Achieving Zero Catheter Related Blood Stream Infections: 15 Month Success In A Community Based Medical Center. Background and Purpose: Catheter related blood stream infection (CRBSI) is a major cause of patient morbidity, mortality, and cost. Lower CRBSI rates would decrease inpatient length of stay. Project: An innovative central line bundle was developed to reduce CRBSI. An innovative combination of focused nursing practice and product technologies were selected for the bundle and implemented through a defined educational program. Data was collected from thirty-two critical care beds: 16 medical/surgical ICU and 16 Trauma-Neuro ICU beds. Results: From January 2006 thru March 2007 there were Zero occurrences of CRBSI. Over this 15 month period our PICC insertions increased by 103%, and our interventional radiology referral rate decreased to less than 2%. Implications/Conclusions: A multimodality bundle, combining nursing practice interventions and technology can successfully decrease the incidence of CRBSI. While some of the bundle components have not been widely researched and instead are based on theory or accepted clinical practice, the early outcome provides a basis for additional study and refinement. It also invites research into the various components of the bundle to evaluate the effect each separate practice and product lends to its success.
Many times a 24-gauge peripheral catheter is the largest that can be safely inserted into patients with limited venous access who require blood transfusions. An invitro project was implemented to test if a person could safely receive blood transfusions, using a 24-gauge peripheral catheter, without resulting hemolysis.
Polyurethane foam dressing impregnated with chlorhexidine gluconate was compared with 4 silver dressings for antimicrobial efficacy. Efficacy of antimicrobial dressings was evaluated using zone of inhibition assay against 7 clinically relevant bacteria and yeast. The test was carried out for up to 7 consecutive days by transferring the dressings daily. Microbiocidal activity exhibited by different dressings within the zone of inhibition was also evaluated as a part of the study. Three silver dressings were similar to each other in performance and had different patterns of efficacy varying from days 1 to 6 than the chlorhexidine dressing. A hydrogel dressing containing silver performed poorly compared to all other dressings. The study results indicated that the antimicrobial dressing impregnated with chlorhexidine gluconate had excellent antimicrobial activity and showed sustained efficacy for a period of 7 days.
Emerging technology has changed the way nurse educators teach students about the use and management of vascular access devices. The current generation of students expects engagement and immersion in their learning experience. This article focuses on methods for teaching basic and advanced skills involving vascular access and discusses the equipment and technology used to enhance the learning experience. Patient safety, competency assessment and the transition into clinical practice are important concepts that are also presented.