Midline Catheter Research Paper

Upon arrival, she noted that the patient was experience excess fluid volume and that the IV in the patient’s right antecubital must be stopped, removed, and started again in the other arm. As I had just learned to remove and IV from another patient, my co-caring nurse allowed me to remove Grace’s IV. During this procedure, I observed that Grace was in minor discomfort, but only when I was peeling the tape up that secured the IV line. Additionally, I reflected during this period of time and decided that in order to increase her level of comfort during a relatively uncomfortable time, to stop for a few seconds to allow her to relax and then proceeded to remove the tape, but changed my technique by applying an increased amount of pressure to ensure less movement of the IV line. After the tape was removed, I applied light pressure to the IV site and swiftly removed the catheter. I then waited a few minutes after removal to assess the irritated area and Grace’s pain level, which she stated to have

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

Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)

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

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.

Until recently it was not uncommon for patients admitted to an acute care facility to have an indwelling catheter anchored for unnecessary reasons. Patients that came in thru the emergency department typically were sent to the units with unnecessary indwelling catheters in place and it was not unusual for a surgery patient to have an indwelling catheter anchored before or during a procedure. Once a patient was admitted and was transported to the units nursing would also anchor indwelling catheters for multiple unnecessary reasons. These Catheters could be

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.

You will have a bandage (dressing) around the area where the VAD tube exits your abdomen. The dressing consists of a drain sponge, gauze, and adhesive tape. Your VAD coordinator may help you order the supplies you need to change your dressing.

A percutaneous central line is entered into the patient’s subclavian vein. Because TPN solution is concentrated it is better to have CVC access in the subclavian vein so the solution has less distance to travel to its destination. This reduces the risk of the line clotting or damaging the vein.

Peripheral intravenous catheters are one of the most routinely used devices in hospitalized patients. They are used in anticipation of an emergent need, to administers fluids, nutrition, medications, blood products and to take samples of blood for testing. The Centers for Disease Control and Prevention require that catheters are to be replaced every 72-96 hours to prevent infection and phlebitis. Signs and symptoms of infection and phlebitis which are clinical indications to change an IV. They may present as redness, pain, swelling, or purulent discharge. Research done by Morrison and Holt (2015) found that there was no rise of incidence of peripheral catheters whether they were changed every 72-96 hours versus clinically indicated. According

A PICC line (peripherally inserted central catheter) is a thin tube that is inserted in a vein in a patient’s arm and is advanced toward the heart until it reaches the superior vena cava. A chest x-ray confirms the placement of the PICC line. It is used for IV administration of medications and antibiotics. Chemotherapy and TPN (total parenteral nutrition) can also be administered and blood samples can be drawn. The PICC line can last up to a year. Trained professionals such as PICC-certified nurses are able to do both insertion and removal. Do not put a blood pressure cuff on the same arm as the PICC line because it could fracture the IV line.

Brusch says, “Once a indwelling catheter is placed, the daily incidence of bacteriuria can be between 3-10%.” Another large problem that results CAUTI’s is that at times, catheters are left in a patient longer than necessary. Prolonged use of

I was slightly familiar with the foley catheter, however, I need some slight guidance. I knew that I needed to drain the foley bag because it was slightly full, but I did not know where to unclamp to drain it. The nurse’s aid taught me how to unclamp the bag so I can drain the urine. I also learned that when moving the patient who has a foley bag, it was important to make sure that the patient is not going to get a UTI. UTI can be caused by holding the foley bag at a higher positon causing the urine to backtrack. It is important to keep that in mind as a healthcare worker. I have not been skill checked on foley catheters, however, I need to practice working around foley catheters to protect the patient. I could always go on youtube and search videos on foley catheters or I can use the perry and potter book to learn

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).