Preventing and Reducing Risk of Central Line Infections November 6, 2009

No matter where you work in the hospital, you will no doubt run across patients that are in need of a central line or have one currently in use. Whether the patient is a hard stick or needs a long course of antibiotics or medications, there are many reasons why they will have them. It is our job as their nurses to strive to reduce their risk of acquiring an infection. According to the Institute for Healthcare Improvement, 90% of all bloodstream infections are associated with central lines and between 500 and 4000 patients die each year in the United States due to blood stream infections.

 

Because the line goes directly into the patient’s blood stream, it is important to provide aseptic care anytime you are accessing the line. Organisms can be introduced to the body through insertion of the line, through contaminated medications and improper administration, non sterile dressing changes, or infections found somewhere else in the patient’s body.

 

In order to reduce the risk of these infections, it is important to always use proper hand hygiene anytime you come into contact with the central line. Whether it is administering medications through a hub, insertion, or changing the dressing. In addition, it is also important to use chlorhexidine to clean and prep the skin and insertion site and also clean the skin that is underneath the sterile dressing. This reduces the amount of bacteria that will be held under the patient’s dressing. Also, it is important to clean the hubs off and allow them to dry before administering medications because those germs on the outside can be pushed into the patient’s bloodstream.

 

The Institute of Healthcare Improvement

Prevent Central Line-Associated Bloodstream Infections

http://www.ihi.org/IHI/Programs/Campaign/CentralLineInfection.htm

This website provides links to many different techniques for teaching how to reduce infection and how to teach others the techniques. It provides a how-to for bringing this education to your organization and also power points for presentations on methods to reduce. This website would be useful for a person providing education in the healthcare setting.

 

Centers for Disease Control and Prevention

Reduction in Central Line–Associated Bloodstream Infections among Patients in Intensive Care Units

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a2.htm

This website discusses decisions made by an advisory committee that have been established around the country to prevent infection through dressings, insertion, and sterile technique. This website would be good to use as a nurse or care provider.

 

National Guideline Clearinghouse

Strategies to prevent central line-associated bloodstream infections in acute care hospitals

http://www.guideline.gov/summary/summary.aspx?doc_id=13395

This website provides a guideline for proper technique to be used before insertion, during, and after. The aftercare would be assessment, administration of medications and blood, as well as proper documentation. This website shows many strategies as well as showing the nurse what they are accountable for when they are inserting a central line. This website would be good to use as a nurse.

 

Northern Inyo Hospital

Central Line Infections

http://nih.kramesonline.com/HealthSheets/3,S,89223

This website talks about what hospitals are doing to reduce the risk of infections with a central line. It provides a picture to show someone where exactly a central line is placed. It also goes beyond just central line care and teaches about hand hygiene and how to properly wash your hands. This website would be good for patients and patients’ families as an educational tool.

 

Nursing Journal

Keeping Central Line Infection at Bay

Cinahl

April 2006

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,cookie,uid&db=rzh&AN=2009154625&loginpage=custlogin.asp&site=ehost-live&scope=site

This article gives great resources on how to properly care for patients with central lines. It also provides statistics about nosocomial infections related to central lines and how these infections enter the patient’s body. It gives background and education on infections and provides a checklist for central line care.

 

Australian Nursing Journal

Nursing Central Line Service Prevents Catheter Related Infections

June 2008

Academic Search Premiere

 

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,cookie,uid&db=aph&AN=33226629&loginpage=Login.asp&site=ehost-live&scope=site

This article also provides information about central lines and how to prevent and reduce risks of infection. This article would be a good resource for any nurse or care provider.

Electronic Health Records October 22, 2009

Electronic health records are patient records that combine all aspects of their health care such as medications, notes, charting, immunizations, and demographics all put together into one main chart stored electronically. Because this information is put out for thousands of people to see daily it is important that these charts be regulated and secured to preserve each patients confidentiality.

When figuring out who owns each health record it because very complicated. I would think that the patient owns the health record because all the information is about them. It is their information, but going through and learning about these charts, I know that you cannot just go through and find your chart and look up your information. This aspect makes me think that the individual patient does not belong to us. So then who does it belong to? According to an article by the American Medical Association, talks about paper charting the providers and insurance companies own them because they control them, but it is more difficult to determine who owns the electronic ones.

 The article discusses that the patient does not have complete ownership of the records because us as providers can get on there and change information or add information as needed. They do point out the patient should have control over who sees the record and their own privacy. This is done through HIPPA. It is important for each patient that their charts be secured and their information be confidential. I suppose in some way the patient has ultimate control over their health records because they for the most part have control over who is accessing it and providing care for them. It seems like no one fully owns the health record, but the closest that comes to this is the patient.

MedTech Publishing (2009) Ownership of EHRs poses barrier to adoption. Found at http://www.healthcareitnews.com/news/ownership-ehrs-poises-barrier-adoption

Hello world! October 8, 2009

Healthcare is constantly changing at such a rapid pace. Everywhere you look there are new studies being done, new research being performed that changes the way we do everything in our jobs. It is important to stay updated on current findings and events. This class has already taught me many different ways to stay involvd in changes in healthcare that I had not thought of before.

I am currently taking Health Care Informatics as a class for by BSN degree. Prior to this class, I had not really known exactly what health care informatics really was. According to our texts, informatics uses computer science, health care science, as well as information science to communicate data, information, knowledge and wisdom to others as well as keep the data organized.

Basically, it is a way for each specialty to share their knowledge with others in the specialty as well as others that may not be associated with their type of science. This type of informatics is especially important in healthcare because it is constantly changing and expanding. There is new information daily that needs to be organized and shared with others.

I have learned a lot in just this first week. I have learned what exactly healthcare informatics meant, which I hadn’t really known prior to reading powerpoints and text. I also learned how important it is to check the validity and reliability of resources before using them in  your papers. I had always known how to spot information that is not useful for school types of papers, but this week I took it into a little more depth. I also learned how to social network. I never would hav thought I would have a twitter account or I would be writing in a blog. This class has shown me that twitter really is a good way to stay current on new information, studies and research being done in healthcare. Also, it is interesting to read blogs and see how other people feel about issues and things that we are learning in our class.

I have also learned what the difference between a search engine, a database, and an internet search directory is. Search directories organize the internet by certain subjects and are easy to use. Search directories contain lists of websites and are helpful for browsing. Search engines are a way of organizing information on the internet. When you search you find “hits”. These can be either images, websites, or files. Databases are a collection of related files all put together for a common use.