Infection Control
What is the FIRST thing you should do when you enter a patient's room to do any central line care?
Hand Hygiene
How often should a dressing change be preformed?
7 days
Or sooner if it becomes wet, soiled or loose
What kind of gloves do you need for any central line care?
Sterile Gloves
Chemotherapy can be administered through a midline catheter.
False
You cannot administer chemotherapy via midline catheter
You enter the patient's room and upon assessment notice that the central line measurement is π cm displaced. What is the RN priority action?
Call the MD for displacement over 2cm
What should you instruct your patient to do before the dressing change in order to prevent contamination?
Provide patient with a mask and instruct them to look away
Don't forget yours :)
Describe how you clean the port and when do you know to stop?
Scrub the hub 15-30 sec facing downward and you know to stop when there is no more debris
Before applying the Tegaderm what must the RN confirm is there to protect line from infection?
Biopatch
You must wear sterile gloves in order to remove old dressing
False
Non-Sterile gloves can be used
How often are you reassessing the site? (Adult and NICU)
Adult - Q4h (every 4 hours)
NICU - Q1h (every hour)
If the patient reports a chlorhexidine allergy what is the alternative solution used?
Iodine
Gauze can be used instead of a Tegaderm for dressing in what circumstance and how often must it be changed?
Patient is allergic to Tegaderm
Must change every 48 hours
What color is the Stat lock package that should be used for central line care
Green
Minimum 5ml NS can be used to flush a valve
False
10ml is the minimum amount of flush to be used
What would the RN do if there is swelling at the site? (Hint...2 things)
Elevate the arm
Notify the provider
What should be used to clean your station before providing central line care?
Hospital Approved Wipes (Purple Container)
How do you scrub to clean the patients skin?
Scrub away from the insertion site in a circular motion starting from the middle going out
What type of valves are used for valve change?
Positive Pressure Reflux Valves
True
So smart :)
What signs and symptoms would you see in a patient with an active infection? (5 s/s)
Temperature Change
Increased Heart Rate
Increased RR
Redness/Tenderness/Swelling
Increased Drainage/Purulent
Sterile Gloves, Mask, Sterile Field
Name the supplies needed for Central line dressing change.
Central Line Dressing Kit
PICC line STAT Lock
Biopatch
2 masks
Sterile Drape/Gloves
Tegaderm
What supplies are needed for valve change
Nonsterile Gloves
2 Positive Pressure Valves
4x4 Gauze
10 ml Saline Flushes
Curos Caps
Chlorhexidine Swabs
A new grad RN without certifications can remove a long term PICC line.
False
Only providers, PAs, NPs, and PICC certified RNs can remove PICC lines
In what instances would the RN reassess the central line site?
After Insertion
Upon Admission
Transfer
With every dressing change