Arvaniti K., Lathyris D., Blot S., Apostolidou-Kiouti F., Koulenti D., Haidich A. Cumulative evidence of randomized controlled and observational studies on catheterrelated infection risk of central venous catheter insertion site in ICU patients. Critical Care Medicine. 2017; 45:(4)

Damschroder L. J., Aron D. C., Keith R. E., Kirsh S. R., Alexander J. A., Lowery J. C. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science. 2009; 4:(1)

de Barros L. de F. N. M., Arênas V. G., Bettencourt A. R. C., Diccini Fram, D. S., Belasco A. G. S., Barbosa D. A. Evaluation of two types of dressings used on central venous catheters for hemodialysis. Acta Paulista de Enfermagem. 2009; 22:481-486

Ferroni A., Gaudin F., Guiffant G., Flaud P., Descamps P., Berche P., Durussel J. Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices. Medical Devices: Evidence and Research. 2014;

Gorski L., Hadaway L., Hagle M. E., McGoldrick M., Orr M., Doellman D. Infusion therapy standards of practice. Journal of Infusion Nursing. 2016; 39:(1S)

Gowardman J. R., Robertson I. K., Parkes S., Rickard C. M. Influence of insertion site on central venous catheter colonization and bloodstream infection rates. Intensive Care Medicine. 2008; 34:(6)1038-1045

Ivers N., Jamtvedt G., Flottorp S. Audit and feedback: Effects on professional practice and health care outcomes. The Cochrane Database of Systematic Reviews. 2012;

Guidelines for the prevention of intravascular catheter-related infections. Center for Disease Control. 2011.

Raad I., Costerton W., Sabharwal U., Sadlowski M., Anaissie E., Bodey G. P. Ultrastructural analysis of indwelling vascular catheters: A quantitative relationship between luminal colonization and duration of placement. Journal of Infectious Diseases. 1993; 168:(2)400-407

Timsit J. F., Bouadma L., Ruckly S. Dressing disruption is a major risk factor for catheter-related infections. Critical Care Medicine. 2012; 40:1707-1714

Treston-Aurand J., Olmsted R. N., Allen-Bridson K., Craig C. P. Impact of dressing material on central venous catheter infection rates. Journal of Intravenous Nursing. 1997; 20:(4)

Webster J., Gillise D., O'Riordan E., Sherriff K. L., Rickard C. M. Gauze and tape and transparent polyurethane dressings for central venous catheters. Cochrane Database of Systematic Reviews 2011. 2015;

Use of dry dressings for central venous access devices (CVADs) to decrease central line-associated blood stream infections (CLABSI) in a trauma intensive care unit (ICU)

22 April 2021
7 min read
Volume 30 · Issue 8


This article reports the results of a pre-post study conducted in a trauma-medical-surgical intensive care unit (ICU) regarding dressings of central venous access devices (CVADs) for the reduction of central line-associated blood stream infection (CLABSI) and improvement of adherence and integrity of the dressing. Available evidence indicates that dry dressings changed every 48 hours are equivalent to transparent dressings, changed when soiled or loose, or routinely every seven days. In our intensive care unit, where the majority of CVADs are inserted in the internal jugular vein and where there is an important usage of cervical collars, we questioned if dry dressings would be more appropriate than transparent dressings.


In the 12 months following the change in practice, we noted a CLABSI reduction from 2.36/1,000 catheter days to zero, improvement in dressing audits from 19.61% to 85.34% of clean dressings (P=0.00001) and 62.75% to 90.58% of adherent dressings. Conclusion: In this pre-post study, a simple change in dressing type was implemented, resulting in a significant reduction in the CLABSI rate.

Interventions aiming at reducing the incidence of central line-associated blood stream infections (CLABSI) have been well described in the literature, as strategies to reduce morbidity, mortality and associated cost with the provision of care (Bell et al., 2012; O'Grady et al., 2011; Gorski et al., 2016). Bundles of interventions targeting insertion and maintenance have demonstrated effectiveness (Bell et al., 2012). Maintenance intervention measures include assessment of insertion site with prompt dressing change when soiled, damp or non-adherent, reduction of unnecessary catheter access, appropriate disinfection of the connector with every access, removal of the catheter when no longer needed, and proper flushing of the device (Bell et al., 2012; O'Grady et al., 2011; Gorski et al., 2016; Ferroni et al., 2014).

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