...Preventing Central Line Associated Bloodstream Infections Angie Rees Grand Canyon University: NRS-433V March 28, 2015 Abstract Central line-associated bloodstream infection is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of, or within 48 hours, prior to the onset of symptoms and the infection is not related to an infection from another site. Central line-associated bloodstream infections (CLABSIs) occur when germs enter the bloodstream through a central line. A central line is a tube that is placed in a large vein to give fluids, blood, medications, or nutrition. CLABSI continues to be one of the most deadly and costly hospital-associated infections in the United States. Many lives have been saved in the past decade due to improvements. However, these infections continue to occur and more occur in other areas of the hospital outside of the ICU. One in four patients die with CLABSI complications. These serious infections usually cause a prolonged hospital stay with an increased cost. The average CLASBI cost an additional 0.6-2.7 billion every year. Some patients may be at higher risk for developing a CLABSI due to their length of hospitalization before catheterization, duration of catheterization, underlying medical conditions, location of catheter placement, or other factors. It is important that both the patient and the healthcare providers take the appropriate steps to help prevent an infection. Rutkoff, G. S. (2014). The...
Words: 1819 - Pages: 8
...of 3 Antiseptic Solutions for Prevention of Catheter Colonization in an Intensive Care Unit for Adult Patients Author(s): By J. Vallés , MD; I. Fernández , RN; D. Alcaraz , RN; E. Chacón , RN; A. Cazorla , RN; M. Canals , RN; D. Mariscal , MD; D. Fontanals , PharmD; A. Morón , PharmD Source: Infection Control and Hospital Epidemiology, Vol. 29, No. 9 (September 2008), pp. 847853 Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America Stable URL: http://www.jstor.org/stable/10.1086/590259 . Accessed: 30/09/2013 10:14 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. . The University of Chicago Press and The Society for Healthcare Epidemiology of America are collaborating with JSTOR to digitize, preserve and extend access to Infection Control and Hospital Epidemiology. http://www.jstor.org This content downloaded from 115.165.210.196 on Mon, 30 Sep 2013 10:14:09 AM All use subject to JSTOR Terms and Conditions infection control and hospital epidemiology september...
Words: 5706 - Pages: 23
...Strategies (Vol. 6: Prevention of Healthcare–Associated Infections)" under the head Quality Improvement and Patient Safety What is Accountability? In Fundamentals of Nursing it says “The ability and willingness to assume responsibility for ones’ actions and accepting the consequences of one's behavior.” Accountability of nursing professional is a legal obligation; for a professional nurse it is relating to ethics and moral responsibility. Within the kingdom of professional accountability, there are many factors. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for nursing judgment and actions. A professional nurse has the responsibility to take decisions and practice within the scope of care, calling upon his/her information and skills to make judgments in favor of the patient. A professional nurse is accountable to their profession, their patients, employer, and other health care team members and to themselves. Nurses are accountable to provide safest care for their patient based on evidence based practice and safe nursing interventions. Nursing profession as a whole is build up on accountability, unselfishness, integrity and social justice. A professional nurse who take decisions and practice on the basis of those ethical values will always be in favor of the patient, no matter what is his/her professional level. Methods The Healthcare-associated infections. In a patient care situation as a nursing professional...
Words: 915 - Pages: 4
...Nosocomial central line bloodstream infections are becoming one of the lead causes of death within hospitals (Smith, Egger, Franklin, Harbrecht & Richardson, 2011, p.1038). A blood stream infection is defined as having a positive blood culture while central venous access is in place without any further evidence of infection related to the patient’s comorbidities (Smith, et al., p. 1038). Organisms that are known to cause these infections include staphylococcus aureus and enterobacteriaceal (Curry, Honeycutt, Goins & Gilliam, 2009, p.151). It is concluded that one in ten patients experience an adverse event such as a central line bloodstream infection during their stay at the hospital (McPeake, Cantwell, Malcolm & Malcolm, 2012, p. 123). Furthermore, it has also been researched that over fifty percent of those cases could have been avoided if there were increased patient safety processes that were followed strictly and routinely evaluated for effectiveness (McPeake, et al., p. 123). Recent changes in government and insurance reimbursement suggests the elimination of payment for central line bloodstream infections especially when proven to be obtained during their hospital stay (Duane, Brown, Borchers, Wolfe, Malhotra, Aboutanos & Ivatury, 2009, p.1166). Hospital charges for central line infections increase the cost of stay nearly threefold (Duane, et al, p. 1166). The invasive nature of the catheters insertion predisposes patients to infection and it is healthcare...
