Catheter Reasearch Paper

Once the dressings were securely on and the procedure had been finished, I removed my apron and gloves and disposed of them in the plastic bag, along with everything thing else I had used and then washed my hands again. After leaving the patients home I discussed my practical experience with the Nurse who informed me that I although I had carried out the procedure well it was actually carried out using a clinically clean technique rather than the Aseptic Non Touch Technique as I had thought. As I had used the same gloves to remove the dirty dressings from the leg ulcer and then apply new sterile dressings I had not maintained the Aseptic Non Touch Technique. The Nurse informed me that this was perfectly suitable for the procedure I carried out as the wound was still kept as clean as possible and dressings and equipment used were sterile.

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

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.

In contemporary times, lots of registered nurses practice wound dressing based upon expertise of sequential step-by-step actions as opposed to comprehending the concepts underpinning the most efficient strategies to wound dressing. Presently 2 leading dressing techniques, aseptic (clean hand/dirty hand) method and wound industry, are being instructed to undergraduate nursing pupils. Jointly and relatively, both methods have actually stimulated some debate relating to the most suitable and efficient method to use (Gillespie and Fenwick, 2009).

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.

To remove your VAD dressing and put on a new dressing, take the following steps:

Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.

Arterial catheterization is a commonly performed invasive procedure in the ICU and anesthetized patients, facilitating accurate hemodynamic monitoring and frequent blood sampling. The insertion of arterial catheter especially in patients with hypotension, edema, and obesity, is often difficult and may require multiple attempts. Repeated attempts may lead to more difficult catheterization due to arterial spasm and may increase the incidence of thrombosis and hematoma formation [1]. The radial artery is the commonest site for catheterization owing to its superficial course and its dual arterial supply to the hand [2].

Starting Peripheral Intravenous (PIV) access has become so common a practice among Registered Nurses (RN’s) that many nurses do not give much thought as to how to prepare the site for PIV insertion. Many times, finding a vein takes the priority especially in the older patient population. Teaching PIV insertion has also become a routine: Watch the video, practice on the mannequin arm, and have the student start one on a live patient. Recently, the videos in use for the students preclinical learning have changed. Mosby videos used to show the RN wiping the PIV site with one alcohol swab in a concentric circle to clean the area. New Mosby videos now show the RN wiping the PIV site with three alcohol swabs using the

Reports of vascular perforations during use of soft polyurethane catheters are rare, although Duntley et al. described eight patients with pleural effusions, detected some days after insertion of subclavian or, in one case, internal jugular venous catheter (Duntley 1992). In one of these patients, the catheter tip seemed radiographically to be in an extravascular position at the time of clinical diagnosis. The pleural space in each patient was nevertheless filled with the solution intended for parental nutrition. In only one case, there was a return of blood through the catheter, possible indicating that most catheters were placed into the pleura immediately at central venous cannulation, possibly following guide wire-induced vascular injury. Vascular perforation may often be attributed to immediate cannulation-associated injury (Kalen 1991; Robinson 1995), and most morbidity from vascular CVC perforation is due to infusion of fluid into pleura or pericardium (Duntley 1992; Collier 1995; Walshe 2007), although avoidable by careful aspiration of blood, or (if no blood can be obtained) chest X-ray with iv contrast injection, before clinical use. Since any central venous catheter appropriately, according to tradition, positioned within the SCV could be associated with vascular perforation - knowledge

Oral hygiene should be maintained with antiseptic mouthwash, a diluted hydrogen peroxide rinse, or both. Routine surgical wound care includes regular cleaning of suture lines to minimize crust formation. Hydrogen peroxide solution is helpful for atraumatic removal of sutures. Cutaneous suture lines should be cared for in the typical postoperative fashion by routinely cleansing with 1:1 hydrogen peroxide and water mixture followed by the application of antibiotic ointment.

Health care workers (e.g., nurses, patient care technicians) will abide by facility policy and protocol with regards to infection control measures (e.g., mandatory hand washing) and aseptic technique in CVC care (e.g., donning gloves and masks covering nose and mouth). Catheter dressing will be assessed for signs and symptoms of infection (e.g., redness, drainage, erythema) every treatment and dressing change implemented before

One of the CQI I am currently involved in is focusing on surgical site infection prevention. Use of aseptic technique when changing dressings is key in prevention of surgical wound infection. I observed my team perform dressing change and in 43% of the procedures, there were gaps on maintaining sterility throughout the procedure and

A central venous catheter is known as a central line or a CVC. A CVC is a thin flexible catheter that is inserted into a large vein near the heart in either the arm or the chest. (Web MD, 2016) This central line is used to provide medication, fluids, nutrients, or blood products over a long period of time. This is generally used for patients who have chemotherapy, frequent blood draws, need additional nutritional support, or have kidney failure. (ATS, 2015) There are several considerations to keep in mind when a CVC is being administered such as understanding why a CVC is being placed, safety guidelines, teaching considerations, and ways to care for the CVC.

Central Lines are inserted for a number of clinical reasons including measurement of CVP, Administration of IV drugs, IV fluids, Blood Draw for difficult to stick patients and some times for nutritional reason (Administration of TPN). The main benefit of central line is for extremely sick people multiple drugs/treatments can be administered simultaneously. The major disadvantages of central lines, it can increase the risk of infection, pneumothorax, hemothorax, subclavian artery puncture, Catheter misplacement, air embolism, thrombosis and malfunctioning. The aim of this study is to discuss the methods adopted by hospitals to minimize