Cauti/Foley Care
What is the 5th most common healthcare-associated infection, which is 100% related to an indwelling catheter.
CAUTI - Catheter Associated Urinary Tract Infection
What does CLABSI stand for?
Central Line Associated Blood Stream Infection
What should the patient take pre-op CHG shower(s) or bath(s)?
The night before and the morning of surgery.
What are the clinical symptoms of C-Diff?
Temperature greater than 110.6, nausea, loss of appetite, abdominal pain.
What are the criteria for Sepsis?
2 SIRS criteria AND a confirmed or suspected infection
What is the best way to prevent a CAUTI?
Avoid placing a catheter!
What agent should you use to clean central line sites?
Chlorhexidine
What should be removed prior to surgery?
Underwear, dentures, contact lenses, jewelry.
What is the antibiotic of choice to treat C-Diff?
Vancomycin
What do we see with Severe Sepsis?
Organ Dysfunction
Ex: Hypotension (SBP<90 mm/hg or MAP <65), Lactate > 2, Platelets < 100,000, INR >1.5, Creatinine over 2.0, Bilirubin over 2.0, Need for mechanical ventilation
How often a foley collection bag should be emptied
What is every 8 hours or when half-full
What is the technique used to flush central lines in order to prevent fibrin build up?
Push-Pause Technique
What are some signs and symptoms of a surgical site infection?
Redness, warmth, fever, tachycardia, tenderness, delayed healing, swelling, odor, discharge.
How do you clean your hands when exiting a C-Diff room?
Soap & Water
What is the formula for fluid resuscitation in Septic Shock?
30mg/kg bolus of 0.9NS or LR
What are alternative methods to placing a foley catheter?
Bedside commode, programmed toileting, condom catheter, primo-fit, purewick, urinal, scheduled straight caths.
Prior to use, what should be done with every central venous access device?
Confirm placement.
What gauge IV should a patient have prior to surgery?
20 gauge or larger.
What type of cleaning agent is used in C-Diff rooms?
Bleach
What is the vasopressor of choice for septic shock?
Levophed - to constrict peripheral vessels offsetting the peripheral vasodilation of sepsis.
What prevents urine from backflowing into the bladder?
Having NO dependent loops in the tubing.
How long should you clean (and let dry) the central line site prior to applying dressing?
*NOT a groin line*
30 seconds each
What parts of the body should patient's NOT use CHG foaming soap?
Ears, eyes or mucus membranes.
What are other factors that can contribute to new onset liquid/watery stool?
Stool softeners, laxatives, enemas, lactulose, medications, newly initiated enteral feeding, oral contrast, bowel prep.
What orders can the nurse place *per protocol* when the Sepsis BPA (best practice alert) fires?
Lactate, CBC, Paired Blood Cultures