Preventing Central Line Blood Stream Infections Essays

Preventing Central Line Blood Stream Infections Essays Preventing Central Line Blood Stream Infections Essay Preventing Central Line Blood Stream Infections Essay maximal sterile barrier precautions, catheter placement and optimal timing of replacement, surveillance, education, improved hand hygiene technique and compliance, etc. ), and technological (e. g. , use of preferred skin antiseptics such as chlorhexidine gluconate, closed infusion containers, catheter dressings, etc. ) practices† (Torricone et al, 2010). Another intervention includes a closed infusion container with self-sealing injection ports that reduces the risk of air and organisms from entering the infusion. According to the American Association of Critical Care Nurses (AACN), a large proportion of nosocomial infections result from â€Å"cross-contamination from the hands of healthcare workers† (2005). It is important to Always wash your hands  before and after  putting on or removing gloves, direct patient contact, inserting a peripheral catheter or assisting with CVC nsertion, palpating a catheter insertion site, changing a catheter dressing, accessing the catheter to administer a medication or flush (Hadaway, 2006). The CDC also recommends the use of alcohol-based hand rubs between patient contacts instead of just hand washing alone (AACN, 2005). Always wash your hands  before and after  putting on or removing gloves, direct patient contact, inserting a peripheral catheter or assisting with CVC insertion, palp ating a catheter insertion site, changing a catheter dressing, accessing the catheter to administer a medication or flush (Hadaway, 2006). Also, change gloves  used for other patient-care tasks before you perform any infusion or catheter care tasks. The use of the Central Line Bundle is also beneficial. The bundle focuses on hand hygiene, maximal barrier precautions, chlorhexidine skin prep, optimal catheter site selection, and daily assessment of line necessity with prompt removal of unnecessary lines (Institute for Healthcare Improvement, 2008). An article written by Suzanne M. Brungs, RN, MSN, MBA, OCN, and Marta L. Render, MD, supports the use of bundles for Central Lines in an effort to reduce infections. The bundle is composed of hand hygiene, use of chlorhexidene as a skin prep prior to insertion, a full body-drape that covers the patient from head to toe, barriers such as sterile gloves, gown, masks and caps to be worn by the inserter and avoidance of using the femoral insertion site (2005). The article reports that since the implantation of these bundles, central line associated blood stream infections were reduced by at least 50% and â€Å"compliance with using evidenced-based practices increased from 30% to nearly 95%† (Brungs Render, 2005). Florence Nightingales Environmental Theory supports the Joint Commissions patient safety goal to reduce central-line related blood stream infections. She believed that the patient is affected by the environment and that the nurse acted on the patient. By controlling the environment you could control the patient’s health. Cleanliness, among other factors, in her theory, facilitated the patients healing process. This is essentially the same thing we are doing with the use of CVC bundles. By controlling our environment and maintaining sterility during insertion, management and care of central lines, we reduce the risk of infection and promote the patients well being. Good hand hygiene prevents bacteria from being passed from one patient to another, which therefore reduces risks of infection. Another theorist that supports the Joint Commissions patient safety goal is Dorothea Orem. Her self-care model states that when the patient cannot care for his/herself, it is the nurse who in turn meets the patient’s needs by acting and doing for the patient (Current Nursing, 2010). The nurse guides, teaches, supports and provides an environment that promotes patient care and health. This is the whole premise of advocacy. When the patient cannot speak for his/herself or when they aren’t knowledgeable about a specific procedure it is our duty to make sure we assume the role of patient advocate and do for the patient and teach the patient. It is up to us that the patient received optimum care. Ultimately, patients are at risk with any intra vascular device but there are steps that we can take to minimize risks for infection. Many national efforts today are aimed to reduce the risk of blood stream infections related to central lines. I believe that infection control programs must strive to apply universal and consistent control measures and prevention tips with all types of CVC’s. There is no doubt they are here to stay but it is essential that all healthcare providers are given the tools necessary to ensure patient safety and satisfaction. There is no excuse for an infection. We must advocate and we must strive to protect our entire patient population. References American Association of Critical Nurses. (9/2005). AACN practice alert: Preventing catheter elated blood stream infections. Retrieved from aacn. org/WD/Practice/Docs/Preventing_Catheter_Related_Bloodstream_Infections_9-2005. pdf Brungs, S. M. , Render, M. L.. (2005). Using evidenced-based practice to reduce central line infections. Clinical Journal of Oncology Nursing, 10(6), 723-25. Hadaway, L. C.. (2006). Keeping central line infectio n at bay. Nursing 2006, 36(4), 58-64. Haller, L. T. , Rush, K. L.. (1992). Central line infection: a review. Journal of Clinical Nursing, 1, 61-66. Institute for Healthcare Improvement. (2008). Prevention of central line-associated bloodstream infection. Retrieved from hi. org/NR/rdonlyres/01E7F0ED-EEDE-41BA-ABB0-982405602158/0/cli. pdf Maki, D. G. , Kluger, D. M. , Crnich, C. J.. (2006). The risk of bloodstream infection in adults with different intravascular devices: A systemic review of 200 published studies. Mayo Clinic Proceedings, 81(9), 1159-71. Nursing theorists: A companion to nursing theories and models. (2010). Retrieved from http://currentnursing. com/nursing_theory/nursing_theorists. html The Joint Commission. (2009). Accreditation program: Hospital national patient safety goals. Retrieved from http://scholar360. com/cchs/media/user/1341/Joint%20Commission%202010%20NPSGs_3. pdf