Words: 1540 - Pages: 7
...Bloodstream infections in intensive care units (ICU) are a major trigger of morbidity and mortality[1, 2]. Several risk factors for bloodstream infections in ICU have been previously established, like length of stay[3] and performance of invasive procedures, such as placement of central venous, arterial or hemodialysis catheters[4, 5], mechanical ventilation[3] and tracheostomy[6]. Additionally, it has been suggested that patients with iron deficiency could also be more susceptible to infections than those with a normal iron status[7–9]. In fact, iron is a fundamental nutrient for humans, but also a key element for bacteria growth[10–13]. Essentially, free iron in circulation promotes the release of siderophores by various bacteria, which in turn, allows the latter to compete with the host for the existing free iron. To enhance bacterial growth, the iron complexes formed are thus incorporated by receptor-mediated endocytosis[14, 15]. Moreover, evidence also suggests that a second mechanism exists for acquiring available iron in the bloodstream, through the secretion of hemolysins[16]. Iron metabolism is extensively altered by inflammation. In fact, sequestration of this element normally occurs in response to an acute inflammatory reaction, which might represent part of a defense mechanism of the human body[10]. For patients admitted to the ICU, two correlations have been established for sepsis: a direct correlation between C-reactive protein (CRP) and ferritin concentrations...
Words: 1129 - Pages: 5
...Catheter-Associated Bloodstream Infection Surveillance Variability Kochurani Thomas Grand Canyon University NRS-433V May 1, 2011 Bloodstream infections are the most common hospital-associated infection (HAI) in intensive care units (ICU) and a significant source of in-hospital deaths, increased length of stay and added medical costs. Both adult and pediatric patients who have catheters inserted into their blood vessels face increased risk of an infection developing along the invasive plastic devices which can become life-threatening as they spread into the bloodstream. According to Centers for Disease Control and Prevention (CDC), an estimated 248,000 blood stream infections are reported per year (CDC, June 2010), and mortality rate of 12%-25 %( CDC, 2011) .This dangerous lethal medical complication can be prevented by proper management of the catheter insertion and strict aseptic technique during care. Even though CDC has recommended standard catheter associated blood stream infections (CA-BSI) prevention strategies, the study shows areas of variability in the surveillance. A central line is an intravascular catheter that terminates at or close to the heart or in one of the great vessels which is used for infusion, withdrawal of blood, or hemodynamic monitoring. The Aorta, pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic veins, internal jugular veins, subclavian veins, external iliac veins, common iliac veins, common femoral veins...
Words: 2098 - Pages: 9
...Medicine, 853. doi:10.1186/1741-7015-8-53 Background Information The purpose of this article was to study if only changing peripheral intravenous catheters when clinically indicated verses every 72-96 hours was beneficial in regards to cost, patient outcomes, and staff workload. This subject made sense to this author as a practicing nurse on an inpatient oncology unit that manages all intravenous access sites. As a practicing nurse, it was not a rational process. This author often questioned discontinuing an access site when there was no evidence of clinical necessity. The authors indicated that peripheral intravenous catheters are the most common invasive treatment that patients experience while hospitalized. As an invasive procedure, the authors note that there is a risk of phlebitis and bloodstream bacterial infections. Phlebitis is indicated if there is pain, redness, or swelling at the site due to irritation from the catheter. The CDC currently recommends replacement of peripheral intravenous catheters every 72-96 hours. The authors reference previous studies indicating that the longer the need for treatment requiring a catheter the greater the risk of developing phlebitis versus the length of time one catheter is left in place. Using this information, the authors were compelled to challenge current recommendations of the CDC through a randomized controlled equivalent study. The authors’ use of a well structured purpose statement and introduction gave rise to my interest...
Words: 7010 - Pages: 29
...PREVENTING INTRAVENOUS SITE INFECTIONS AND Preventing Intravenous Site Infections and Phlebitis Betina McCrosky WGU Evidence-Based Nursing Research WZT Task 1 Dec. 27, 2014 1 PREVENTING INTRAVENOUS SITE INFECTIONS AND Article A 1-2 Uslusoy, E., & Mete, S. (2008). Predisposing factors to phlebitis in patients with peripheral intravenous catheters: a descriptive study. Journal Of The American Academy Of Nurse Practitioners, 20(4), 172-180. doi:10.1111/j.17457599.2008.00305.x Introduction Authors of this investigative review wanted to research the predisposing factors in peripheral intravenous (IV) catheters causing phlebitis. Millions of patients hospitalized in the U.S. each year have had an IV or IVs’. The patients in this study received a variety of IV drugs and IV infusion solutions. Review of Literature Phlebitis rates from previous studies range from 41.8% to 68.8%. These studies also looked into consideration of predisposing factors such as age, gender, immunosuppression, aseptic techniques, medications and high osmolality solutions. The authors found conflicting correlations with age, gender and infusion rates being a cause for phlebitis. Catheter size, length of time it was in place, location (site) and the drugs infused had not been studied. Discussion of Methodology This is a descriptive comparative study. Standard protocol for this hospital: Sites are assessed and cared for with povidone iodine 10% every 24 h....
