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2010 cv annual ed central line care

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CVC Care & Maintenance to prevent CR-BSIs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is a CR-BSI? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CR-BSIs ,[object Object]
Bloodstream Infections (BSIs) and Device Use ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biofilm ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources of Contamination 1. Safdar N, Maki DG. The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters. Int Care Med . 2004;30:62-67. 1 Skin Organisms Endogenous- Skin flora Extrinsic-HCW hands 2 Contaminated Catheter Hub Endogenous-Skin flora Extrinsic-HCW hands 3 Contaminated Infusate Extrinsic-Fluid Medication Intrinsic-Manufacturer
Why is CVC care and maintenance so crucial ? I- Antibiotic resistance trends are likely to continue placing upward pressure on infection rates. 1 II- Accrediting agencies are now holding hospitals and their executives accountable for infection control. 2 III- CR-BSIs (Catheter Related-Blood Stream Infections) are a significant cause of hospital morbidity and mortality. 3 IV- CMS (Centers for Medicare & Medicaid Services) will no longer reimburse for CR-BSIs due to recent changes. V- Most importantly our patients expect and deserve the best health care we can provide. 1. Wenzel, RP. The impact of hospital-acquired bloodstream infections. Emerging Inf Dis . 2001; 7(2):174-177. 2. Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections. Morbidity Mortality Weekly Report . 2002;51:1-29. 3.JCAHO, Hospital Program Infection Control Standards: Surveillance, prevention, and control of infection. 2005. 1-10.
Why is CVC care and maintenance so crucial ? ,[object Object],[object Object],[object Object]
Why is CVC care and maintenance so crucial ? ,[object Object],[object Object]
Why is CVC care and maintenance so crucial ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why is CVC care and maintenance so crucial ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why is CVC care and maintenance so crucial ? ,[object Object],[object Object]
CR-BSIs ,[object Object]
CDC Recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CDC Recommendations cont ,[object Object],[object Object],[object Object],[object Object],[object Object]
What can we do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What we can do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What we can do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What we can do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What we can do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object]
a- Injection Caps ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
b- Medication Administration ***ALWAYS WASH HANDS FIRST*** 1- Using aseptic technique, draw up medication to be given or spike IVF/IV ABX 2- Don clean exam gloves. 3- Open an alcohol pad. 4- Clean the injection cap with an alcohol pad for 15 seconds with a twisting motion like juicing an orange. Allow to air dry for 15 seconds. Do not fan or blow on the cap.
b- Medication Administration cont ,[object Object],[object Object],[object Object],[object Object]
c- Flushing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
c- Flushing cont ,[object Object],[object Object],[object Object],[object Object],[object Object]
What we can do to prevent CR-BSIs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
V. Dressing changes a-Scheduled & PRN. ,[object Object],[object Object]
V. Dressing changes b- Sterile Aseptic Technique. ,[object Object],[object Object],[object Object],[object Object],[object Object]
V. Dressing changes c- Removal of old dressing with site inspection . ,[object Object],[object Object],[object Object]
V. Dressing changes d- Thorough cleaning with antiseptic skin prep. ,[object Object],[object Object],[object Object],[object Object],[object Object],Use repeated back-and-forth strokes of the applicator for approximately 30 seconds . Completely wet the treatment area with antiseptic. Allow the area to air dry for approximately 30 seconds . Do not blot or wipe away.
V. Dressing changes e- Securing Your PICC After Cleaning. (Skip this section if CVC is sutured.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
V. Dressing changes e- Proper CHG disk application 1- Soft foam side to the skin “Foam To The Bone” 2- Foam side has the CHG 3- ”If you see white, the disk is not right”. 1- BLUE Side Up 2- BLUE to the Sky 3- BLUE side does NOT release CHG 1- Adequate distance between catheter hub & insertion site. 2- 360 o coverage around insertion site. 3- Slit at the 11 o’clock or 1 o’clock position (shown here).
Several Examples of Properly Placed CHG Disk ,[object Object],[object Object],[object Object],[object Object],[object Object]
V. Dressing changes e- Application of new dressing. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Several Examples of proper application of transparent dressing .
VI- Proper Venous Access Selection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Annual ed core measures.09 10
 
Annual ed pain mgt.clin staff.09.10
Annual ed pain mgt.clin staff.09.10Annual ed pain mgt.clin staff.09.10
Annual ed pain mgt.clin staff.09.10
 
