clabs is & ppe
TRANSCRIPT
Central Line Associated BloodStream Infections
(CLABSIs)
By: Richel Grace T. Baldoza
Central Line-Associated Bloodstream Infection
• Infection can occur when bacteria grow in the line and spread into the bloodstream.
• is a primary blood stream infection (BSI) in a patient that had a central line within the 48 hour period before the development of the BSI
• If BSI develops in a patient within 48 hours of discharge from a location, attribute the CLABSI to the discharging location.
Central Line-Associated Bloodstream Infection
• Signs or symptoms: temperature above normal, fever, chills, or the skin around the central venous catheter (CVC) is painful, red, swollen or oozing,
CRITERIA 2Patient has at least one of the
following signs or symptoms: fever (>38ºC), chills, or hypotension
Central line associatedbloodstream infection
CRITERIA 1Patient has a recognized
pathogen cultured from one or more blood cultures
Organism culturedfrom blood is not
related to an infection at another site.
Common skin contaminant is cultured from two or
more blood cultures drawn on separate occasions
Signs and symptoms andpositive laboratory results
are not related to aninfection at another site
NOCentral line associatedbloodstream infection
Yes
No
Yes
Yes
Yes
No
No
No
No
Yes
Laboratory Confirmed Bloodstream Infection
Central Line or Central Venous Catheter
• A vascular infusion device that terminates at or close to the heart or in one of the great vessels and is used for infusion, withdrawal of blood, or hemodynamic monitoring.
The following are considered great vessels for the purpose of reporting central line associated
infections and counting central line days
• Aorta• Pulmonary artery• Superior vena cava• Inferior vena cava• Umbilical artery and
vein for neonates
• Brachiocephalic veins• Internal jugular veins• Subclavein veins• External iliac veins• Common femoral
veins
Modifiable Risk FactorsCharacteristic Greater Risk Lower RiskInsertion sercumstances
Emergency elective
Skill of inserter General specializedInsertion site 70% alcohol
10% povidone-iodine
2% chlorhexidine
Catheter lumens Multilumen single lumenDuration of catheter use
Longer duration of use greater risk
Barrier precautions Submaximal maximal
Central Line Care
A. Dressing:
1. All dressing shall be changed using sterile technique.
2. Initial dressing should be left in place for 24hrs unless heavy soild.
3. Gauze dressing should be changed daily for seven (7) days following insertion, then every forty eight (48) hour if no signs of infection or if the dressing becomes loose, wet or soiled.
B.Frequency of Flushing
1. A physician’s order is required to flushed with heparin 10 u/ml.
3. Flushed twice a day, if no IV fluids infusing or treatment.
2. Flush before and after every use of antibiotics blood products utilize SASH technique.
S- Flush the device with 10 ml 0.9% sterile salineA- administer the medication/ drw blood workS- Flush the device with 10ml 0.9% sterile salineH- Flush the device with 2ml heparin (10 u/ ml)
F. Change all injection ports every three days.
C. The catheter is to be looped and anchored with taped.
D. Required to keep vein open
E. Not required to swab for culture and sensitivity from central line insertion site that appears infected, however the physician must be notified that the site looks infected
To prevent catheter-associated bloodstream infections doctors and nurses will:
• Choose a vein where the catheter can be safely inserted and where the risk for infection is small.
Subclavian Vein First Choice
• Clean their hands with soap and water or an alcohol-based hand rub before putting in the catheter.
• Wear a mask, cap, sterile gown, and sterile gloves when putting in the catheter to keep it sterile. The patient will be covered with a sterile sheet.
• Clean their hands, wear gloves, and clean the catheter opening with an antiseptic solution before using the catheter to draw blood or give medications. Healthcare providers also clean their hands and wear gloves when changing the bandage that covers the area where the catheter enters the skin.
• Clean the patient’s skin with an antiseptic cleanser before putting in the catheter.
• Decide every day if the patient still needs to have the catheter. The catheter will be removed as soon as it is no longer needed.
Carefully handle medications and fluids that are given through the catheter.
Some patients are sent home from the hospital with a catheter in order to continue their treatment.
• Make sure you understand how to care for the catheter before leaving the hospital. For example, ask for instructions on showering or bathing with the catheter and how to change the catheter dressing.
• Make sure you know who to contact if you have questions or problems after you get home.
Some patients are sent home from the hospital with a catheter in order to continue their treatment.
• Make sure you wash your hands with soap and water or an alcohol-based hand rub before handling your catheter.
• Watch for the signs and symptoms of catheter-associated bloodstream infection, such as soreness or redness at the catheter site or fever, and call your healthcare provider immediately if any occur.
• Watch for the signs and symptoms
Personal Protective Equipment
(PPE)
Purpose
Refers to protective clothing, helmets, goggles,
or other garment or equipment designed to
protect the worker’s body from injury by blunt
impacts, electrical hazards, heat, chemicals and
infection, for job-related occupational safety and
health purposes
Personal Protective Equipment ( PPE)
Designed to protect the skin and mucuos membranes of the
eyes, nose and mouth from exposure to
blood or other potentially infectious
material.
How to Don a PPE
How to Don a PPE