...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. PIVs are changed routinely every...
Words: 4047 - Pages: 17
...Evidence Based Practice: Aseptic Technique for Peripheral IV Insertion Name: Course: Instructor’s Name Date: Introduction The significance of asepsis in the intravenous IV therapy is integral in the modern patient care because of the increased patients number requiring IV therapy due to changes in patterns of prescription and the today’s illnesses which has acute nature (Bofah et al, 2012). Peripheral Intravenous Cannulation according to Bofah et al (2012), is a procedure in which patent’s skin is punctured with a needle allowing a device to be temporarily inserted into the hand or forearm veins in administering intravenous medications or fluids, although other body sites can be used. It is vital to use intravenous drugs in the management of the patients who are hospitalized. The infections linked to the intravenous therapy may affect the blood stream or the skin around the insertion site of the catheter (Bofah et al, 2012). For this reason, Bofah et al (2012) suggested that general infection control and universal precautions measures need to be taken into considerations when undertaking a clinical procedure. However, specific measures need to be taken into consideration when administering intravenous therapy especially those in the home setting and the vulnerable patients. Kampf et al (2013) conducted an observational intervention study on “Improving Patient Safety during the Insertion of Peripheral Venous Catheters. The aim of the study was to determine the...
Words: 1259 - Pages: 6
...Prospective Randomized Trial 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...
Words: 5706 - Pages: 23
...Newborn and premature critically ill infants in neonatal intensive care units face many challenges. Infants have delicate veins, so peripheral IVs usually last only a few days. A centrally inserted intravenous line is similar to a peripheral IV line, but lasts longer. It is difficult to insert these lines in newborn and premature infants and takes several attempts, thus making them more prone to infections, especially nosocomial infections which are very common in neonatal intensive care units. The most common infection is the central line associated blood stream infection (CLABSI). The risk is greater when the central intravenous line is in place for a longer duration, prolonged use of antibiotics, parental nutrition, low birth weight infants, low immune system, and lack of staff education. Inserting a central intravenous line is a sterile procedure so it is a nurse’s responsibility to minimize the risk of infections. Health care-associated infections increase the length of hospitalization, hospital cost, patient discomfort, and morbidity and mortality rates (O'Grady & Pearson, 2002). Thus, it is important for health care professionals to be responsible for knowing their roles and using maximum sterile barriers while placing and caring for central venous catheters. According to the Agency for Healthcare and Research Quality (AHRQ), there are many practices healthcare professionals should follow to prevent CLABSI (Marschall, 2008). The use of maximum sterile barriers are one of...
Words: 1004 - Pages: 5
...Evidence Based Practice: Aseptic Technique for Peripheral IV Insertion Name: Course: Instructor’s Name Date: Introduction The significance of asepsis in the intravenous IV therapy is integral in the modern patient care because of the increased patients number requiring IV therapy due to changes in patterns of prescription and the today’s illnesses which has acute nature (Bofah et al, 2012). Peripheral Intravenous Cannulation according to Bofah et al (2012), is a procedure in which patent’s skin is punctured with a needle allowing a device to be temporarily inserted into the hand or forearm veins in administering intravenous medications or fluids, although other body sites can be used. It is vital to use intravenous drugs in the management of the patients who are hospitalized. The infections linked to the intravenous therapy may affect the blood stream or the skin around the insertion site of the catheter (Bofah et al, 2012). For this reason, Bofah et al (2012) suggested that general infection control and universal precautions measures need to be taken into considerations when undertaking a clinical procedure. However, specific measures need to be taken into consideration when administering intravenous therapy especially those in the home setting and the vulnerable patients. Kampf et al (2013) conducted an observational intervention study on “Improving Patient Safety during the Insertion of Peripheral Venous Catheters. The aim of the study was to determine the application...
Words: 1243 - Pages: 5
...Central venous access located in the chest; the digestive system is bypassed. The TPN catheter is used only for nutrients; medications are not added to the solution. Often the placement is done in an operating room under local anesthesia and sterile conditions to decrease the chance of infection. Once the catheter is in place, a chest x ray is done to make sure the placement is correct. The outside tubing leading from the bag of solution to the catheter is changed daily, and special dressings covering the catheter are changed every other...
