associated with CVCs require proper policies and medical practices. The management practices should be conventional in nature and they should have the capacity to relieve patients from the adverse effects of bloodstream complications. The management and treatment initiatives should also be socially acceptable and economically viable (Safdar, 2011). These elements are significant since proper management of CVC-related complications requires adequate preparation. In particular, clinical service providers should consider using evidence-based Medicare management practices. The practices are recommended since they equip service providers with basic guidelines on how to deal with severe health complications in a more systematic manner.
The evidence-based practices include proper execution of disease diagnosis, medical prescription, chlorhexidine cleansing, and blood infusion. Another notable management measure is the use of maxima sterile precautions. The precautionary measures are instrumental because they contribute to decreasing the risks that are associated with CRABS. They also reduce the cost of treating bloodstream-related infections as compared to other preventive measures such as intravenous antimicrobial prophylaxis. Other management and treatment strategies include the use of relevant medicine for the identified complication, effective infusion of medications, blood sampling, and hemodynamic measurements. Use of catheters checklist, specialized insertion CVC, education, and continuous sensitization on the preventive measures of the diseases caused by bloodstream infections are also important (Safdar, 2011).
Preventive measures
Imperatively, authorities and clinic officials should undertake effective preventive measures to curb the spread or effects of intravascular venous catheters that form key causes of bloodstream infections. The authorities should design sustainable preventive measures that hold the capacity of providing holistic solutions to patients. Key preventive measures that they should consider adopting include continuous education and sensitization of locals about effective interventions of the infections (Safdar, 2011). This precautionary measure is primarily set with an aim of ensuring that individuals are able to cushion themselves from falling victims of the infections. Training and education of healthcare providers are also important to enable them to insert and maintain catheters patients properly.
Secondly, medical service providers should use maximal sterile barrier precautions at the time of CVC insertion. The precautionary measures are important since they help in reducing the effects of CRABS. Another key preventive measure of bloodstream infections is the avoidance of routine replacement of CVCs. This is essential in eradicating blood infusion that normally takes place in the ICU centers. Other preventive measures include systematic removal of unessential CVCs, chlorhexidine cleansing, use of 2% chlorhexidine preparation, and use of antimicrobial catheters to mitigate the infections (Dellinger & Parrillo, 2008).
Conclusion
Indeed, intravascular catheters that are associated with bloodstream health complications are increasingly becoming indispensable in the modern world. However, the identified preventive measures that are being adopted in various settings remain relevant in ensuring that the effects of the extreme health conditions are mitigated. The preventive measures present requisite incentives and guidelines that seek to offer holistic solutions to patients.
References
Boeckh, M. (2008). Complications, Diagnosis, Management, and Prevention of CMV Infections: Current and Future. Web.
Dellinger, P. & Parrillo, E. (2008). Critical Care Medicine: Principles of Diagnosis and Management in the Adult. Philadelphia, PA: Mosby Elsevier.
Kaye, K. S. (2011). Infection Prevention and Control in the Hospital. Philadelphia: Saunders Press.
Mokrzycki, M. & Lock, M. (2011). Prevention and Management of Catheter-related Infection in Hemodialysis Patients. Web.
Safdar, A. (2011). Principles and Practice of Cancer Infectious Diseases. New York: Humana Press.
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