Essay On Port-A-Cath

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

4) Significance: This research shows that there is a gap in the evidence, but that the primary concern for nursing staff is to ensure that catheters are removed as soon as it is possible to do so.

National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is to help accredited organizations address specific areas of concern in regard to patient safety ("Catheter-Associated," 2015). NPSG.07.06.01 Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission," 2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing CAUTIs can be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.

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

A nurse-driven protocol is the recommended tool to be used by the nurse to remove catheters without orders following set CDC guidelines and prevent CAUTI

Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection

After an initial search of scholarly databases, a total of fifteen articles was selected for their application to the PICO question. An appraisal of each article uses the following format:

The requirements for obtaining this status are numerous. My main focus is the requirements that are directly effected by everyday nursing care. According to the ANCC this is known as “clinical indicators” (ANCC, 2011). These clinical indicators include “pressure sores, falls, foley catheter infections (CAUTI), and central line infections (CLABSI)” (ANCC, 2011). The amount of work to ensure the rates are low requires dedication from the nurse. The nurse must make sure they turn the bed-bound patient every 2 hours (Martin, Zieve, Ogilvie, & A.D.A.M Editorial team, 2015). As well as making sure the bony prominences on the patient are being cared for, i.e. proper cushioning with bandage brands or use of pillows. Nurses must make sure high quality skin care is done with application of protection gels. When the nurse has a patient who is high fall risk, it is their responsibility to ensure the proper alerts are on the patient. This includes fall bands, special gowns, and possibly bed alarms, as well as frequent rounding. In order to reduce the CAUTI rates in hospitals nurses insert a foley using aseptic technique, performing daily catheter care, and pericare care to prevent infection. A goal for many hospitals is to reduce the central line infections that occur. Insertion is the responsibility of the physician, however, the care after relies on the nurse.

One object of the NIH is improving the health of Americans by building a scientific foundation for clinical practice through reach and training (NIH, n.d.). The NIH’s mission is to promote and improve the health of individuals, families and the community (NIH, n.d.). Gaining the support of the NIH is important because the organization promotes the use of evidence-based practice. NIH uses research to validate its findings through continuous research in the areas of acute and chronic diseases and ways to manage the disease. NIH would be able to provide numerous confirmations as to why early Foley catheter discontinuation is vital to patient care outcomes.

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.

Staff nurses on the unit expressed their frustration with the current practice regarding the frequency of PIV catheter replacements, stating that it was “time-consuming” and contributed to “patient dissatisfaction.” The process of replacing a PIV can often be time consuming and may take multiple attempts in order to successfully insert a new PIV. Research supports a change in practice that address these concerns. A pilot study performed in 2012, by Rickard, Webster, Wallis, Marsh, McGrail, French and Whitby indicated that replacing PIV catheters only when clinically indicated did not lead to catheter-related complications, as previously

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

Yes. I do see an incidence of vascular access failures, particularly in some immunocompromised patients in the intensive care unit (ICU) that require temporary dialysis due to an acute kidney injury. Permacath central venous catheter is the modality of choice in the ICU. According to Chng & Gilbert (2013, p. 1004), central venous catheters are used while dialysis access is warranted before permanent AV grafts become mature or if there is a failure of the AV graft.

Catheters have always been a way to introduce infection into the body. Although, they are needed in some cases, it is of very high importance to insert them with aseptic technique and to not insert them if there are other ways to properly care for the patient. Sometimes as a ED nurse, nurses may get in a rush, and lack the proper techniques or by less wait time and time being an issue. I have long term experience as well, and catheter care, and removing catheters as soon as possible remain of high importance there as well. Without proper care it easily introduces infection for a urinary tract infection.

The Quality Improvement nursing process that I have chosen to research is patient safety. I have chosen to focus specifically on the topic of catheter associated urinary tract infections (CAUTI’s) during hospitalization and their preventions. It is estimated that 15-25% of hospitalized patients receive a urinary catheter throughout their stay, whether or not they need it. A large 80% of all patients diagnosed with a urinary tract infection (UTI) can be attributed to a catheter (Bernard, Hunter, and Moore, 2012). The bacteria may gain entry into the bladder during insertion of the catheter, during manipulation of the catheter or drainage system, around the catheter, and after removal.