Words: 4047 - Pages: 17
...------------------------------------------------- Applications of Epidemiology – A Case Study Shaneil White July 19, 2015 hSA505 Dr. Chad Moretz July 19, 2015 hSA505 Dr. Chad Moretz Analyze Good Health Hospital’s records and itemize recent nosocomial infections that occurred within the past year. In your report, categorize the different parameters (i.e., person, time, place, ethnicity, and gender) used in the compilation of data into the nformation summative. Currently at the Good Health Hospital, there’s a nosocomial outbreak of E. coli on Ward 10 on the second floor. Four cases have been identified so far linked to spoil food from the cafeteria, with two more cases pending. After meeting with chief administrator Joe Wellborn, one patient could possibly been symptomatic with the bacteria prior to admission. Parameters discussion below: * Person: 4 identified cases. (1. Male, age 23), (2. Female, age 21), (Male, age 15), and (Female, age 42). * Place: Good Health Hospital, Ward 10, second floor; Good Health Hospital cafeteria. Also research has indicated that other area hospitals around Tampa Bay has been contaminated with E. coli as well. * Time: Within the past week. Propose at least six (6) questions for the health care administrator at Good Health Hospital, regarding potential litigation issues with infections from the nosocomial diseases. Rationalize, in your report, the logic behind your six (6) questions. Traditionally, nosocomial infections have generally been viewed as an unavoidable...
Words: 2061 - Pages: 9
...treated in time, can quickly lead to organ failure and death. Approximately one third of people diagnosed with sepsis die from it. The role of emergency departments throughout the country has become vitally important to the early detection and treatment of sepsis. With the implementation of sepsis protocols in the emergency department the mortality of patients with sepsis admitted through the ED is significantly lower. The word sepsis is commonly used to diagnose patients, but the debate continues as to the true definition. The word sepsis comes from the Greek meaning decay or to putrefy.” (A). Sepsis is a general term that is applied to patients that develop clinical signs of infection. Unlike other diseases sepsis is not diagnosed by the location or type of microbe involved in the infection. Some of the criteria used to diagnose sepsis are abnormalities of body temperature, pulse, respirations, and white blood cell counts. Some symptoms that are common in septic patients are fever, hypothermia, heart rate greater than 90 beats per minute, altered mental status, swelling of the extremities, and high blood glucose in diabetic patients. Sepsis is considered severe when there is organ dysfunction involved. Some examples of this kind of dysfunction are low oxygen level, low urine output; high levels of creatnine in the blood, absent bowel sounds, and low...
Words: 1023 - Pages: 5
...for candidemia. The reason for this being, many of the antibiotics like beta-lactams and vancomycin used in the wards and intensive care unit (ICU) settings lead to the depletion of normal bacterial flora resulting in fungal overgrowth. The increasing use of oral vancomycin in the ICUs results in the depletion of anaerobic bacterial flora of the gut. 1.2.2 Intravascular Catheters and Central Venous Catheters Intravascular catheters are also one of the important risk factors in the acquisition of candidemia. Candida species adhere avidly to materials used in intravascular catheters and provide a potential nidus for infection. Some species like Candida parapsilosis are especially implicated in intravascular catheter-related infections in neonates and in the paediatric age group. The role played by intravascular catheters in perpetuating candidemia has implications for its management. Removal of vascular catheters has been advocated as an adjunctive strategy for treating patients with catheter-related candidemia. However, there is some controversy regarding the benefits and risks of removal of vascular catheters in management of candidemia....
