IV CATHETER-RELATED RELATED
|
|
- Jodie Hood
- 7 years ago
- Views:
Transcription
1 IV CATHETER-RELATED RELATED INFECTIONS Javier Garau Department of Medicine Universidad de Barcelona SPAIN
2 Scope of the problem Catheter types and terms Epidemiology and pathogenesis Diagnosis Etiology Local and systemic therapy Preventive measures
3 ACCESS TO THE VASCULAR TREE Administration of : Hydroelectrolitic solutions Drugs Hemodyalisis Blood derivatives parentheral nutrition Hemodinamic monitoring
4 CATHETER-RELATED RELATED SEPSIS CONSECUENCES Increased morbidity/mortality 2573 episodes* Mortality global: 14% attributable, 19% (2.7%) (S. aureus, 8.2%; Coag neg Staph, 0.7%) Increased LOS Increased costs *Byers et al. En Mermel LA et al. CID 2001
5 TYPES OF INTRAVASCULAR CATHETERS AND DEVICES Peripheral venous catheter Peripheral arterial catheter Middle sized venous catheter Central venous catheter (CVC) Pulmonary artery catheter Presure monitoring systems Central catheter with peripheral implantation Tunnelized CVC Subcutaneous device
6 TYPES OF INTRAVASCULAR CATHETERS Peripheral venous catheter. Usually in veins of the arm or hand; short duration; low incidence of infection Peripheral arterial catheter. Short duration. Measures hemodynamic status or blood gas analysis in critical patients; risk of infection similar to CVC Middle size venous catheter. Peripheral catheter in antecubital fossa (basilic, cephalic veins). Does not reach central veins; lesser risk than CVC Non tunnelized CVC. Yugular, subclavian veins.the commonest type in ICU; 90% of all catheter related sepsis. Yugular vein, higher risk than subclavian Central catheter with peripheral insertion. Usually from antecubital fossa to superior vena cava
7 TYPES OF INTRAVASCULAR DEVICES Tunnelized CVC. Surgically placed CVC ( Hickman, Broviac, Groshong, Quinton); for prolonged catheterization Totally Implantable device. A subcutaneous reservoir under the skin. Access through the skin with a needle; low incidence of infection
8
9
10 Estimated risk of catheter-related related bacteremia for different catheter types TYPE OF CATHETER BACTEREMIAS PER 1000 DAYS OF CATHETER Short, peripheral < 2 Arterial 10 Central Venous, multilumen 30 Swan-Ganz 10 Hemodyalisis 50 Long duration CVC, peripheral insertion Tunneled CVC Totally implantable device 2 2 < 1 Sheretz RJ. ASM, Washington 2000
11 INTRAVASCULAR DEVICES TERMINOLOGY Catheter colonización Significant growth of a microorganism in culture of catheter tip, subcutaneous segment or catheter hub Exit site infection CLINICAL: Erythema, induration and/or tenderness whithin 2 cm of catheter exit site; may be associated to other signs (pus) or symptoms of infection (fever) MICROBIOLOGAL: Exudate at catheter exit site yields a microorganism with or without concomitant blood stream infection
12 INTRAVASCULAR DEVICES TERMINOLOGY Tunnel infection Erythema, induration and/or tenderness along the subcutaneous track of a tunneled catheter (Hickman o Broviac) with or without concomitant bloodstream infection Pocket infection Infected fluid in the subcutaneous pocket of a totally implantable intravascular device. Often associated with local signs of infection;spontaneous rupture and drainage or necrosis of skin can occur
13 EPIDEMIOLOGY AND PATHOGENESIS. Each year, approximately > 27 millions of iv catheters and iv devices are sold in Spain for iv administration The majority are peripheral venous catheters, but there are at least 3 million CVC Risk factors for infection vary with the type of catheter, hospital size, Unit or Service, site of insertion and duration of catheterization
14 Maki DG et al. New Egl J Med 1977 Liñares J, Sitges-Serra A, Garau J et al. J Clin Microbiol 1985 Sitges-Serra A, Liñares J, Garau J et al. Surgery 1985
15 CATHETER RELATED SEPSIS I. Skin and extralumenal progression The traditional mechanism Historical importance of focal infection The most important cause of bacteremic catheter-related related infection Early infection
16 CATHETER RELATED SEPSIS II. Hub and intralumenal colonization Commonly associated with bacteremia Late infection 80% of sepsis in CVC for TPN Sources : Skin Orotracheal secretions Hands Infusate Cercenado et al 1990