Words: 488 - Pages: 2
... Page 2 Page 3 Page 4 • Market studies identified new opportunity, which will increase company market share for central venous catheter product by 10 % profit. Introduction about central venous catheter • Heart block and arrhythmia are complications of pulmonary artery and cardiac catheterization. Injury to the conducting system of the heart often involves the right bundle causing right bundle branch block (RBBB). If patients already have left bundle branch block (LBBB), complete heart block (CHB) may result. After trauma, impairment of the right bundle is usually transient with recovery in hours, but complete heart block can lead to symptoms requiring invasive treatment. Similar complications are rare with insertion of central venous catheters, as they should not enter the heart. Injury to the right bundle during central venous catheter insertion can be by trauma from the guide wire or from the catheter itself. The function of the AV node and bundle of His in these patients has not been studied before. We report a patient with LBBB who developed CHB during insertion of a central venous cannula. Conduction through the AV node and His–Purkinje system was intact, showing that the transient RBBB was caused by traumatic injury rather than by other disease of the conduction system. Designing central venous catheter product, which will appeal customer who are looking for a quality, healthy, sterility, and pyrogen free. The new product should be on shelf in test...
Words: 2122 - Pages: 9
...NR 447 Collaborative Health Care Introduction Smart goal #1; nursing will assess for appropriate use of indwelling catheters every shift in order to prevent CAUTI, nursing will obtain an order for discontinuation if no longer needed, this will be audited weekly in order to reach the goal of zero UTI’s on a monthly basis. This smart goal was developed to insure nursing is doing everything possible to prevent CAUTI. The goal steers toward patient safety and because Medicare and Medicaid do not reimburse for UTI’s acquired while hospitalized any longer. Smart goal #2; there will be 100% compliance in doing CVAD assessments, dressing changes, and the use of 70% isopropyl alcohol caps (CURO’s) in order to decrease the rate of CLABSI’s in the Medical-Surgical unit. This goal is to insure nursing is doing proper assessments, dressing changes, proper hand hygiene, using CURO’s caps and handling techniques in order to prevent contaminating the line. Goal 1: Preventing CAUTI Prevention of Hospital-acquired UTI’s should be a goal for every acute care setting to prevent the high cost of treatment, each episode of symptomatic CAUTI cost at least $600. It is not surprisingly the most common of health care associated infections accounting for about 40% of HAI’s. (Saint Et.al) This goal is to develop a way for nursing to assess the use of indwelling catheters and discontinue them if not needed to prevent CAUTI. Peer Reviewed Article Translating Health Care- Associated Urinary...
Words: 1011 - Pages: 5
...M. R. (2010). Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial. BMC 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...
Words: 7010 - Pages: 29
...narrowing/ hardening of the arteries, respectively. Vascular surgeons are focused on fixing vessels in nearly all parts of the body with the exception of the brain and heart. They also deal with peripheral vascular disorders like ulcers on the lower extremities and poor circulation. Surgical approaches to vascular repair may be endovascular (i.e. closed) or open surgery. Endovascular surgery Procedures that fall...
Words: 718 - Pages: 3
...Help me; I have to start an IV, and now! Darmeshia Brunson Leadership Mrs. Erica Lue Fortis Institute ABSTRACT Nurses frequently face challenges placing peripheral intravenous (IV) lines in adults and children. Multiple venipuncture attempts can heighten patient anxiety and suffering, delay vital treatment, and increase costs. Numerous factors such as small, fragile or hidden veins can predispose patients to collapsed veins due to dehydration are especially challenging. Several techniques can improve venous prominence, but when IV access cannot be achieved promptly, other routes of administration can be valuable. For rehydration fluids and certain drugs, subcutaneous administration may be a safe and effective alternative, providing cost and ease-of-use advantages. The word intravenous simply means “within a vein”, but it is usually used to refer to IV therapy. Intravenous therapy is getting fluid directly into a vein. It can be intermittent or continuous; continuous administration is called an intravenous drip. Treatments administered intravenously are often much needed medications. Compared with other routes of giving medications, the intravenous route is the fastest way to deliver fluids and medications to the body. Some medications, like blood transfusions, can only be given intravenously. I have to put in an IV, my patients’ pervious IV is older than 72 hours and per protocol a new has to go in. Oh, I remember back in nursing school going to clinical watching the...
Words: 1573 - Pages: 7
...1. Describe nursing care of the post angioplasty patient. A coronary angioplasty is a procedure to open an area of the arterial blockage in the heart that has become narrowed. This allows better blood flow through the artery and to the heart muscle. It is often done with a catheter that has an inflatable small sausage-shaped balloon at its tip. Coronary angioplasty is being increasingly used as a treatment for coronary artery disease; the proper evaluation and management of patients after the procedure are important issues. Although coronary angioplasty is a complex technical procedure, the methods routinely used to evaluate its results have many limitations. The management of the patient during the first 24 hours after angioplasty should focus on the prevention, detection, and if necessary treatment of acute vessel closure. Assessment: When the patient returns from the cardiac catheterization laboratory, the stability of the patient should be established initially. This will include, but is not limited to, EKG, vital signs, oxygenation level, urine output, cardiac, respiratory, pulmonary, gastrointestinal, and gentle urinary assessment. Particular attention must be paid to the peripheral vascular assessment of the lower extremities. Often the patient may return from the cardiac catheterization laboratory with a sheath in place. If this is the case, the institutional procedures for caring for sheaths should be applied. Some institutions, may allow the nurse to remove that...
