Catheter related bloodstream infections : midlines versus peripherally inserted central catheters

Abstract

Background Information: CRBSI is when bacteraemia originates from an intravenous catheter (Gahlot et al, 2014). It can increase the morbidity and mortality rates in hospitals, lengthens hospital stays and comes with costly complications. In the United Kingdom, CRBSI contributes for 10% to 20% of hospital-acquired infections (HAIs) (Gahlot et al, 2014). This dissertation compares midlines and Peripherally Inserted Central Catheters, to evaluate if there is any significant discrepancy in terms of CRBSI. The Formulated Research Question: Do midline catheters reduce the risk of catheter related blood stream infections, when compared to peripherally inserted central catheter, in patients receiving intravenous treatment? PICO Elements: The population studied: males and females receiving IV treatment. The intervention: Midlines. Comparison: PICCS. The outcome: Reduced risk of CRBSI. Method: A criteria for inclusion and exclusion was established. Only publications published in the previous ten years, performed on individuals with PICCs or midlines, receiving IV therapy, and published in English were considered. Excluded were studies conducted on animals or persons who received IV therapy via other forms of VADs. Using key phrases, a complete search trail was conducted on Medline (Pro Quest), Biomed Central, SAGE Journals, PubMed, Hydi, and EBSCO Host. Results: A total of 25 possible articles were recovered. The Prisma 2009 flow diagram was used to screen and exclude non-related articles. A total of five articles were identified. One Randomised Control Trial and four cohort studies. The great majority of literature showed insignificant statistical difference in CLABSI rates between the midline and PICCs group. Only one study, conducted by Xu et al, (2016), favoured midlines over PICCs in terms of lower rates of CLABSI. The inconsistency between results and the limitations that occurred in all studies shows that more research with larger group samples needs to be done in order to answer the PICO question. Recommendations and Implications: More research should be taken into consideration to provide a clear answer to the PICO question being asked in this dissertation. More meta analysis and systematic reviews should be done in order to provide proof to results from previous studies and hence make them more reliable. Moreover, more studies with larger samples should be taken into consideration.