17 CATHETER RELATED SEPSIS III. Contamination of infusate Uncommon Intralumenal colonization Hub frequently colonized Intrínsic TPN Intralípid Blood derivatives Tribe Klebsiellae Non fermenting GNB
18 CATHETER RELATED SEPSIS IV. Hematogenous seeding Exceptional Importance of fibrin cuff
19 Relative importance of the different routes of colonization of intravascular catheters* Reference Nº catheters Implantation days Episodes SRC Hub Skin Mixed Other A Cercenado et al De Cicco et al Salzman et al Liñares et al Fan et al Weightman et al Segura et al D 8,6 18,2 23, (30.8%) B 6(5.5%) 28(24.7%) 20(14.8%) 11(7.1%) 11(26.1%) 24(6%) C 8 BRC: catheter related bacteremia A Hematogenous seeding. B Positive culture of tip C Cultures not completed D Number of patients Sitges-Serra A et al. Nutrition, 1997;13:30s-35s
20 RATE (MEAN) OF CATHETER-RELATED RELATED BACTEREMIA. NNISS TYPE OF ICU Coronary Cardiothorathic Medical/surgical Neonatal < 1000 g > 2500 Pediatric Nº of ICUs Catheter days , , , , , , , ,831 Rate/1000 catheter days Seguin J et al, Am J Perinatol 1994; Loisel DB et al, J Perinatol 1996; O Grady NP et al, Clin Infect Dis 2001
21 CATHETER RELATED SEPSIS Clinical diagnosis Rapid diagnosis Catheter cultures DIAGNOSIS Paired CVC and peripheral cultures (Quantitative cultures; Differences in growing time to positivity) Infusate contamination
22 DIAGNOSIS CLINICAL DIAGNOSIS Low sensitivity and specificity TECHNIQUES OF RAPID DIAGNOSIS Gram stain, useful in local infection, but low sensitivity In some studies, orange of acridine stain has a positive predictive value of 91% and a negative predictive value of 97%* *Kite P et al. Lancet 1999
23 CATHETER CULTURES Qualitative cultures of catheter tip Semiquantitative cultures of catheter tip (Maki et al, 1977) Quantitative cultures of the catheter tip - Cleri et al (1980) - Liñares et al (1985) - Brun-Buisson Buisson et al (1990) - Sheretz et al (1990)
24
25
26 Catheter related bacteremias-causative organisms Microorganism % % GRAM POSITIVE COCCI Cagulase negative staphylococci Staphylococcus aureus Enterococcus spp GRAM NEGATIVE BACILLI Escherichia coli Enterobacter spp Pseudomonas aeruginosa Klebsiella pneumoniae FUNGI Candida spp CDC. Am J Infect Control 1999; Schaberg DR et al. Am J Med 1991
27 Main coagulase negative staphylococci of interest in human infetions S. epidermidis Most common pathogen; bacteremia, infection prothesis, wound, endoftalmitis S. saprophyticus Common pathogen; UTI S. haemolyticus S. lungdunensis S. auricularis, capitis, cohnii, hominis, simulans, warneri, saccharolyticus, schleiferi, xylosus Less common pathogens; bacteremia, endocarditis Rare pathogens; infection prosthesis
28 When to remove the catheter Clinical picture Presence of local signs of infection Type of catheter Microorganism Possibility of conservative treatment Change of catheter through a metallic wire serving as a guide can be an alternative to consider in cases where there is an extreme difficulty in finding a new vascular access
29 Indications of immediate withdrawal of IV catheter when infection is suspected Unnecessary catheters Catheters easy to replace Catheters in patients with persistent bacteremia despite adequate antibiotic treatment Tunnelized catheters with infection of subcutaneous track Catheters causing embolization Catheters as a cause of endocarditis Catheters infected with difficult to treat microorganisms without their removal
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
Components of CVC Care Bundle. selection
Components of CVC Care Bundle Catheter site selection Site of insertion influences the subsequent risk for CR-BSI and phlebitis The influence of site is related in part to the risk for thrombophlebitis
More informationCentral Line-Associated Bloodstream Infection (CLABSI) Prevention. Basics of Infection Prevention 2-Day Mini-Course 2013
Central Line-Associated Bloodstream Infection (CLABSI) Prevention Basics of Infection Prevention 2-Day Mini-Course 2013 2 Objectives Describe the etiology and epidemiology of central line associated bloodstream
More informationI. Questions for VAD slide program
