Central line-associated bloodstream infections (CLABSIs) are responsible for 100,000 patient deaths per year, creating a critical need for prevention of these deadly infections that occur with central venous lines (CVLs). Alternative forms of IV access such as midline catheters (MLCs) may offer lower rates of infection than those seen with CVLs. MLCs were implemented at the practice setting in 2016; however, no evaluation of their effectiveness had been conducted. The purpose of this project was to evaluate the effectiveness of MLCs using a retrospective, pre- post- comparison of CLABSI rates and device utilization rates (DUR) obtained from the practice setting before and after implementation of MLCs. Infection control and Lewin's change theories were used to provide a foundation for the project. This retrospective, pre-post comparison of CLABSI and DUR 6 months before and after introduction of MLCs sought to determine if MLC use affected either rate. Results of a Wilcoxon signed-rank test showed no statistical differences (p > .05) in CLABSI rates and DUR when comparing the rates from the specified 6 month periods. A secondary purpose was to identify the characteristics and conditions in which MLCs were used. Patients with cardiovascular, neuro, and infection diagnoses constituted 43% of the 262 MLC placements. No statistically significant improvement in infection rates was demonstrated by this project; however, these findings illuminate the types of patients or conditions where MLCs are a viable alternative for IV access, and this knowledge may assist providers in options for patient care. This project promotes positive social change by raising awareness of potential strategies for reducing infections in patients when they are at their most vulnerable.

Presented dissertation deals with the problematics of optimal choice of venous access for each hospitalized patient at standard internal wards. Introduction of vascular access must be safe for the patient and must allow the fulfillment of all the goals for which it was indicated. In recent years, in addition to peripheral cannulas and non-tunneled central catheters, introduction of midline catheters and PICC gets into everyday practice. The choice of optimal vascular access device since adminition can bring benefit to the patients in the form of decline of complications. Goal: The goal of master thesis was to prove that the use of new types of vascular access devices has influence on the decline of vascular access devices related complication occurence. Methods: To reach the goal we used a quantitative method of data collection during certain time period using created collection protocols. Research investigation took place from November 2017 to February 2018 at two standard wards of Department of Internal Medicine FN Motol. Results: A total of 350 venous access devices (271 peripheral cannulas, 54 midline catheters, 35 PICC) in 187 hospitalized patients was monitored. Prevalence of complications, average length of placement and reasons for extraction of individual vascular access devices was...