Bloodstream Intervention

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

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.

Usage of indwelling urinary catheters in critically ill patients can seem to be a permanent fixture in intensive care units. Most critical care nurse expect their patients to have an indwelling urinary catheter (IUC) in place without much regard to the risk of catheter associated urinary tract infections (CAUTI) or the ability to implement IUC alternatives. Critical care patients may require IUC usage due to diagnosis, need for accurate hourly intake and output measurements, or other specified documented reasons. The risk of acquiring a catheter associated urinary tract infections is a result of IUC usage. The Centers for Disease Control and Prevention’s Guideline for Prevention of Catheter-associated

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.

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

Central line associated blood stream infection, better known as CLABSI, are on a continual rise in critical patients. CLABSI are implemented to help improve vascular access in patients where venous access is minimal or reduced. They help to maintain intraveneous access to deliver medications to the body and in case of emergency. Central lines are not given to every patient admitted into the hospital, only those who are critical. The purpose of this paper is to provide reasoning and evidence behind my research strategy for this particular topic. In the critical populations, how does not using chlorhexidine containing dressing compare to using the dressings influence the central line associated blood stream infection rates over two years.

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.

Upon completion of this project I learned that many times patients were unaware of the compilations such as infection that may occur with central lines. This has taught me the importance of proving education to our patients in addition to staff members. Patients can help decrease central line associated blood stream infections by being aware of their surroundings and ensuring that nurses, physicians, and visitors take proper steps in decreasing infections rate. Implementing a policy to place alcohol infused caps on all central line that are not currently infusing is best practice back by evidence based practice to significantly decrease infection rates. This project as helped me identify evidence based practice and incorporate these practice in our daily care to help improve patient outcomes. The first couple of days there was not any patients within the intensive care unit with central line.

Furthermore, medical providers should replace dressings if they become damp, dirty or dislodged. Central lines should be removed when they are no longer necessary. Failure to report problems could allow a CLASBI to develop or

Lastly, non-adherence to Aseptic techniques for surgical patients and with the use invasive of devices such as urinary catheter and central lines can pose as a threat to patients. Bathing patients prior to surgery with a chlorhexidine solution rather than regular soap has proven to reduce the spread of hospital acquired infections. Following protocols with urinary catheters and central lines and also following the guidelines in the care and maintenance of such devices. Another factor is the importance of using chlorhexidine solution for patients who have central lines in an effort to prevent getting an infection in the blood stream. Finally, the importance educating patients on all lines and surgical site care. According to Lobley, “the National Institute for Health and Clinical Excellence found that surgical site infections (SSIs) accounted for 14% of all HAIs and affected 5% of all surgical patients” (Lobley, 2013). Surgical site infection which is another form of hospital acquired infection can

A few of the interventions included: proper hand hygiene, appropriate indwelling foley catheter care, and educating the patient on how to care for the incision. The nurse washed her hands and wore gloves before every incision check in order to reduce the amount of bacteria that could enter the site. Once the patient reached the PACU, the nurse immediately cleaned the foley catheter with antiseptic wipes. This action will be performed once a shift until the Foley catheter is removed. The nurse educated the patient on how to care for her incision site and explained to her the signs and symptoms of an

Patients who are expected to have long hospital stays and extensive IV therapy are likely to receive a peripherally inserted central catheter (PICC). PICC lines have been found to be a relatively safe and cost effective route to administer long term intravenous (IV) medications such as antibiotics, chemotherapy and total parenteral nutrition (TPN). These devices are most often inserted at the patient’s bedside by nurses who have received advanced training in the placement of PICC lines. Evidence based practice for sterile technique during insertion has been established and as a result, infection rates remain relatively low. There is one going debate, however, as to the safety of these catheters in patients who are at an increased risk

Almost all patients that are admitted into the acute care setting require peripheral intravenous therapy. PIV therapy is an important factor in the care of patients in the hospital and it is most often used to maintain or correct fluid and electrolyte balances, administer medications, and replace blood or blood products (Ignatavicius and Workman, 2013). PIV therapy is an invasive therapy that requires catheter insertion into the vascular system and access is gained through the patient’s skin. Because this is an invasive procedure, patients are at a risk of developing catheter related infections. Catheter related infections are preventable and as nurses it is our responsibility to maintain the PIV site and use the appropriate protocols and interventions to

Blanck (2014) explains in preparation of the study nurses and nursing assistance was required to attend a mandatory training class for best practice standards, infection control nurse and clinical manager conducted the class. Also, verbal feedback was utilized to ensure understanding of the educational material. Furthermore, feedback included, CAUTI occurrence rates, frequency of bundle care, and research evidence, in order to increase their knowledge in the need for preventative measures in reducing CAUTI’s. Also, included in the educational text was the standard practice care of three wipes, utilized for perineal/meatal region, and catheter tubing. Also, the bedside checklist contained all the necessary components for the bundle. Nonetheless,

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