I. Questions for VAD slide program 1. The rate of central line associated blood stream infections (CLABSI) in the adult ICUs in Johns Hopkins Hospital is lower than the national average. 2. The mortality
More informationNursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection
L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after
More informationAntibiotic Lock Therapy Guideline
Antibiotic Lock Therapy Guideline I. PURPOSE Central venous catheters are an integral part in medical management for patients requiring long-term total parenteral nutrition, chemotherapy, or hemodialysis,
More informationCatheter-Associated Urinary Tract Infection (CAUTI) Prevention. Basics of Infection Prevention 2 Day Mini-Course 2013
Catheter-Associated Urinary Tract Infection (CAUTI) Prevention Basics of Infection Prevention 2 Day Mini-Course 2013 2 Objectives Define the scope of healthcare-associated urinary tract infections (UTI)
More informationPICC/Midclavicular/Midline Catheter
47 PICC/Midclavicular/Midline Catheter Introduction- PICC/ MCV/ Midline You have a PICC/Midclavicular/Midline (peripherally inserted) catheter. This catheter should make receiving I.V. medicines or solutions
More informationCVC = central venous catheter. Insertion and Maintenance
Central Venous Catheter Insertion and Maintenance A Tutorial on Recommended Practices Introduction Central venous catheters (CVCs) are a commonly used modality throughout the medical center and especially
More informationIDSA GUIDELINES EXECUTIVE SUMMARY
IDSA GUIDELINES Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America Leonard A. Mermel, 1
More informationBLOOD CULTURE. Its Role in the Management of the Septic Patient
BLOOD CULTURE Its Role in the Management of the Septic Patient Types of Blood Stream Infections Transient: Usually follows mechanical or surgical manipulation of infected tissue, dental procedures, cystoscopy
More informationCriteria to Define CLABSI and SSI
Criteria to Define CLABSI and SSI Teresa C. Horan, MPH Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases Objectives Review BSI and SSI criteria Review
More informationHemodialysis catheter infection
Hemodialysis catheter infection Scary facts In 2006, 82% of patients in the United States initiated dialysis via a catheter The overall likelihood of Tunneled cuffed catheters use was 35% greater in 2005
More informationURINE CULTURES GENERAL PROCEDURE
University of Nebraska Medical Center Division of Laboratory Science Clinical Laboratory Science Program CLS 418/CLS 419 URINE CULTURES GENERAL PROCEDURE I. Principle Urine cultures are performed to detect
More informationAre venous catheters safe in terms of blood tream infection? What should I know?
Are venous catheters safe in terms of blood tream infection? What should I know? DIAGNOSIS, PREVENTION AND TREATMENT OF HAEMODIALYSIS CATHETER-RELATED BLOOD STREAM INFECTIONS (CRBSI): A POSITION STATEMENT
More informationIntravenous Cannula Site Infection Presenting as Endocarditis A Preventable Complication
ISSN: 2319-7706 Special Issue-1 (2015) pp. 75-80 http://www.ijcmas.com Case Study Intravenous Cannula Site Infection Presenting as Endocarditis A Preventable Complication Divya Rabindranath 1 *, Rabindranath
More informationAnswers to Frequently Asked Questions on Reporting in NHSN
Answers to Frequently Asked Questions on Reporting in NHSN 1. With multiple infection sites, if you are unsure of the primary site of the infection, what should you do? If more than one NHSN operative
More informationCertofix protect More certainty, more safety, more success
Certofix protect More certainty, more safety, more success Highly effective, long-term protection against catheter infection Central Venous Catheters Antimicrobial modified hydrophilic surface We help
More informationPERIPHERALLY INSERTED CENTRAL CATHETERS (PICC) Fong So Kwan APN, Haematology unit Medical Department, QMH
PERIPHERALLY INSERTED CENTRAL CATHETERS (PICC) Fong So Kwan APN, Haematology unit Medical Department, QMH 1 What is a PICC catheter? Primary vascular access device since their introduction in the mid-1970s,
More informationBestPractice. Evidence Based Practice Information Sheets for Health Professionals. This Practice Information Sheet Covers The Following Concepts:
