Controlling infections in the hospital setting has been a major issue for hundreds of years. Patients have largely been effected by pathogens transferred from those appointed to care for them. Florence Nightingale became famous for changing the way we practice patient care. Her idea was simple yet powerful and it is still considered the standard worldwide. She promoted hand washing in order to reduce healthcare infections. Flash-forward a hundred years and we are now seeing infections increase through a different route. The CDC estimated about 31,100 central line associated blood stream infections occur each year (Control, 2015). According to the Centers for Disease Control and Prevention, the most commonly reported pathogens include coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida. (Tavianini, Deacon, Negrete, & Salapka, 2014). Although central lines was not yet a technology created in healthcare, implementing the fundamental skills as emphasized by Nightingale …show more content…
Evaluators compare the three most popular disc on the market. Usually containing one of three agents’ silver, chlorhexidine, or Polyhexamethylene Biguanide (PHMB). The disc is to place at the insertion site where the catheter meets the skin. Due to the clever design of the disc it serves two purposes. One the disc is made with a Polyurethane foam. Making it very absorptive allowing for the collection of drainage therefore decreasing the opportunity for pathogen growth. Secondly the disc is impregnated with chlorhexidine or PHMB, therefore allowing for 7 day extended release antimicrobial protection (Daniels & Frei, 2012). Evaluators concluded Chlorhexidine impregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals (Daniels & Frei,
It can also occur during blood transfusion or during dressing change. The insertion of central catheters can occur in the Interventional Radiology or sometimes at the bedside. Regardless of the where the insertion process occur, a sterile field must always be maintained and sterile techniques must always be employed to prevent any organisms from being introduced to the central line into the patient. According to The Joint Commission (2013), many organizations such as Michigan Keystone Intensive Care Unit Project and Institute for Healthcare Improvement are actually adhering to insertion bundles to reduce the CLABSI rates. The bundles include hand hygiene, maximal barrier precautions, chlorhexidine skin preparation, avoidance of femoral vein, and prompt removal of central catheter. Furuya et al. (2011) studied the effectiveness of the insertion bundle and how it impacts the bloodstream infections for patients in the Intensive Care Unit. As a result, lesser infection have occurred when the compliance is high. As mentioned, the site of the catheter also needs to be considered in the insertion process. Avoiding areas such as the groin to access the femoral artery is recommended because this area can be easily contaminated with urine or feces. In addition, after the insertion of a new central line, all the used IV tubing
Hospital acquired infections (HAIs) affect over 1.7 million patients each year, causing almost 100,000 deaths annually in the United States alone (Johnson, 2010). According to the World Health Organization, HAIs are the most frequent adverse event in the healthcare industry. Fortunately, most of these infections can be prevented with one single intervention, proper hand hygiene (“The Evidence,” n.d.). Four out of five pathogens that cause illness are spread by direct contact. Proper hand hygiene eliminates these pathogens and helps to prevent cross-contamination and HAIs (Linton, 2015; “Hand Hygiene,” n.d.). Reduction of cross-contamination and HAIs improves patient outcomes, increases employee wellness, and lowers health care costs. Adherence to proper hand hygiene is the single most important safety measure in the health care setting. However, for many years compliance to proper hand hygiene in the healthcare industry has been dismally low. New and inventive measures must be implemented to increase compliance to proper hand hygiene and lower the rate of hospital-acquired infections.
Getting an infection from improper care during or after insertion of a central line is the last thing you want to get while in the hospital. This paper will discuss Kaiser Permanente’s policy on central venous catheter, also known as a central line, care and dressing change, and whether it follows the current evidence-based practice on preventing bloodstream infection in patients who have them inserted. I will explain about what a central line is, why evidence-based practice is important in the clinical setting, what Kaiser Permanente’s policy about central line care and dressing change is, if Kaiser is currently following evidence-based practice based on current articles about preventing central line associated bloodstream infections (CLABSIs), and what my role in using evidence-based practice is as a future registered nurse.
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.
