Tell me more - bloodstream infections
what is a bloodstream infection?
bacteria enters bloodstream
where do I document abnormal findings about Saline locks?
Progress notes
Why do we cleanse the catheter site with alcohol swabs?
maintain sterility and prevents infection
True or false: when an intermittent infusion is complete, I can cap the tubing with an aseptic cap or loop the exposed end to an available opening on the tubing.
False
How often should Intermittent administration sets be changed?
Q24 hours
Symptoms of Bloodstream infection
Fever, Abdominal pain, malaise, nausea/vomiting, SOB, high heart rate, confusion
what do I need to include in my progress note when inserting a new IV?
IV cannula insertion site
gauge, length and type of cannula inserted
number of attempts to insert cannula
patient's response to procedure
Why do we flush IV locks? (2)
1. prevents thrombi and fibrin deposit formation - prevent microbial colonization
2. maintain patency and reduce phlebitis
How do you establish and maintain patency of a PICC?
> aspirate blood from catheter
> flush with 20ml NaCl using start stop technique
How often should central or peripheral IV dressings be changed?
Q7 days and PRN
Complications from bloodstream infections
meningitis, endocarditis, osteomyelitis, sepsis, cellulitis, peritonitis
where do I document continuous infusions
Continuous Parentral therapy record on the clinical flowsheet
What is the purpose fo using the "start-stop" method when flushing a PICC
creates turbulent effect to remove blood and or meds from inside catheter to prevent occlusion
True or false: When initiating intermittent IV medications, you must flush the IV lock with NaCl flush before and after medication infusion.
True
how often should lines for blood products, fat emulsion, or TPN's be changed?
Q 24 hours
True of False: CVC's are the primary source of hospital acquired bloodstream infections
TRUE
Where do you document your an PIV of PICC site assessment?
under skin integrity in your progress note, OR flow sheet
why do I need to change parental nutrition lines and bags more frequently?
there is a higher risk of infection associated with PN infusions.
best practice for PICC bloodwork
> establish patency through aspirating blood
> flush with 20cc Nacl Using start stop method then clamp
> insert vacutainer and unclamp
> insert waste tube and discard
> insert appropriate tubes according to order
> flush with 20ml NaCl and clamp with positive pressure technique
How often should catheter caps for picc lines be changed?
Q72h
What to do when you suspect infection in your patient?
> Document abnormal findings
> inform patient's physician
> blood cultures will likely be ordered
>antibiotics will likely be ordered
> monitor for worsening symptoms
True or False: IV lock flushes should be documented in the MAR
True
Why is it important to use the positive pressure technique on IV lock devices?
Ensures that pressure is maintained when engaging the clamp to prevent reflux of blood into catheter.
What do you assess for when assessing the IV site?
check for redness, pain, swelling, fluid leaking, catheter dislodgement
How often should continuous lines be changed?
Q 96 hours for central lines
Q no more than 96h to 7 days for peripheral lines