Volume 2, Issue 1, 1998 ISSN 1329-1874 BestPractice Evidence Based Practice Information Sheets for Health Professionals Purpose The purpose of this practice information sheet is to provide summarised best
More informationStaphylococcus aureus Bloodstream Infection Treatment Guideline
Staphylococcus aureus Bloodstream Infection Treatment Guideline Purpose: To provide a framework for the evaluation and management patients with Methicillin- Susceptible (MSSA) and Methicillin-Resistant
More informationX-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary
X-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary Introduction A Subclavian Inserted Central Catheter, or subclavian line, is a long thin hollow tube inserted in a vein under the
More informationState of Kuwait Ministry of Health Infection Control Directorate. Guidelines for Prevention of Surgical Site Infection (SSI)
State of Kuwait Ministry of Health Infection Control Directorate Guidelines for Prevention of Surgical Site Infection (SSI) September 1999 Updated 2007 Surgical Wound: According to 1998 Kuwait National
More informationA4.7 Management of a totally occluded central catheter and persistent withdrawal occlusion (PWO)
A4.7 Management of a totally occluded central catheter and persistent withdrawal occlusion (PWO) Types of Catheter Related Thrombotic A catheter-related thrombus may be intraluminal (inside the catheter)
More informationTunneled Central Venous Catheter (CVC) Placement
PATIENT EDUCATION patienteducation.osumc.edu Tunneled Central Venous Catheter (CVC) Placement A tunneled Central Venous Catheter (CVC) is a special type of intravenous (IV) line that is placed into a large
More informationVaxcel PICCs Valved and Non-Valved. A Patient s Guide
Vaxcel PICCs Valved and Non-Valved A Patient s Guide Information about your Vaxcel PICC is available by calling the Navilyst Medical Vascular Access Information Line 800.513.6876 Vaxcel Peripherally Inserted
More informationPICC & Midline Catheters Patient Information Guide
PICC & Midline Catheters Patient Information Guide medcompnet.com 1 table of contents Introduction 4 What is a PICC or Midline Catheter? 4 How is the PICC or Midline Catheter Inserted? 6 Catheter Care
More informationTony Melendez Version 2013 LINES, TUBES, PORTS, WHAT TO DO WITH THEM
Tony Melendez Version 2013 LINES, TUBES, PORTS, WHAT TO DO WITH THEM Discusion of the following PICC Line Hickman Cath Chest Tubes PICC s & Midlines Classic PICC Line A PICC line is essentially a narrow
More informationDRG 416 Septicemia. ICD-9-CM Coding Guidelines
oding uidelines Septicemia ICD-9-CM Coding Guidelines The below listed septicemia guidelines are not inclusive. The coder should refer to the applicable Coding Clinic guidelines for additional information.
More informationCentral venous catheters. Care of the site 88 CVP measurement 90 Removal of CVC (non-tunnelled) 93 Care of long-term CVCs 95
4 Central venous catheters Care of the site 88 CVP measurement 90 Removal of CVC (non-tunnelled) 93 Care of long-term CVCs 95 CARE OF THE SITE Preparation Patient Equipment/Environment Nurse Explain the
More informationLifecath Midline. A Nurses Guide to Lifecath Midline
Lifecath Midline A Nurses Guide to Lifecath Midline vygon@vygon.co.uk www.vygon.co.uk Lifecath Midline A Nurses Guide to Lifecath Midline This booklet provides guidance in the care and maintenance of Midline
More informationCentral Venous Catheters and Upper Extremity DVT: Update, Diagnosis and Management
Central Venous Catheters and Upper Extremity DVT: Update, Diagnosis and Management David Hahn, MD Interventional Radiology NorthShore University HealthSystem Objectives Discuss the epidemiology and clinical
More informationWound Classification Name That Wound Sheridan, WY June 8 th 2013
Initial Wound Care Consult Sheridan, WY June 8 th, 2013 History Physical Examination Detailed examination of the wound Photographs Cultures Procedures TCOM ABI Debridement Management Decisions A Detailed
More informationAPPENDIX B: UWHC SURGICAL ANTIMICROBIAL PROPHYLAXIS GUIDELINES
APPENDIX B: UWHC SURGICAL ANTIMICROBIAL PROPHYLAXIS GUIDELINES Principles of prophylaxis 1) Use antimicrobials for surgical procedures where prophylactic antimicrobials have been found to be beneficial.
