Peripheral Intravenous Infusion For Medications, Fluids, And Nutrient Administration

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.

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.

The purpose of this author for this project is to analyze current literature reviews to establish a firm basis to implement evidence based central line bundle intervention to decrease catheter related blood stream infection in neonatal intensive care unit.

Identifying what factors contribute to occlusion are background questions (Melnyk & Fineout-Overholt, 2015) that should be addressed to ensure the foreground question is appropriately answered. Medication administration, fibrin sheath formation, duration, and frequency of use can each contribute to clot formation (Gabriel, 2011). If a patient is scheduled to receive a specific medication over a duration of time, it is imperative that the central venous catheter is patent and available for continuous use. Encouraging patient compliance will assist with ensuring that duration and catheter access doesn’t increase the risk of clot

Femoral arterial and venous access is traditionally the method of choice in infancy. The right and/or the left groins may be used. This port of access provides advantage of being away from the thoracic region for ease of catheter manipulation away from the radiographic cameras surrounding the child’s thorax. Umbilical arterial and venous access can be used in newborn babies up to 7 days of age. Other alternative route for arterial access includes: carotid artery, brachial artery, and axillary artery. On the other hand, alternative venous access includes: internal jugular vein, subclavian vein, axillary vein, and transhepatic venous access. Alternative vascular access (ARVA) is occasionally required due to the lack of femoral vascular patency or the need to position the catheter at a particular trajectory not provided through the traditional femoral access. The use of ARVA is safe and effective for performing a wide variety of interventions across. In addition, its use may improve the results of selected

Hospital acquired infections (HAI) are inflecting a tremendous impact on healthcare safety and medical costs. The purpose of this qualitative analysis is to evaluate current research and evidence based practice on central line acquired blood stream infections (CLABSI) in the neonatal intensive care unit (NICU). Further, this paper will examine how the closed medication line system can help decrease of a CLABSI event. Neonates are a vulnerable population with a low immune suppression where an infection could simply mean life or death. This particular topic is crucial; with the continual rise in pre-term neonates, this topic is crucial to eliminate CLABSI 100% in the NICU environment

An unplanned extubation (UE) in the Neonatal Intensive Care Unit (NICU) is an unforeseen occurrence observed due to various factors. One of these is due to the lack of a procedural standardization among healthcare providers. This is notably evident when staff is handling the infant during daily assessments and when care is rendered. The reason this issue was selected was because of the potential serious complications or death that a can occur to a patient due to the lack of procedural standardization, preventing UE is the issue that will be addressed.

The method used was double blind randomized control study, the neonates were placed into either the experimental or control group by computer. The study was conducted by registered nurses who all had at least two years of experience in the NICU as a staff nurse. The nurse obtaining the study data remained blind to whether the patient received the intervention of sucrose or not, by stepping out of the room while the patients primary nurse opened up an envelope containing information if the patient was to receive 0.5mL of sucrose or not. The primary nurse would then administer the sucrose if indicated prior to the nurse collecting data for the study would return. The sucrose was administered between one and three minutes prior to the arterial puncture procedure. Every neonate was swaddled for the procedure and a pacifier was held in place lightly while the arterial puncture was performed. The nurse investigator would obtain the NIPS score, heart rate, and oxygen saturation, after the needle was inserted and then one minute after completion of the procedure. Milazzo, et al. (2011), found that the average gestation of the neonate in this study was 33.8 weeks and there was no difference in age of gestation for the experimental or control groups. The NIPS score was found to be between zero and three

Peripheral IV catheterization is a painful and potentially anxiety-provoking procedure for the patients. The interventions to reduce the pain caused by venipuncture were explored in the past decades (Oman, 2014). The majority of the studies reviewed in this summary included one level 1 evidence of meta-analyses (Oman, 2014), three level 2 evidences of randomized controlled trials (Beck, 2011; Deguzman, 2012; Kahre, 2011) and one level 3 evidence of controlled trials without randomization (Levitt , 2013). Many studies have demonstrated that 1% lidocaine intradermal injection before IV insertion can reduce the pain significantly (Oman, 2014). Kahre and his colleagues’ study indicated bacteriostatic normal saline (BNS) group had lower pain score

Here, we first look at how catheters are used and then discuss the problems that may appear when they are not used in the proper manner.

Central lines and peripherally inserted central catheter are tubes inserted in a patient’s vein. They are required to help the patient get medication and nutrition. There are so many articles about these tubes, what they are, how to put them, and how to care about them. To achieve the aim of these tubes without complications, the people with them should know about them and know how to care for them, what is not normal about them, what to do in case of complications, and when to call their healthcare provider. In this paper the safety, teaching and care about the central and peripherally inserted central catheter will be discussed.

In reviewing Heparin flushes in Central Venous Catheters (CVCs); one must first understand the importance of their placement. To properly investigate central venous catheter (CVC) care; documentation will focus on Heparin flushes as it relates to renal care. The renal dialysis patient undergoes CVC placement as a basis of receiving hemodialysis treatments. It is essentially the first access point placed in preparation of a more permanent access point. Central venous catheters, fistulas, and grafts are considered the lifeline of a dialysis patient. Their function and patency is of the utmost importance to the morbidity and mortality rate of a renal patient. “Venous catheters generally develop a fibrin sheath at the tip, which evolve into a clot due to body’s physiological response to the vein injury and the foreign catheter 1 and subsequent catheter obstruction.” (Journal of Evolution of Medical and Dental Sciences, 2014, pg. 46).

Central venous catheters, usually called CVCs, are extremely important for patients in any type of intensive care unit. It is because of their crucial role in the care of these patients that their troublesome risk of catheter-related bloodstream infections, sometimes referred to as CR-BSIs, has developed into such a problem. There are approximately 80,000 CR-BSIs diagnosed each year in the United States alone. These infections lead to nearly 28,000 patient deaths in intensive care units. Not only is this a dreadful loss of life; it is also incredibly expensive. Extra care and treatment for a patient suffering from a CR-BSI can cost an average of $45,000. In fact, these infections can cost as much as $2.3 billion for the United States each

One of the major components of the SYNTAX score that enhances its predictive value on the eventual achievement of microvascular perfusion is the patency (or otherwise) of the infarct related artery (IRA). An occluded IRA has been shown to be associated with a worse post-procedural myocardial perfusion (TIMI myocardial perfusion grade of 3” 54.9% versus 18.7%”, p <0.0001). Patency of the IRA often signifies earlier spontaneous reperfusion, which reduces the actual ischemic time. As a result, infarction size is limited, and improvement in the left ventricular ejection fraction is greater in such patients, which is reflected in improved 1-year

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).