Words: 2162 - Pages: 9
...8, 2009 Nurse Perspective Epidural anesthesia is a procedure utilized frequently, for pain relief, by woman enduring the labor process. There are many considerations that the nurse is responsible for prior to, during, and after the procedure is performed. Knowing what these assessments, provisions, interventions, and evaluations are will prevent harm of the patient and ensure suitable pain relief measures are successful. According to Wong, epidural is the most effective pain relief measure used for labor (Wong, Perry, Hockenberry, & Deitra Leonard Lowdermilk, 2006). Epidural by Definition Epidural anesthesia involves the process of placing a needle fed catheter into the epidural space of the spinal column in between the L4 and L5 lumbar vertebrae. The purpose of this placement during labor is to block the T10 to S5 required for pain relief of all body areas involved in labor without suppressing organ function and decreasing LOC (Wong, Perry, Hockenberry, & Deitra Leonard Lowdermilk, 2006). The quantity and type of medication used determines the inhibitory effects on motor function and activity. This is a consented procedure which requires adequate education. Assessment Upon admission to the labor and delivery unit, the nurse should be attentive to any surgical history, allergies, obstetrics history, current medications, renal function, last meal eaten and at what time, contraction pattern, progression status of labor, and current maternal...
Words: 1702 - Pages: 7
...Arterial Lines 3/8/05 1- What is an a-line? 2- What are the parts of an a-line? 3- Does it matter if the flush setup is made with saline or heparin? 4- What are a-lines used for? 5- What do I have to think about before the a-line goes in? 6- What is an Allen test? 7- Where can a-lines go besides the radial artery? 8- Who inserts a-lines? 9- How is it done? 10- What kinds of problems can happen during a-line placement? 11- How do I use an a-line to monitor blood pressure? 12- How should I set the alarm limits? 13- How do I draw blood samples from a-lines? 14- What order do I draw the tubes? 15- How often does the transducer setup have to be changed? 16- What kind of dressing goes on an a-line site? 17- What is the armboard for? 18- Does the patient’s arm have to be restrained? 19- What if my a-line has a good tracing on the screen, but I can’t draw blood from it? 20- What does “dampened” mean? 21- What if I lose the trace completely? 22- How often should I check the pulse at the a-line site? 23- How do I know if the patient’s hand is at risk? 24- What do I do if the line disconnects at the hub/stopcock/transducer? 25- What do I do if the patient pulls out her a-line? 26- How do...
Words: 3995 - Pages: 16
...NURSING CARE PLAN COURSE: Basic Adult Health CLIENT INITIALS: DATE OF ADMISSION: AGE: GENDER: JL June 13, 2011 85 M HT: WT: ALLERGIES: 140 lbs. NKA CODE STATUS: FULL RACE/ETHNICITY: CULTURAL CONSIDERATIONS: Caucasian None RELIGION/SPIRITUAL CONSIDERATIONS: Unknown OCCUPATION/HOBBIES/RECREATIONAL ACTIVITIES: Retired LIVING SITUATION/WITH WHOM: (home, assisted living, LTC, etc) Lives with daughter. SOCIAL HISTORY: (tobacco, ETOH, illicit drugs, family dynamics) Quit smoking many years ago, no history of ETOH or drug use. NURSING CARE PLAN ADMITTING MEDICAL DIAGNOSIS: Client's principal admitting diagnosis was leukocytosis. Definition: (from Taber’s) “An increase in the number of leukocytes (usually above 10,000/mm3) in the blood. It occurs most commonly in disease processes involving infection, inflammation, trauma, or stress, but it also can result from the use of some medications” (Venes, 2009, p. 1327). Etiology/pathophysiology: ( NOT from Taber’s or Wikipedia) Etiology: Causes of leukocytosis are infection, inflammation, tissue damage, immune reaction, bone marrow problems, medications, and stress (Drug Information Online, 2011). Pathophysiology: “Leukocytosis can be a reaction to various infectious, inflammatory, and, in certain instances, physiologic processes (eg, stress, exercise). This reaction is mediated by several molecules, which are released or regulated in response to stimulatory events that include growth or survival factors (eg, granulocyte...
Words: 3941 - Pages: 16
