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FACTS

FACTS. Fibrin Analysis Catheter Testing System. Background: CRBSI Catheter Related Blood Stream Infections.

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FACTS

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  1. FACTS Fibrin Analysis Catheter Testing System

  2. Background: CRBSICatheter Related Blood Stream Infections • The high incidence of CRBSIs, and the potential for morbidity and mortality related to CVC use, have put the prevention of central line infections at the forefront of US national health care (1). • It is one of the six initiatives implemented by the Institute of Healthcare Improvement’s 100,000 Lives Campaign. 1. CDC.(2002).Guidelines for the prevention of intravascular catheter related infections. Morbidity and Mortality Weekly Report,51.

  3. Background: CRBSICatheter Related Blood Stream Infections • Approximately 250,000 cases of CRBSI are estimated to occur in the US with attributable mortality estimated at 12%-25% for each infection, and cost to the healthcare system is estimated to be $25,000 per episode (1). • Bottom line, approx. 3,200 – 50,000 deaths per year can be attributed to CRBSI’s. 1. CDC.(2002).Guidelines for the prevention of intravascular catheter related infections. Morbidity and Mortality Weekly Report,51.

  4. Background: CRBSICatheter Related Blood Stream Infections • Infections occur during insertion or use • 80,000 patients annually in the ICU will develop a CRBSI • Complications will occur in 10% of these patients

  5. Background: CRBSICatheter Related Blood Stream Infections • Approximately 20% of CVCs removed for suspicion of catheter related blood stream infections (CRBSIs) are actually the source of infection (2). 2. Mermel,L.A.,et al.(2001) Guidelines for management of intravascular catheter-related infections. Journal of Infusion Nursing, 24(3).

  6. Treatment for CRBSI’s • Treatment for CRBSI or catheter related sepsis (CRS) traditionally is to remove the central line and replace it.

  7. CDC INITIATIVES • Maximum sterile barriers with insertion • Proper catheter insertion site selection • Follow CDC recommendations for catheter care • CDC guidelines include not replacing catheters routinely for prevention of infection or for fever alone (1). DO NOT replace CVC for fever alone • DO NOT routinely replace CVC’s 1. CDC.(2002).Guidelines for the prevention of intravascular catheter related infections. Morbidity and Mortality Weekly Report,51.

  8. CURRENT TESTING OF CVC’S FOR INFECTION • Pull line upon suspicion and send tip to lab for analysis • Samples of outer portion of catheter to be included • Blood cultures • Results in 24-48 hours

  9. Lines are removed unnecessarily Costly to reinsert CVC (if able) Blood cultures are NOT conclusive Potential for complications with reinsertion As a Result…

  10. A New Alternative for Testing CVC’s for Catheter Related Blood Stream Infections • The FDA-approved FACTS™ procedure offers a simple and economical way to test a CVC for sepsis while it remains in-situ (in the patient), preventing the unnecessary removal and replacement of central venous catheters thus reducing costs and improving patient outcomes (3). 3. Catton, J.,et.al.2002. Quantitative culture of through line blood is an accurate method for the diagnosis of central venous catheter-related bloodstream infection without catheter removal.26th Clinical Congress of Nutrition Practice.

  11. FACTS: Endoluminal Brush • A sterile nylon bristled brush in a sterile polyurethane sheath • Attaches to the hub of a CVC, is advanced through the line and swabs the biofilm and fibrin in the catheter, then is removed with the samples to be cultured. • Determines if the CVC itself is infected prior to removal and replacement

  12. Here is how FACTS™ works • The sheath is attached to the catheter hub through the slip luer and the brush is introduced into the catheter lumen through the hub

  13. As the brush passes through the catheter it effectively samples the entire internal surface. Brushes are available in sizes to accommodate all standard CVC specifications.

  14. The brush is withdrawn into the sterile sheath which is then capped. The brush is never contaminated by external contact.

  15. 10 ml of blood is withdrawn and the brush and blood are sent to the laboratory for testing. Standard laboratory techniques (acridine orange leukocyte cytospin) provide results within 60 minutes.

  16. BENEFITS • The CVC remains in place • The entire brush assembly and blood sample are sent to the lab • Results in 60 Minutes (24-48 hrs for blood) • Catheter is pulled only if positive for infection. • Eliminates the need to remove and reinsert a CVC on suspicion of infection. • Patient morbidity is reduced due to decreased insertion of CVCs. • Reduces the costs of healthcare. • The procedure can be administered by RNs or MDs. • The endoluminal brush used in the Fibrin Analysis Catheter Testing System is FDA-approved

  17. Thank You for Your attention ?????Questions?????

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