Blood Cultures
T or F: If the patient is a hard stick you can insert a central line to pull blood cultures?
False. Optimally, all blood cultures should be obtained by peripheral venipuncture unless indicated for a diagnosis of CR-BSI (Best practice guidelines indicate that drawing blood cultures from a central line or peripheral IV are more likely to produce false positive results).Page 12
This is how we choose the best insertion site for any IV.
What is "the best insertion site will minimize infections and noninfectious complications based on individual patient characteristics"? Page 1
This is how long you scrub the hub.
What is 15 seconds?
A vigorous 15- second manual mechanical scrub (regardless of product)
Page 9
This is how often you change a central line dressing.
What is every 7 days and PRN? Page 7
What is ITRACE?
I: Illuminate
T: Touch the line or tube and Trace it
R: Perform a cognitive review
A: Act
C: Clarify & Correct
E: Expect to use I-TRACE
Page 2
Used for skin cleansing, done this long and with what technique.
Perform skin antisepsis with CHG using a side to side motion for 30 seconds with 30 second dry time and No Touch Technique. Page 12
This is the type of barrier precautions used for a traditional Midline insertion procedure.
What is "maximal sterile barrier precautions"?
This is when you scrub the hub.
What is prior to each VAD access?
Page 9
This is how often you change a peripheral IV dressing.
What is every 7 days and PRN. Page 7
This is how often to replace IV tubing.
What is "every 96 hours except with placement of new VAD or specific medication requirements"? Page 10
I can draw blood cultures.
The person drawing the culture must be checked off on the correct procedure before drawing a blood culture. (On most units this is restricted to the Charge nurse or CNC.)
Do you use guidewire exchanges to prevent infection?
Do not use guide wire exchanges routinely for non-tunneled catheters to prevent infection. d. Do not use guide wire exchanges to replace a non-tunneled catheter suspected of infection. Page 15
This is how often to change needless connectors.
What is with every dressing change and PRN.
Needleless connectors shall be changed with dressing change (every 7 calendar days) or PRN. (Mask required). Page 8
This is what we cleanse with during a dressing change.
What is CHG?
You waste this much when drawing blood cultures from a central line.
What is none?
Do not draw any waste before obtaining blood culture sample from a CVAD. Page 13
This is how often we routinely replace CVC's, PICC's, HD catheters or Pulmonary Artery Lines in order to prevent catheter related infections.
What is never?
Do not routinely replace CVCs, PICCs, or hemodialysis catheters, or pulmonary artery catheters to prevent catheter-related infections. Page 14
This is the type of flushing method used to flush an IV.
What is pulsatile flushing?
Pulsatile flushing: flushing in a push/ pause method to create turbulent flow on the inside of the catheter. Page 2
This is when a dressing change should be performed on a patient with a pre-existing CVAD.
What is "on admission"?
This is what to clean with if the patient has an allergy to CHG.
What is "70% alcohol or iodine applied with concentric motion for 30 seconds with 2 minute dry time using No Touch Technique"?
These are the types of lines that require a biopatch.
What are "CVC, PICC, HD catheters, Implanted port, Arterial lines and Midlines"?
This is how much NS you should flush your VAD with before each use.
What is "10 mLs"?
This is the technique that is used for all CVAD/ Implanted Port/ PICC/ ML dressing changes.
What is "sterile technique"?