Arterial Lines

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Lewis et al. explain in Medical-Surgical Nursing, a central line is a catheter placed into a large blood vessel for a patient who requires frequent or long-term access to the vascular system. The authors explain that catheters are used for the administration of high volume fluids, medications that are irritating (such as chemotherapy), long term pain medication, blood products, parenteral nutrition, and hemodialysis. Kaiser policy states four different types of central line used for patients: Centrally inserted catheters, peripherally inserted catheters, injection implanted ports and hemodialysis catheters. Centrally inserted catheters

Article by Clancy (2009) explained central lines were a result of an estimated 250,000 blood stream infections and accounted for 30,000 to 62,000 patient deaths, then adding that each infection cost upwards of $36,000 and cumulatively add up to at least $9 billion in preventable costs annually. The article also explains how the mindset has changed from the cost of having a central line in place and expecting complications to lowering infection rates by an intentional interventional process/s. The article speaks of 5 basic steps to reduce CLABSI, hand washing, insertion techniques, skin cleansing, avoidance of certain sites and earlier removal of the CVC. Studies showed that these guidelines were only followed 62% of the time. The system was changed to ascertain that all the clinicians were in compliance. This prompted 5 interventions, education, a CVC insertion cart with all necessary equipment, physicians having to validate central line necessity, a concise checklist for bedside clinicians and the empower of nurses to stop procedures if guidelines were not followed. These low cost interventions from 11.3/1000 in catheter days in 1998 to zero in the fourth quarter of 2002.

Benefits Increase quality of care Bedside charting access Ability to access your patients records at one time All information in one place

a. Ask the family to stay in the waiting room until the initial assessment is completed.

peripheral line- IV line inserted into a vein in the arm, leg, or scalp in an infant

an intravenous line that would go into the main blood vessel of the heart, in a patient. Although

Central line bundle is a group of evidence-based practice strategy for patient with central catheters, when implemented together, produce better outcomes than implemented individually (Institute of health care improvement, 2010.). The main elements of central line bundle are hand hygiene, maximal barrier precaution upon insertion, Chlorhexidine skin antisepsis, optimal catheter selection, and daily review of line necessity with prompt removal of unnecessary lines Aseptic technique when using and caring for a central line catheter can decrease the chance of contamination in this critically ill infants. Staff education on adherence to aseptic technique and strict central line care guidelines are essential to decreasing bloodstream infections.

PICCs lines have become well recognized as reliable central venous access devices (VADs), with lower potential for complications than short-term central venous catheters. PICCs first gained popularity in the 1980s, and their use has grown steadily since then. They were initially popular in many parts of the United States due to the need for venous access in home care patients. They have grown in popularity because of their reduction in potential complications and costs compared with short-term central venous catheters, and because PICCs can be inserted by registered nurses who have been trained in the procedure.

Together with other heathcare providers, AGNP will be determining if it is necessary for the patient to have a central line. If the patient must have one, the practitioners should determine how long it will be in place. Practitioners have participated in development of various evidence based researches to develop evidence-based guidelines and protocols that improves patient care. I consider prevention of CLABSIs as a project to improve patient’s outcome because if the required guidelines and protocols are followed, there will be absolute decrease in the rate of these

health issues , to enhance public health , and to help support ill patients both physically

there is no pumping mechanism to do so); veins have to be able to hold

Compare and contrasts the anatomy and physiology of blood vessels: arteries, veins and capillaries. Why are these differences significant in the overall function of the circulatory system? Please be specific.

Discussing potential risk issues associated with using automated blood pressure/pulse machine in relation to contemporary practice.

The use of intravenous therapy in the hospitals is now considered a routine therapy. In 2016, DeVries and Valentine stated that 70% to 80% of hospital patients have peripheral intravenous lines at some time during their stay. A peripheral intravenous (PIV) line is a small hollow tube (catheter) that is inserted into a vein and can be connected to special tubing. PIV line is commonly used to administer medications or fluids directly into the vein. The article “Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access,” states that the history of intravenous (IV) therapy dates back to the Middle Ages. Dr. Thomas Latta pioneered the use of IV saline infusion during the cholera epidemic and in the 20th century, two world wars established a role for IV therapy as routine medical practice (Dychter, Gold, Carson, & Haller, 2012).