Implementation of patient care practices for infection control is the role of the nursing staff. Nurses are responsible for maintaining hygiene, consistent with hospital policies and good nursing practice on the ward and monitoring aseptic techniques, including hand-washing and use of isolation. It is also in their scope of practice to promptly report to the attending physician any evidence of infection in patients under the nurse’s care and initiating patient isolation and ordering culture specimens from any patient showing signs of a communicable disease, when the physician is not immediately available. Limiting patient exposure to infections from visitors, hospital staff, other patients, or equipment used for diagnosis or treatment and maintaining
One of the ways to combat the incidence of Central Line Associated Bloodstream Infection (CLABSI) is by following the proper steps in Central Line Dressing changes. The topic you picked is an important one, both for patients and our overall health care system as well. If nurses will learn, and follow the proper manner in the way Central Venous Lines should be changed it can have a positive outcome for patients. CLABSI can be fatal to the patient, this can devastate the patient's family as well. “Although a 46% decrease in CLABSIs has occurred in hospitals across the U.S. from 2008-2013, an estimated 30,100 central line-associated bloodstream infections (CLABSI) still occur in intensive care units and wards of U.S. acute care facilities each
The purpose of this initiative is to decrease and/or eliminate central line-associated bloodstream infections (CLABSI) in the neonatal intensive care unit (NICU) at Aurora Bay Care Medical Center. Hospital acquired infections, including CLABSI, is a major cause of mortality, prolonged hospitalization, and extra costs for NICU patients (Stevens & Schulman, 2012). The goal of this initiative is to decrease CLABSI by 75% by reducing the number of days lines are in and standardizing the insertion process and line maintenance.
Elimination of HAI’s are a top priority for many healthcare related organizations and as such, the reduction of certain types of HAIs have been achieved. On the national level, the HAI Progress Report states that there has been, “Au 46 percent decrease in central line-associated bloodstream infections (CLABSI) and a 19 percent decrease in select surgical site infections (SSIs) between 2008 and 2013” as well as “an 8 percent decrease in hospital-onset MRSA bacteremia and a 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013” (CDC, 2015).
The priority nursing diagnosis of hospital acquired infection is risk for any kind of infection. One of the main goals for each patient in the hospital is the patient will remain free of infection as evidence by absence of heat, pain, redness, or swelling in any area of the patient’s body during each nurse’s shift. (care plan book). Frequently hand washing is the best intervention for preventing infection. Hand washing reduces the risk of transmission of pathogens by inhibiting the growth of or killing the microorganisms. (cb)Proper sterile technique during urinary
Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).
I chose the topic of hospital acquired blood stream infections because it raises a serious concern in the health care industry. As a nurse it is important to be educated on how this infection occurs and ways that it can be prevented. Being educated on this topic will affect my overall clinical decision-making and help me grow as a nurse. Educating nurses on this issue can save a great amount of lives and money. I will use this information in my nursing practice by making sure to use the proper techniques so that this issue does not continue and my patients get the care that they deserve. It is my responsibility as a nurse to create a healthy and safe environment for patients. Ways that I can reduce the number of patients affected my blood stream
Report for priority focus area under infection control standard, for Nightingale Community Hospital. Our hospital is 13 months away from its anticipated next Joint Commission visit (JAHCO).
Overall, a few individuals accept, that blood is red when it is oxygenated and that blood in veins is blue when it is not oxygenated. Presumably veins really look somewhat blue through your skin. In fact, the blood in veins is light red, rather than the bright red, oxygenated blood in arteries. The skin and fatty tissue between our eyes and the veins make them somewhat blue. So, if a vein is close to the surface of the skin, most of the blue light will be absorbed, and even though red light doesn't reflect as much, the red light:blue light ratio is high enough to make the vein appear red
Nurses should also have patients demonstrate hand washing technique. Teaching patients about infusion therapy and how to avoid the risk of intravenous infection will help calm their fears and decrease their risks of obtaining an infection. Technology today can help by having patients either record a video of the steps on their smart phone or by writing the steps down. This can decrease patient’s anxiety and stress while increasing confidence. While this topic has been around for many years, both medical professionals and patients need to be educated and strict compliance needs to be followed in order to avoid intravenous and central line infections. Further research is needed in order to discover additional ways of decreasing intravenous and central line infections in the home
Exchanges between the catheters, used to allow dialysis solution into and out of the abdominal cavity, must be done carefully because there is a risk of infection from bacteria on the outside of the body. This infection is called peritonitis, an infection of the peritoneum