Tubing
CVAD General
CVAD CARE
MISC
PICC Dressing change
100
Continuous IV tubing hang time
What is 96 hours?
100
Clinical indications to place or continue the use of a CVAD (Central Venous Access Device)
What is
1.Caustic Medications/Vasoactive/Chemotherapy 2. Clinical instability/complex infusion regimen 3. Hemodynamic Monitoring 4.Inadequate peripheral access 5. HD/CRRT/Pheresis 6. TPN 7. Long term infusion therapy/antibiotics
100
Method used to maintain aseptic non touch technique when handling tubing
Wearing gloves after hand hygeine
100
These lines are used for placement of other CVADS and have a port to deliver fluids but requiring a central tip location should not be delivered through them.
What is an introducer?
200
Propofol and Lipid infusion hang time
What is 12 hours?
200
Patient admitted with a CVAD, steps required to use this line.
What is 1.Order for CXR with verification of tip before use. 2. Change dressing to assess site within 12-24 hours. 3. Change Needless connectors and apply curos caps to all lumens and port 4. Assess blood return and patency of each lumen 5.PiCC lines placed at Swedish- check external catheter measurements for migration
200
Prior to accessing injection ports or hubs the scrub time and dry time for hub and injection ports
What is 5 seconds scrub time and 5 seconds dry time for prevantics?
What is 15 seconds scrub time and dry time until dry(15 seconds) for alcohol wipes.
200
Your assessment findings of a peripheral IV site
What is extravasation?
200
After removing the PICC dressing, on inspection you notice the line has migrated out 4 cm. Next step
What is get a CXR to verify placement is still correct?
300
Blood Tubing hang time/
What is 4 hours?
300
Elements of QS and PRN assessment of a central line through the transparent dressing.
What is assess dressing to ensure clean, dry, and intact. Ensure entire dressing is adherent to the skin and antimicrobial square is over the insertion site of the CVAD. CVAD and Surrounding skin is assessed for color, temperature, swelling, redness, or drainage
300
Frequency of CVAD dressing changes when they remain clean, dry, and intact.
What is 7 days.
300
On assessment you find:
What is a reaction to CHG or tegaderm? Use an alternate dressing; sorbaview or nonocclusive dressing-gauze
300
Prior to removing the dressing, both the patient and you should
What is don a mask? If patient refuses, have them keep their head turned away
400
TPN Tubing hang time?
What is 24 hours?
400
Completed prior to applying gloves to access a central catheter or midline.
Wash your hands or complete hand hygeine
400
Claves or Needless access devices need to be changed
What is every 7 days or when blood/debris can be see in them or prior to blood cultures
400
On assessment of the CVAD, one lumen has no blood return and is sluggish to flush.
What is a partial occlusion? Follow the occlusion algorithm and infuse 2 mLs of TPA to the lumen with no blood return.
400
The patient is allergic to chlorhexidine, you use betadine swabs instead. The dry time changes to
What is two minutes? You also go back to the bullseye approach to cleansing the site.
500
Secondary tubing is disconnected from primary tubing, intermittent tubing hang time
What is 24 hours
500
Flushing volume pre and post blood draws
What is 10 mLS before blood draw and 20 mLs post draw. Flushed with intermittent push pause method.
500
Intervention and frequency of intervention to prevent Staph Epidermis
What is CHG wipes applied to clean skin every 24 hours?
500
Reduce harm when extravasation occurs in the peripheral IV infusion of levophed.
What is stop the infusion, disconnect the IV but leave in place, call the provider and request phentolamine, consider a cool compress.
500
I am concerned the PICC will fall out once the stat lock is off. To prevent this an action is taken
What is apply a small piece of tape to the PICC ensuring the tape is not on the catheter itself