Improving the quality of care of the critically ill patient. Implementing the central venous line care bundle in the ICU

Intravascular (IV) access in the care of the critically ill patient is an intervention that is both life-saving and life-threatening under certain circumstances. Critically ill patients frequently require the administration of intravenous fluids, blood products, medication, nutritional replacement therapy as well as monitoring of the intravascular volume. Such invasive interventions, together with the critically ill patient's impaired immune system as a result of multiple and complex medications, co-morbid illnesses, prolonged intensive care unit (ICU) admission and multiple intravascular line insertions, make such patients at risk of developing catheter-related bloodstream infections (CRBSIs). According to the Centers for Disease Control (CDC) in the USA, 80 000 central venous catheter (CVC)-associated bloodstream infections (BSIs) occur in American ICUs each year based on an average rate of 5.3 CVC-associated BSIs per 1 000 catheter days in ICU. Southern African Journal of Critical Care Vol. 24 (1) 2008: pp. 26-31