Extending the interval for changing flushing solutions for central venous and arterial line systems in the intensive care unit: An evidence-based quality improvement project.
Junel Padigos, Lauren Murray, Olivia Bredhauer and 2 others
PMID 40189941WHAT IT FOUND
No line-associated bloodstream infections were recorded in a one-year ICU quality improvement project that changed saline flush bags for central venous and arterial lines from every 24 hours to every 96 hours, and the project reported per-patient fluid bag savings.
Key findings
01The ICU changed the interval for 0.9% sodium chloride flush bags for central venous and arterial lines from every 24 hours to every 96 hours on 15 March 2023.
02The ICU had 1343 patient admissions during the one-year intervention period. No bloodstream infection cases associated with central venous or arterial line use were recorded in that period, while two such cases occurred in the year before.
03The economic analysis reported per-patient saving of AU$3.21 for any individual arterial or central venous line, and up to AU$6.42 per patient when both were in place, based on a fluid bag cost of AU$1.07.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-site quality improvement project, not a randomized controlled trial. The authors stated that any difference in bloodstream infection rates could not be attributed to the intervention because infections are multifactorial and the sample was small at a single site. The number of individual central venous and arterial line days was not captured. The reviewed primary studies were old, and the paper says randomized controlled trials are needed to test longer flush solution intervals. The economic analysis counted only saline fluid bags and excluded nursing time, infection-related costs and recycling costs. The staff survey was open-ended and asked for feedback and improvement areas. Benchmarking showed variable practice across hospitals.
Declared interests
The project was not funded. Open access publishing was facilitated by The University of Queensland. Stakeholder consultation included a product representative.
The easy way to misread this
Do not read the absence of recorded bloodstream infections as proof that changing flush bags every 96 hours is safe or effective. The authors said bloodstream infections are multifactorial, the sample was small and single-site, and the change was not tested in a randomized controlled trial.