CLABSI
If qwick clot is used on bleeding central line insertion site, what is the length of time the dressing can stay in place before needing to be changed?
Dressing can remain in place for 24 and must be redressed with use of biopatch per protocol.
How often can you straight catheterize a patient post foley removal?
Patients can be straight catheterized 4-6 times in 24 hours. All patients are assessed for voiding AND post void residual THUS you need to bladder scan for the first 48 post foley catheter removal.
Who is responsible for cleaning the work on wheels (WOW) table top and keyboard and what products are used?
IC 71 Portable Electronic Device Guidelines state environmental services clean BELOW the keyboard but staff should clean at least daily the work surface and keyboard with appropriate products. Supersani cloths unless in an isolation room necessitating bleach wipes.
What policy governs Indwelling Urinary Catheters including post foley catheter removal protocols?
CO 2.662
When are TKO caps changed?
When you draw BLOOD CULTURES (not routine labs) and every 7 days.
What do you do if you receive an order to obtain a urine CULTURE from an indwelling urinary catheter(IUC)?
In patients with an IUC, a urinalysis should be sent using a disinfected sampling port and results interpreted by provider PRIOR to ordering culture. IF culture is required, REPLACE catheter with a new catheter prior to obtaining the urine specimen.
What type of precautions are used for a patient with c. diff or norovirus?
The expanded isolation table will identify patient needing CONTACT PLUS. This includes ALL wear gowns and gloves, Clean hands going in and SOAP AND WATER (not hand sanitizer) cleansing upon leaving and a SPORICIDAL product (not Supersani cloth) to clean and disinfect surfaces & equip before use on other pts.
What policy governs CHG bathing for adults?
IC 99 CHG Bathing for Adult Critical Care
What is the treatment for COMPLETE, PARTIAL or WITHDRAWAL occlusion and where can you find guideance?
NA 7.300 Central Vascular Access Device (CVAD) Occlusion Management and the Administration of TPA/Alteplase Guidelines. If line is not functioning appropriately, it should be fixed. Do NOT leave one line occluded if other are functional. ALL LUMENS NEED TO FUNCTION PROPERLY.
What is a bundled maintenance approach to preventing CA-UTI?
Hand hygiene before/after glove use, Properly secured, Bag below level of bladder at ALL times, NO kinks/dependent loops, NEVER more than 2/3 full bag, EMPTY bag before ALL transports, ALWAYS closed system, Date/Time of insertion on bag, Catheter MUST be changed every 30 days or when unable to determine date of insertion, graduates for emptying bags should be labeled w/pt sticker and identified as foley, Peri/foley care Q shift
Procedure before touching any central line
What is hand sanitizing and donning clean gloves?
Where can you find information on where medications can be administered by nursing?
CO 13. 420 Guidelines for IV Medication Administration by Nursing ....This lists where IV medications can be given ie critical care, intercare, acute medical
What do all adult patients 18 years and older receive while in the ICU as part of CLABSI prevention even if they do not have any central access?
IC 99 CHG Bathing for Adult Critical Care . ALL patients in the ICU need this daily unless sensitive or allergic. It must be appropriately documented in patient hygiene section identified as CHG wipes.
If patient requires a indwelling catheter for urinary retention, how long should it stay in place before removal?
RN will remove the ICU after 72 hours to do a voiding trial and reassess the need for the ICU.
What do you use to describe stool consistency and whether to send for c diff testing?
Bristol Stool Chart is used for describing stool consistency. NEW C Diff algorithm used to determine need for testing.
Where can you find information on what type of isolation a particular infection warrants?
Expanded Isolation Table lists various types of isolation
What is the correct way to use a BIOPATCH?
BIOPATCH must have printed side up (blue to sky) with edges of radial slit approximated so the edges touch together. BIOPATCH that is upside down, saturated, on top of the line or slits not touching together MUST BE CHANGED per protocol with sorbaview dsg.
Urinary catheters should be evaluated twice daily for need and promptly removed when no longer necessary. What are the exclusions from this nurse driven protocol?
***Select Urology and Urogynecology patients that have undergone bladder, urethral or ureteral surgery and those that required a Urologist to insert the catheter may be excluded from the nurse driven protocol to remove catheter. Pediatrics confirm w/provider prior to removal***
What are the 5 moments of hand hygiene?
Before touching a patient
Before a procedure
After a procedure or exposure to body fluids
After touching a patient
After touching a patient's surroundingsWhere can you find information on Vascular Access and Management?
IC 93 Vascular Access and Management