More informationAdult Catheter Care & Infection Prevention Guide
proudly presents the Adult Catheter Care & Infection Prevention Guide to accompany the interactive, educational program available at www.oley.org sponsored by assembled by March 17, 2010. Updated regularly.
More informationIntroduction to Infection Control
CHAPTER 3 Introduction to Infection Control George Byrns and Mary Elkins Learning Objectives 1 Define terms used in infection control. 2. Review significant risk factors for infection. 3. Identify the
More informationManagement of Catheters Infectious Diseases Working Party/Nurses Group
Management of Catheters Infectious Diseases Working Party/Nurses Group Arno Mank RN PhD, Amsterdam (NL) www.ebmt.org London 09/04/2012 Content Background Management of CVC Types of CVC Care aspect of CVC
More informationInstructions for Completion of Primary Bloodstream Infection (BSI) Form (CDC 57.108)
Instructions for Completion of Primary Bloodstream Infection (BSI) Form (CDC 57.108) Facility ID Event # Patient ID Social Security # Secondary ID Medicare # Patient name Gender Date of Birth Ethnicity
More informationLow complication rates in the use of port-a-caths in oncology patients
ORIGINAL ARTICLE Low complication rates in the use of portacaths in oncology patients M.M.E.M. Bos 1 *, L. Smeets 2, J. Koning 3, I. Dumay 1, E. de Jonge 4 Departments of 1 Internal Medicine, 2 Microbiology,
More informationCatheter-Associated Urinary Tract Infection (CAUTI) Event
Catheter-Associated Urinary Tract Infection () Event Introduction: Urinary tract infections (UTIs) are tied with pneumonia as the second most common type of healthcare-associated infection, second only
More informationV: Infusion Therapy. Alberta Licensed Practical Nurses Competency Profile 217
V: Infusion Therapy Alberta Licensed Practical Nurses Competency Profile 217 Competency: V-1 Knowledge of Intravenous Therapy V-1-1 V-1-2 V-1-3 V-1-4 V-1-5 Demonstrate knowledge and ability to apply critical
More informationProspective Multicenter Study of Vascular-Catheter-Related Complications and Risk Factors for Positive Central-
JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 1990, p. 2520-2525 Vol. 28, No. 11 0095-1137/90/112520-06$02.00/0 Copyright (O 1990, American Society for Microbiology Prospective Multicenter Study of Vascular-Catheter-Related
More informationCentral Venous Catheters for Veterinary Technicians
Central Venous Catheters for Veterinary Technicians Erica Mattox, CVT, VTS (ECC) Central venous catheterization is passing a long catheter into a large vein, such as the jugular or caudal vena cava. This
More informationWhat is CUSP? Stop Bloodstream Infections. Comprehensive. Alyssa DeJong RN, BSN, CCRN, Clinical Nurse Educator ICU 10/3/2011
Stop Bloodstream Infections Alyssa DeJong RN, BSN, CCRN, Clinical Nurse Educator ICU Lola Twedt RN, BSN, OCN, Clinical Nurse Educator Transplant &Oncology Services What is CUSP? Comprehensive Unit-Based
More informationJames T. Dwyer DO, FACOI
Antibiotics in the Surgical Patient James T. Dwyer DO, FACOI Objectives Define current prophylactic recommendations for the use of antibiotics in the surgical patient List current antibiotics available
More informationGuidelines for the Prevention of Intravascular Catheter-Related Infections
Morbidity and Mortality Weekly Report Recommendations and Reports August 9, 2002 / Vol. 51 / No. RR-10 Guidelines for the Prevention of Intravascular Catheter-Related Infections Centers for Disease Control
More informationTOTAL PARENTERAL NUTRITION (TPN) Revised January 2013
TOTAL PARENTERAL NUTRITION (TPN) Revised January 2013 OBJECTIVES Definition Indications for TPN administration Composition of TPN solutions Access routes for TPN administration Monitoring TPN administration
More informationOverview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017
Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017 Bethany Wheeler Hospital VBP Program Support Contract Lead HSAG February 17, 2015 2 p.m. ET Purpose This event will provide an
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Entity: Fairview Pharmacy Services Department: Fairview Home Infusion
More informationGuidelines for the Prevention of Intravascular Catheter Related Infections
GUIDELINES Guidelines for the Prevention of Intravascular Catheter Related Infections Naomi P. O Grady, 1 Mary Alexander, 2 E. Patchen Dellinger, 5 Julie L. Gerberding, 6 Stephen O. Heard, 3 Dennis G.