Annual ed pain mgt nonclinical staff.09.10
Annual ed pain mgt nonclinical staff.09.10Annual ed pain mgt nonclinical staff.09.10
Annual ed pain mgt nonclinical staff.09.10
 
Annual ed never events and poa.7 10
Annual ed never events and poa.7 10Annual ed never events and poa.7 10
Annual ed never events and poa.7 10
 
Annual ed workplace violence.07.10
Annual ed workplace violence.07.10Annual ed workplace violence.07.10
Annual ed workplace violence.07.10
 
Annual ed transplant awareness6 2010
Annual ed transplant awareness6 2010Annual ed transplant awareness6 2010
Annual ed transplant awareness6 2010
 
Annual ed infection control.09
Annual ed infection control.09Annual ed infection control.09
Annual ed infection control.09
 
Annual ed patient satisfaction6 2010
Annual ed patient satisfaction6 2010Annual ed patient satisfaction6 2010
Annual ed patient satisfaction6 2010
 
Annual ed transplant awareness6 2010
Annual ed transplant awareness6 2010Annual ed transplant awareness6 2010
Annual ed transplant awareness6 2010
 
Annual ed infection control.09
Annual ed infection control.09Annual ed infection control.09
Annual ed infection control.09
 
Annual ed patient satisfaction6 2010
Annual ed patient satisfaction6 2010Annual ed patient satisfaction6 2010
Annual ed patient satisfaction6 2010
 
Annual ed performance improvement.4 2010
Annual ed performance improvement.4 2010Annual ed performance improvement.4 2010
Annual ed performance improvement.4 2010
 
Annual ed mission vision4 2010
Annual ed mission vision4 2010Annual ed mission vision4 2010
Annual ed mission vision4 2010
 
Annual ed conflict of interest4 2010
Annual ed conflict of interest4 2010Annual ed conflict of interest4 2010
Annual ed conflict of interest4 2010
 

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2010 cv annual ed central line care

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  • 6. Sources of Contamination 1. Safdar N, Maki DG. The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters. Int Care Med . 2004;30:62-67. 1 Skin Organisms Endogenous- Skin flora Extrinsic-HCW hands 2 Contaminated Catheter Hub Endogenous-Skin flora Extrinsic-HCW hands 3 Contaminated Infusate Extrinsic-Fluid Medication Intrinsic-Manufacturer
  • 7. Why is CVC care and maintenance so crucial ? I- Antibiotic resistance trends are likely to continue placing upward pressure on infection rates. 1 II- Accrediting agencies are now holding hospitals and their executives accountable for infection control. 2 III- CR-BSIs (Catheter Related-Blood Stream Infections) are a significant cause of hospital morbidity and mortality. 3 IV- CMS (Centers for Medicare & Medicaid Services) will no longer reimburse for CR-BSIs due to recent changes. V- Most importantly our patients expect and deserve the best health care we can provide. 1. Wenzel, RP. The impact of hospital-acquired bloodstream infections. Emerging Inf Dis . 2001; 7(2):174-177. 2. Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections. Morbidity Mortality Weekly Report . 2002;51:1-29. 3.JCAHO, Hospital Program Infection Control Standards: Surveillance, prevention, and control of infection. 2005. 1-10.
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  • 22. b- Medication Administration ***ALWAYS WASH HANDS FIRST*** 1- Using aseptic technique, draw up medication to be given or spike IVF/IV ABX 2- Don clean exam gloves. 3- Open an alcohol pad. 4- Clean the injection cap with an alcohol pad for 15 seconds with a twisting motion like juicing an orange. Allow to air dry for 15 seconds. Do not fan or blow on the cap.
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  • 32. V. Dressing changes e- Proper CHG disk application 1- Soft foam side to the skin “Foam To The Bone” 2- Foam side has the CHG 3- ”If you see white, the disk is not right”. 1- BLUE Side Up 2- BLUE to the Sky 3- BLUE side does NOT release CHG 1- Adequate distance between catheter hub & insertion site. 2- 360 o coverage around insertion site. 3- Slit at the 11 o’clock or 1 o’clock position (shown here).
  • 33.
  • 34.
  • 35. Several Examples of proper application of transparent dressing .
  • 36.