Words: 1726 - Pages: 7
...Purpose of the Research This paper will perform a research critique on a qualitative research study published in the Infection Control and Hospital Epidemiology, March 2013, Vol. 34, No.3. The study was presented with contributions from multiple individuals, Dr. A. Gaur, Dr. D, Bundy, C. Gao, PhD, Dr. E. Werner, Dr. A. Billett, Dr. J. Hord, Dr. J. Siegel, Dr. D. Dickens, C. Winkle, RN., and Dr. M. Miller. The research was to identify the host and organism characteristics of the hospital-acquired condition, central line-associated bloodstream infections (CLABSIs) in pediatric hematology/oncology patients. Problem Statement CLABSIs increase the risk for increased mortality and morbidity, extended hospital stays, and raises the overall cost of healthcare. Children’s Hospital Association Hematology-Oncology Quality Transformation Collaborative Project (CHAHQTCP), was a qualitative research project that began on November 1, 2009 and ended July 31, 2011. This project was initiated to identify the contributing factors to blood stream infections (BSI) in pediatric hematology patients. The goal of this research was to reduce CLABSIs by 50%. To be included, the CLABSI needed occur 48 hours after being hospitalized or within 48 hours of discharge. By identifying the organism and the time surrounding the reported symptoms, and by incorporating standardized central venous catheter (CVC) maintenance care bundles with an adherence rate of 90%, the decrease in CLABSIs would be...
Words: 1195 - Pages: 5
...al-careessay.php Sepsis is an infection of the bloodstream. The infection tends to spread quickly and often is difficult to recognize. One of our roles as a nurse is that of patient advocate, and as such we are closest to the patient, placing us in a key position to identify any subtle changes at their earliest onset and prevent the spread of severe infection. Knowledge of the signs and symptoms of SIRS, sepsis, and septic shock is key to early recognition. Early recognition allows for appropriate treatment to begin sooner, decreasing the likelihood of septic shock and life-threatening organ failure. Once sepsis is diagnosed, early and aggressive treatment can begin, which greatly reduces mortality rates associated with sepsis. sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body's often deadly response to infection or injury (Merriam-Webster, 2011) Sepsis is a potentially life-threatening condition caused by the immune system's reaction to an infection; it is the leading cause of death in intensive care units (Mayo Clinic Staff, Mayo Clinic 2010). It is defined by the presence of 2 or more SIRS (systemic inflammatory response syndrome) criteria in the setting of a documented or presumed infection (Rivers, McIntyre, Morro, Rivers, 2005 pg 1054). Chemicals that are released into the blood to fight infection trigger widespread inflammation which explains why injury can occur to body tissues far from the original infection. The body may develop the inflammatory...
Words: 3635 - Pages: 15
...Healthy kidneys clean the blood by removing excess fluid, minerals, and wastes. They also make hormones that keep the bones strong and the blood healthy. After removing the water and waste from the bloodstream, it excretes them through urine (McDonnell & Mallon, 2005). Various conditions can damage your kidneys, including both chronic kidney disease and other conditions that affect the kidneys. If kidney damage becomes too severe, your kidneys lose their ability to function normally. This is called kidney failure or end-stage renal failure. According to the National Kidney Foundation (2005), more than 378,000 Americans suffer from chronic kidney failure and need dialysis or kidney transplantation to stay alive. End-stage renal disease is the name for kidney failure so advanced that it cannot be reversed. Renal is another word for kidney. The “renal” name is appropriate due to the fact that the kidneys in end- stage renal disease functions so poorly that they can no longer keep you alive (McDonnell & Mallon, 2005). End-stage renal disease cannot be treated with conventional medical treatments such as drugs. In chronic kidney disease only two treatments allow you to continue living when your kidneys stop functioning: dialysis and kidney transplantation, but only one offers a longer chance of survival. Dialysis is the term for several different methods of artificially filtering the blood (McDonnell & Mallon, 2005). Dialysis is a procedure that replaces some of the...
Words: 2299 - Pages: 10
...This assignment reflects on one day’s care delivered to a patient during my practice as a healthcare support worker (HSW). It presents anatomy and physiology of the urinary system and focuses on the patient’s catheter use, urinalysis, regular intake of medication and legal issues associated with delivery of care to the patient without mental capacity to make crucial decisions in his life. For the purpose of this care study, I use the pseudonym Chris for the patient in order to protect his identity and maintain confidentiality (NMC, 2008). There is also a legal obligation under Data Protection Act (1998) not to disclose patient’s personal details. Chris is a 73 year old male, who I worked with in a residential home for people with learning disabilities and challenging behaviour, where he was residing. Chris has been diagnosed with a learning disability (LD), which means that he has significantly. reduced ability to understand new or complex information and learn new skills (Department of Health, 2002). He has a reduced ability to cope independently due to recent leg amputation and the LD. Amputation is the surgical removal of a limb or body part (Mosquera, 2010). It was performed on Chris’s right leg above the knee to relieve the recurring pain caused by a severe case of peripheral artery disease (PAD). The PAD is a form of peripheral vascular disease in which there is partial or total blockage of an artery, caused by deposits of fat built up along its walls (Patient UK,...
Words: 6993 - Pages: 28