More informationVascular Access. Chapter 3
Vascular Access Chapter 3 Vascular Access Introduction Obtaining vascular access in infants and children can be difficult even under optimal conditions. Attempting emergent access in a hypotensive, struggling
More informationSeveral authors have expressed concern that systemic
Should Central Venous Catheters Be Removed as Soon as Candidemia Is Detected in Neonates? M. Gary Karlowicz, MD*; Laura Nickles Hashimoto, MD*; Robert E. Kelly, Jr, MD ; and E. Stephen Buescher, MD* ABSTRACT.
More informationPICC and Midline Catheters
PICC and Midline Catheters Infusion RN s Deb Bucher RN BSN CRNI Dawn Finch RN CRNI Marianne Hansen RN BSN CRNI Karman Youngblood RN BS CRNI Infusion Pharmacist Kathy Cimakasky Pharm D Tamara Migut RPh
More informationCARE OF PERIPHERALLY INSERTED CENTRAL CATHETERS (PICC LINES)
LEARNING MODULE FOR CARE OF PERIPHERALLY INSERTED CENTRAL CATHETERS (PICC LINES) CC 80-018 POST-ENTRY LEVEL COMPETENCY Date: July, 2004 Developed by: Maxine Young, RN Revised by: Central Venous Access
More informationInsertion of Hickman Catheters by th Percutaneous Tec hnique
Insertion of Hickman Catheters by th Percutaneous Tec hnique e A Teh, MRCP K W Leong, MRCP Department of Medicine, University Hospital, 59100 Kuala Lumpur Summary Hickman catheters have Pfeviously been
More informationManaging Your Non-Tunneled (Percutaneous) Catheter: PICC, SICC, and JCC. What is a PICC catheter?
Managing Your Non-Tunneled The staff of the Procedure, Vascular Access, Conscious Sedation Service has written this information to explain your new PICC (peripherally inserted central catheter), SICC (subclavian
More informationInfection Control Manual. Table of Contents
Infection Control Manual Policy Name The Prevention of Intravascular Catheter-Related Infections Policy Number IC 0032 Date this Version Effective May 2013 Responsible for Content Hospital Epidemiology
More informationVUMC Guidelines for Management of Indwelling Urinary Catheters. UC Access/ Maintenance
VUMC Guidelines for Management of Indwelling Urinary Catheters UC Insertion Preparation & Procedure Indications for insertion and continued use of indwelling urinary catheters include: Urinary retention
More informationHigh Impact Intervention Central venous catheter care bundle
High Impact Intervention Central venous catheter care bundle Aim To reduce the incidence of catheter related bloodstream infection (CRBSI). Introduction The aim of the care bundle, as set out in this high
More informationPolicies & Procedures. I.D. Number: 1073
Policies & Procedures Title:: CENTRAL VENOUS CATHETERS INSERTION ASSISTING I.D. Number: 1073 Authorization [] Pharmacy Nursing Committee [] MAC Motion #: [x] SHR Nursing Practice Committee Source: Nursing
More informationTreatment of dialysis catheter infection
Treatment of dialysis catheter infection Date written: May 2012 Author: George Chin GUIDELINES No recommendations possible based on Level I or II evidence SUGGESTIONS FOR CLINICAL CARE (Suggestions are
More informationIatrogenesis. Suzanne Beyea,, RN, PhD, FAAN Associate Director: Centers for Health and Aging
Iatrogenesis Suzanne Beyea,, RN, PhD, FAAN Associate Director: Centers for Health and Aging Iatrogenesis Definition from the Greek word, iatros,, meaning healer, iatrogenesis means brought forth by a healer
More informationRight-sided infective endocarditis:tunisian experience
Right-sided infective endocarditis:tunisian experience L. Ammari, A. Ghoubontini, A. Berriche, R. Abdelmalek, S.Aissa, F.Kanoun, B.Kilani, H.Tiouiri Benaissa, T.Ben chaabane Department of Infectious diseases,
More informationCare of your peripherally inserted central catheter
Care of your peripherally inserted central catheter A guide for patients and their carers We care, we discover, we teach Contents What is a PICC?.... 1 How is it put in?.... 1 What are the benefits of
