WHY
A peripherally inserted central catheter, more commonly referred to as a PICC line, is a wonderful tool in any medical setting. Providing access for drug administration, blood testing, nutrition, etc. Anything, such as medication, supplemented into the bloodstream will work significantly faster than alternative routes like orally, or even intramuscularly. Whatever is provided via the PICC line will immediately be transported in the blood to desired areas in the body; no longer necessitating a need for the body to break down the components first through the GI tract. However, PICC lines do have dangers associated with the same characteristics that make them remarkable. The rapid transit time, and immediate reaction on the body mean that
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According to Mount Nittany Health patients have a lot to be aware of when going home with a PICC line still in place. They listed protecting the PICC line and your arm as the two biggest factors to patient PICC line care. In protecting the PICC line patients should remember to wash their hands. The IV is a very susceptible area for pathogens to enter the blood stream, which can prove to be life-threatening (NIttany Health Healing Garden, 2016). By washing their hands a patient is able to eliminate pathogen threats on the hands that could very well come into contact with the PICC …show more content…
Sometimes something as simple as applying a warm pack to the insertion site is all that is needed! Other times you may want to be aware when drawing blood, or checking blood pressure, that you use the arm without a PICC line in it. This will prevent any damaging of the vein or cannula (Folbigg, 2016). When flushing a PICC line, only use normal saline or reduced-strength Heparin to prevent blood clotting inside the IV tubing. Occlusions inside the IV tubing can be dangerous. Be alert for signs of infiltration, extravasation, and/or pain. These are indicative of a problem associated with the PICC
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
To avoid contamination as best as possible, if washing hands according to SOP1 is not possible, wearing gloves and spraying with 70% ethanol is also acceptable for the procedure. Furthermore, not touching the ends of the needle and filter are absolutely essential in avoiding contamination thus applying them to the syringe whilst the ends are still in their sterile packaging will aid the prevention of contamination. When not in use placing the syringe on its plunger creates a smaller surface area for the contaminants to attach to as well. Loosening the lids of the broth tubes before placing in the Biohazard cabinet ensures easier removal when required thus less exposure time of the opened end to the environment allowing contaminants in.
Then after threading a catheter through the needle, the anesthesiologist will withdraw the needle and leave the catheter i...
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
I would think the proper method of hand hygiene that would be used in between the two patients would be hand cleansing. Hand cleansing is the removal of dirt, organic material, and/or microorganisms. I would think this would be the proper method to use since a Hemoccult sample was taken from Mr. Santo (World Health Organization, p.2, 2009).
Keep the patient NPO, and establish two IV access sites with a large bore catheters running one IV with NS at KVO and morphine sulfate for pain. Initial laboratory testing including a complete blood cell count (CBC), basic metabolic panel (BMP), cardiac enzymes (creatine kinase, creatine kinase-MB, and cardiac Troponin) and repeat in 90 min. Administer antiplatelet ASA 324mg PO (Sen, B., McNab, A., & Burdess, C., 2009, p. 18). Before administering nitroglycerin 0.4 mg SL (every 5 minutes up to three doses) reassess blood pressure if systolic <90 mmHg, patient has used cocaine in the last 24 hours, or taking PDE-5 inhibitors do not administer. Thrombolytic therapy should be implemented within 30 minutes from the patient’s arrival to the emergency department, and if they are a candidate for cardiac catheterization it should be done within 90 minutes from the patient being admitted to the hospital. Delay on either therapy option increases the risk of mortality (Kosowsky, Yiadom, Hermann, & Jagoda, 2009, p. 10).
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Bowers, L., Allan, T., Simpson, A., Nijman, H., & Warren, J. (2007). Adverse Incidents, Patient
The fifth strategy is to discuss issues related to medications. During this time, coming off nurse should address any issues or concern she had noted regarding the peripheral or central line placement. For the oncoming nurse, it is very important to note the location
administered to prevent clots and perhaps continues post-op. If such a patient is not given
First, you must obtain all of the necessary supplies: gloves, alcohol or Betadine preps, a tourniquet, tape, an appropriately sized IV catheter, a bag of IV solution, the IV tubing, and gauze pads. While obtaining the supplies, you should inform the patient that IV catheter placement is necessary, and why. Do not lie to the patient and tell him or her that it is a painless procedure. Instead, be honest with them and explain that the initial puncture feels like a sharp pinch on the skin and that the pain and discomfort associated with the IV placement is only temporary. You may find it helpful to demonstrate to the patient the amount of pain to expect by pinching the skin on the back of their hand. This is especially helpful for younger patients or patients who are more concrete in their thinking.
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...
After almost one hour of “tube procedure connections”, I got up to go to the restroom with an IV pole following my s...
...s and hoses, control buttons, switches, hand pieces, and X-ray units (Collins). After every patient’s visit, the operatory is to be sterilized and disinfected. All areas that were that were not covered with a barrier, or if the barrier was compromised, must be wiped down with surface disinfectants similarly used in hospitals. OSHA requires disinfectants to be potent enough to fight against HIV and HBV infections (Collins). If there is any blood present on a surface, tuberculocidal type disinfectant should be utilized.
1. Nasogastric (NG): The most common route used in intensive care. Here a feeding tube