CHG
This special antiseptic soap works for 24hs, helps remove germs and prevent infection.
CHG
Bonus:
•CHG is more effective than soap and water
•Soap and water is immediate, short lived, and effect is lost upon contacting new contaminated surfacesRefers to the manual push of fluid via a syringe through the lumen of the catheter with 10 short boluses of 1ml interrupted by brief pauses.
Pulsatile flushing
Perineal care 2 times per day: 1 during CHG bath; soap and water on the alternate shift, describes the care of what type of patient?
Patients WITHOUT a foley catheter and or femoral device
This can occur if insufficient blood was drawn or if patient has received antibiotics prior to culture being drawn.
False negative blood culture
RCA is an abbreviation for…
Root cause analysis
Bonus Info:
This is how long CHG should be on the skin to receive maximum benefit
At least 2 minutes
Bonus: Do you rinse off?
Type of peripheral IV catheter inserted in the upper arm via the basilic, cephalic, or brachial vein with the internal tip located at or near the level of the axilla and distal to the shoulder.
Midline catheter
Perineal care 4 times per day (1 during CHG bath; every 6 hrs thereafter with soap and water) describes what type of patient?
Patients WITH a foley catheter or femoral device
This may occur when cultures are contaminated by improper skin antisepsis during draw or contamination of blood or culture by organisms during culture process.
False Positive blood culture
What should you consider if a patient has unexplained, new onset diarrhea (3 or more loose or watery stools in 24 hrs) or GI symptoms following recent or current course of antibiotics?
C.diff infection
Bonus Info:
Patient’s should clean with CHG their body areas in this order
These are the steps needed to be competent in Central Line Removal on Transplant IMC
Initial completion of UMMS U Module: Central Line Removal
Two observed in practice removals by
When should a foley catheter be replaced?
On admission from an outside facility
Bonus: Urinary catheters are not routinely changed unless...
True or False for Blood Culture Collection
These are strategies to prevent the spread of HAIs
This is something you can tell patients to promote CHG treatment compliance
"This CHG treatment is important while in the hospital to reduce bacteria on the skin and prevent infection.”
“ You can ask your family to bring your home product to bathe. However, you should apply the CHG treatment afterwards to decrease the risk of infection.”
“ What is the best time for your CHG treatment? What time do you usually bathe at home?”
Central Line daily care includes...
RN Assessment of dressing integrity. PCTs/SNs notify RN if dressing is not intact.
RN flushing of lumens.>>>
PCT/SN or RN CHG treatment cleaning of lumens
1. use CHG all around CL dressing
2. Use a new CHG cloth around and down the CL luments
3. Use that CHG cloth to wipe around and down the first 6 inches of CL tubing.
4. Do not use CHG directly on CL dressing
What do you need before placing a foley catheter or straight catheter?
An order from the provider with correct indication
This is needed if a blood culture is obtained from an existing central catheter. *last resort only*
A onetime provider order.
Bonus: Central line culture should be accompanied by a peripheral draw whenever possible.
If a patient is unwilling to accepts a full body CHG treatment after multiple attempts what kind of CHG treatment is acceptable?
A minimal CHG Treatment.
1. Treat armpits, neck and chest
2. If central line present, wipe down the lumens and clamps.
3. Treat groin area and invasive lines.
A full treatment is best, but a minimal treatment is better than no treatment.
Document comment that a minimal treatment was completed
Who do you notify if a patient refuses a CHG treatment?
PCT/SN --> RN
RN --> Charge Nurse --> Provider
Education must be provided directly to the patient prior to escalation to the next level.
BONUS: What information is documented with a refusal?
This is how long a patient should remain in a flat or reclining position after central line removal
30 minutes
Tubing low points may be a contributing cause of bacteriuria and urinary tract infection among catheterized patients is also known as
Dependent loop
Where should the foley bag be hung on the bed?
Label the bottle with the patient's identifying data - avoid placing the label over the bar code on the bottle.
When completing the microbiology requisition form, note whether the culture was drawn from a catheter or peripheral vein, and specify the type and location of catheter and location of vein.
Accurate documentation of collection location is diagnostically important.
This Infection Prevention strategy reduces MRSA bacteremia and other MRSA infections
Nasal decolonization for patients colonized with MRSA + CHG treatments
Screen high risk patients using nasal swab for MRSA colonization to guide use of contact precautions, decolonization and antibiotic mgmt.