More informationMaria Dalbey RN. BSN, MA, MBA March 17 th, 2015
Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 2 Objectives Participants will be able to : Understand the Pathogenesis of Tuberculosis (TB) Identify the Goals of Public Health for TB Identify Hierarchy
More informationEtiology and treatment of chronic bacterial prostatitis the Croatian experience
Etiology and treatment of chronic bacterial prostatitis the Croatian experience Višnja Škerk University Hospital for Infectious Diseases "Dr. Fran Mihaljevic" Zagreb Croatia Milano, Malpensa, 14 Nov 2008
More informationFlushing and Dressing a Peripherally Inserted Central Catheter (PICC Line): a Guide for Nurses
Flushing and Dressing a Peripherally Inserted Central Catheter (PICC Line): a Guide for Nurses Information for Nurses Introduction This information is for community nursing staffs who have been asked to
More informationNational Provider Call: Hospital Value-Based Purchasing (VBP) Program
National Provider Call: Hospital Value-Based Purchasing (VBP) Program Fiscal Year 2016 Overview for Beneficiaries, Providers and Stakeholders Cindy Tourison, MSHI Lead, Hospital Inpatient Quality Reporting
More informationLaboratory Exercise # 11: Differentiation of the Species Staphylococcus and Streptococcus
Laboratory Exercise # 11: Differentiation of the Species Staphylococcus and Streptococcus Purpose: The purpose of this laboratory exercise is to explore the differences between Staphylococcal species and
More informationA PRINTED copy of this guideline may not be the most recent version. The OFFICIAL version is located on IHNET at the Policies & Procedures Home Page
A PRINTED copy of this guideline may not be the most recent version. The OFFICIAL version is located on IHNET at the Policies & Procedures Home Page IX0200: Prevention & Control of Catheter Associated
More informationPeripherally Inserted Central Catheter (PICC) for Outpatient
Peripherally Inserted Central Catheter (PICC) for Outpatient Introduction A Peripherally Inserted Central Catheter, or PICC line, is a thin, long, soft plastic tube inserted into a vein of the arm. It
More informationLab ID Events MRSA Bloodstream Infection and C. difficile
Lab ID Events MRSA Bloodstream Infection and C. difficile MDRO and CDI Module Methicillin-resistant Staphylococcus (MRSA), Vancomycinresistant Enterococcus(VRE), certain gram negative bacilli, Clostridium
More informationHealth-Care Associated Infection Rates among Adult Patients in Bahrain Military Hospital: A Cross Sectional Survey
Bahrain Medical Bulletin, Vol. 32, No. 1, March 2010 Health-Care Associated Infection Rates among Adult Patients in Bahrain Military Hospital: A Cross Sectional Survey Kelechi Austin Ofurum, M.Sc, B.Sc*,
More informationPotential Conflicts of Interest BLOODSTREAM & INTRAVASCULAR CATHETER- RELATED INFECTIONS. Guidelines for Blood Cultures
BLOODSTREAM & INTRAVASCULAR CATHETER- RELATED INFECTIONS Dr. Leonard Mermel Professor of Medicine Warren Alpert Medical School of Brown University Medical Director Department of Epidemiology & Infection
More informationBLOOD CULTURE COLLECTION GUIDELINES FOR PHLEBOTOMISTS (WITHIN REGION 6)
BLOOD CULTURE COLLECTION GUIDELINES FOR PHLEBOTOMISTS (WITHIN REGION 6) The rate of isolation of micro-organisms from blood is directly related to the volume of blood collected. Therefore, it is recommended
More informationUrinary Tract Infections
Urinary Tract Infections Leading cause of morbidity and health care expenditures in persons of all ages. An estimated 50 % of women report having had a UTI at some point in their lives. 8.3 million office
More informationSection 4: Your Vascular Access. What is vascular access?
