This document discusses infection control measures for intravenous drug administration. It describes different types of intravenous devices, potential complications, microorganisms associated with IV therapy, and infection control measures like hand washing, skin preparation, dressing changes, and signs of infection. Adhering to proper aseptic technique and monitoring for signs of infection are important to minimize risks.

1. Infection Control
Measures in IV Drug
Administration
Prepared by : Dr. Ahmed Kholeif
General Practitioner
Date : 12th November,2012

2. Objective:
Every member of SHHC staff involved
with intravenous therapy will be able to
apply the correct infection control
precautions to this procedure .

3. Introduction:
Vascular access devices is vital for
administering various fluids and drug
therapies. it's critical to maintain an
appropriate infection control measures
to save lives and money and reduce
healthcare burdens.

4. Types of intravenous devices:
1. Peripheral cannulas :
placed into a peripheral vein
2. Peripherally inserted central catheters (PICC)
Central line that is placed via the peripheral vasculature. Its tip
terminates in the superior vena cava

5. Types of intravenous devices:
3. Peripheral midline catheters :
Shorter version of the PICC, Its tip terminates in
the axilla

6. Types of intravenous devices:
4. Skin tunneled cuffed central catheters
(Hickman lines)
Central venous catheter most often used for
the administration of chemotherapy

7. Expected Intravenous Catheter
Complications
 Phlebitis:
Inflammation of a blood vessel
 Thrombophlebitis:
Similar to phlebitis but a thrombus
(or clot) is in addition involved
 Local Infection (abscess):
A microscopic organism may use the tiny hole in the
skin created by the IV catheter to find its way into the
body, and cause an infection

8. Expected Intravenous Catheter
Complications
 Infiltration :
This occurs when the catheter unintentionally enters the
tissue surrounding the blood vessel and the IV fluid go into
the tissues.
 Hematoma:
collection of blood caused by internal bleeding.
 Hypothermia:
When large amounts of cold fluids are infused. Rapid
temperature changes occurs and may precipitate
ventricular fibrillation.

9. Infectious Micro-organisms associated
with IV therapy
 Staphylococcus epidermidis
 Staphylococcus aureus
 Enterococcus spp.
 Klebsiella
 Pseudomonas
 E. Coli
 Candida

10. Reservoirs
 Patients Skin – resident microflora
 Equipment
 IV Solutions & drugs
 Environment
 Health care provider Hands

11. INFECTION CONTROL MEASURES
1.Collect all required equipment, checking expiry date and the correct
catheter size for the purpose and length of infusion
2. Confirm patient identity and provide explanation
3. Hand washing
Should be performed before and after inserting, replacing , repairing, or
dressing an intravascular catheter

12. INFECTION CONTROL MEASURES
4. Wearing gloves
Wear clean gloves, rather than sterile gloves, for the insertion or
changing the dressing of peripheral intravascular catheters. Sterile
gloves should be worn for the insertion of arterial, central, and
midline catheters.
5. Patient skin preparation
Alcohol swab to remove bacteria prior to insertion and allow it to
dry; this doesn’t protect the patient for a longer period.
Chlorhexidine Gluconate with 70% alcohol gives longer duration of
protection

13. 6.Securing Catheter insertion site.
7.Disposing of contaminated or soiled equipment and linen appropriately .
8. Safe disposal of sharps .

14. 9. Stay with your patient for 5 to 10 minutes to detect early signs and
symptoms of hypersensitivity, such as sudden fever, joint swelling, rash,
urticaria (hives), bronchospasm, and wheezing.
10.Documentation

15. Function of the dressing
To protect the site of venous access
To stabilize the catheter in place
Prevent mechanical damage
Keep site clean

16. Catheter Site Dressing Regimens
1. Use sterile, transparent, semipermeable dressing to cover
the catheter site it allows continuous visual inspection of the
catheter site and require less frequent changes.
2. Replace catheter site dressing if the dressing becomes
damp, loosened, or visibly soiled
3. No need to replace peripheral catheters more frequently
than every 72 (even in the absence of signs of infection), the
new catheter should be inserted into a separate site.

17. Catheter Site Dressing Regimens
4. For patients not receiving blood, blood products or fat
emulsions, replace administration sets after 72 hours if clear
fluids are used
5. For short-term CVC sites change dressing every 2 days for
gauze and every 7 days for transparent dressings
6. Do not use topical antibiotic ointment or creams on
insertion sites.

18. signs of infection
 Redness (erythema) and warmth with some fever
 Pain or burning along the length of the vein
 Swelling (edema)
 Purulent discharge
If any of these signs are noted, the IV catheter must be removed
immediately .

19. Types of Phlebitis
 Bacterial phlebitis
is usually an indication to an infection at the insertion site.
 Chemical phlebitis
is most commonly seen with peripheral IV devices when medications
or solutions irritate the endothelial lining of the small peripheral
vessel wall, for example:
 erythromycin
 tetracycline
 vancomycin
 Large doses of potassium chloride
 multivitamins

20. Types of Phlebitis
 Mechanical phlebitis
occurs when the size of the cannula is too big for the selected
vein causing unnecessary friction on the internal lining of the
vein leading to inflammation

21. Fighting Phlebitis
1 . Phlebitis is most common after continuous
infusions, developing 2 to 3 days after the vein is
exposed to the drug or solution.
2. Phlebitis is more common in distal veins than in
veins close to the heart.

22. Steps to Prevent Phlebitis:
 Use proper venipuncture technique.
 dilute drugs correctly.
 Monitor administration rates.
 Observe the I.V. site frequently.
 Change the infusion site regularly according to policy.

23. Conclusion
REMEMBER !
 Adhering to aseptic technique during insertion, dressing
changes, preparing medications will minimize the risk of
infection
 Cannula site rotation and using the appropriate Cannula
size
 Adequate securement of the IV device

24. Conclusion
 Patients should be closely monitored for signs of infection
 Patient education of the signs and symptoms of phlebitis
 Good documentation is essential and it should be Daily as
evidence that assessment has been carried out

25. Questions !

26. THANK YOU !