An Analysis of the Central Venous Catheter Care Guideline Using the AGREE Tool

A central venous catheter is a catheter that leads directly to the heart. It is most commonly used in the intensive care unit to monitor vital hemodynamic status or administer fluids and blood to the very ill. It can also be used for plasma exchange, apheresis, and nutritional support. Catheter related infections (CR-BSIs) account for health care associated infections in the millions of dollars. Infection generally occurs because of the body's own production of bacteria and an exposure to these bacteria at point of entry into the catheter. Central venous catheters (CVCs) are indispensable in the intensive care unit (ICU). Central venous catheter related infections account for $296 million-$3.2 billion in health care dollars annually. Guidelines for care and prevention of infection on insertion and during use are recommended by the Centers for Disease Control (CDC) and the Agency for Health Care Research and Quality's (AHRQ) National Guideline Clearing House. Guidelines have been developed to assist practitioners in avoiding infection related to intravascular catheter use, and provide suggestions for their care and use. Using the AGREE tool, a guideline for the care of central venous catheters was examined in this paper. A reduction of the number of bloodstream related infections was shown to be a result of the effective management of central venous catheters. Using alcohol chlorhexidine is the most important factor in maintaining a site free from infection. Inclusion of the AGREE tool is done as an appendix to the article.