Preventing CLABSI

http://tinyurl.com/yaqaung8

In week three you will learn the importance of central line dressing changes, medication administration through a central line, and how to care for a central line that gets intermittent use.  You will utilize the following resources prior to class:

Module notes:  

The lecture will include:

• how to properly care for and change a central line dressing, including proper inspection prior to use.  
• how to properly administer medications through a central line, including flushes.
• how to properly care for a central line that is used intermittently vs. continuously.

Textbook will include Lippincott. (2015). Lippincott Nursing Procedures (Vol. 7th). [N.p.]: Wolters Kluwer Health. 

Articles for the class will include:

Hughes, A. A., Vannello, C., Bingeman, C., & Gilbert, M. (2011). Poster abstract: Reducing CLABSI by Prohibiting
Routine Blood Draws through Central Lines. AJIC: American Journal of Infection Control, 39, E50–E51.
https://doi-org.vlib.excelsior.edu/10.1016/j.ajic.2011.04.107.

Jock, L., Emery, L., Jameson, L., & Woods, P. A. (2016). Original Article: Journey to Zero Central Line-Associated Bloodstream Infections: An Intensive Care Unit’s Story of Sustained Success and Quality Improvement. Journal of the Association for Vascular Access, 21, 76–80. https://doi-org.vlib.excelsior.edu/10.1016/j.java.2016.03.002.

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Original Article: Sustained Reduction and Prevention of Neonatal and Pediatric Central Line- Associated Bloodstream Infection Following a Nurse-Driven Quality Improvement Initiative in a Pediatric Facility. Journal of the Association for Vascular Access, 23, 30– 41. https://doi-org.vlib.excelsior.edu/10.1016/j.java.2017.11.002.

Sheth, H., Trifan, A., Feterik, K., & Jovin, F. (2017). Expanding central line care bundle to address line manipulations. Canadian Journal of Infection Control, 32(4), 217–221. Retrieved from http://vlib.excelsior.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=127789515&site=eds-live&scope=site.

Webster, J., Larsen, E., Marsh, N., Choudhury, A., Harris, P., & Rickard, C. M. (2017). Chlorhexidine gluconate or polyhexamethylene biguanide disc dressing to reduce the incidence of central-line-associated bloodstream infection: a feasibility randomized controlled trial (the CLABSI trial). Journal of Hospital Infection, 96, 223–228.
https://doi-org.vlib.excelsior.edu/10.1016/j.jhin.2017.04.009.

Videos will include:

 https://www.youtube.com/watch?v=iyHPPRk37tA-- Video will demonstrate an example of proper administration of medication through a central line.

https://www.youtube.com/watch?v=qleKCmrFcs4--Video will demonstrate proper blood draw via central line.

Demonstration of skills will be provided during the lecture.

Skill practice will include 2 stations in the laboratory for dressing changes and medication administration, by hospital clinical nurse educators.  

Assessments will include P/F dressing & medication administration assessment. Written exam (75% required for passing).  Remediation will be required if a passing score is not obtained, within the week following course during working hours on unit. RN will not be able to care for a patient with central line until skill has been mastered.

We will discuss the following question during class:  Please think about and explain the consequences of administering medications through a central line improperly,  not caring for a line that only gets intermittent use, or failing to properly change a central line dressing (Learning outcome #3).