Section 4: Your Vascular Access What is vascular access? What is a fistula? Taking care of a new fistula What is a graft? Taking care of a new graft What is a hemodialysis catheter? Taking care of a hemodialysis
More informationC-Difficile Infection Control and Prevention Strategies
C-Difficile Infection Control and Prevention Strategies Adrienne Mims, MD MPH VP, Chief Medical Officer Adrienne.Mims@AlliantQuality.org 1/18/2016 1 Disclosure This educational activity does not have commercial
More informationHighlights of the Revised Official ICD-9-CM Guidelines for Coding and Reporting Effective October 1, 2008
Highlights of the Revised Official ICD-9-CM Guidelines for Coding and Reporting Effective October 1, 2008 Please refer to the complete ICD-9-CM Official Guidelines for Coding and Reporting posted on this
More informationCatheter Associated Urinary Tract Infections (CAUTI) TAKING PRECAU-TIONS
Catheter Associated Urinary Tract Infections (CAUTI) TAKING PRECAU-TIONS Evidence-Based Practice in Prevention of Catheter Associated Urinary Tract Infections (CA-UTI) Catheter Associated Urinary Tract
More informationPATIENT GUIDE. Understand and care for your peripherally inserted central venous catheter (PICC). MEDICAL
PATIENT GUIDE Understand and care for your peripherally inserted central venous catheter (PICC). MEDICAL Introduction The following information is presented as a guideline for your reference. The best
More informationInsertion of a Central Catheter (Hickman/Groshong Catheter)
Insertion of a Central Catheter (Hickman/Groshong Catheter) Patient Information Introduction This booklet has been written to provide information to patients about to have a central catheter inserted in
More informationManagement of Extended Spectrum Beta- Lactamase (ESBL) Producing Enterobacteriaceae in health care settings
Management of Extended Spectrum Beta- Lactamase (ESBL) Producing Enterobacteriaceae in health care settings Dr. Mary Vearncombe PIDAC-IPC February 2012 Objectives: To provide an overview of the RP/AP Annex
More informationFever in the Post-operative Patient:
Focus on CME at the University of Manitoba Fever in the Post-operative Patient: A Chilling Problem Christopher Sikora, BSc, MSc; John M. Embil, MD, FRCPC Presented at Bug Day 2003, Health Sciences Centre,
More informationSurveillance cultures PRO. Kurt Espersen ICU 4131 Rigshospitalet Copenhagen
Kurt Espersen ICU 4131 Rigshospitalet Copenhagen Difficult to Diagnose Systemic Candidal Infection Immunsuppression in critically ill patients Frequent manifestation of fungus in ICU Fungi were isolated
More informationCoding Central Venous Access Devices
Coding Central Venous Access Devices Audio Seminar/Webinar August 7, 2008 Practical Tools for Seminar Learning Copyright 2008 American Health Information Management Association. All rights reserved. Disclaimer
More informationTREATMENT OF PERITONEAL DIALYSIS (PD) RELATED PERITONITIS. General Principles
WA HOME DIALYSIS PROGRAM (WAHDIP) GUIDELINES General Principles 1. PD related peritonitis is an EMERGENCY early empiric treatment followed by close review is essential 2. When culture results and sensitivities
More informationHickman*, Leonard* and Broviac* Central Venous Catheters
Bard Access Systems Hickman*, Leonard* and Broviac* Central Venous Catheters Long Term Instructions For Use Table of Contents Introduction Contents Page Introduction....................................
More informationREMOVAL OF A PICC. Possible Cause Nursing Actions Prevention
REMOVAL OF A PICC PICC lines are removed following a physician order, when therapy is completed or complications such as line sepsis, thrombosis or phlebitis, require removal. The removal of a PICC line
More informationColocutaneous Fistula. Disclosures
Colocutaneous Fistula Madhulika G. Varma MD Associate Professor Chief, Colorectal Surgery University of California, San Francisco Honoraria Applied Medical Covidien Disclosures 1 Colocutaneous Fistula
More informationSPONTANEOUS PNEUMOTHORAX AS A COMPLICATION OF SEPTIC PULMONARY EMBOLISM IN AN INTRAVENOUS DRUG USER: A CASE REPORT
Spontaneous pneumothorax in an IV drug user SPONTANEOUS PNEUMOTHORAX AS A COMPLICATION OF SEPTIC PULMONARY EMBOLISM IN AN INTRAVENOUS DRUG USER: A CASE REPORT Chau-Chyun Sheu, Jhi-Jhu Hwang, Jong-Rung
More informationStrategies to Prevent Deadly Central-Line Associated
SHEA / IDSA Practices and the Arrow Maximal Barrier Kit Strategies to Prevent Deadly Central-Line Associated Bloodstream Infections SHEA Society for Healthcare Epidemiology in America, IDSA Infection Diseases
More informationA PROCEDURAL GUIDE TO MIDLINE CATHETER INSERTION
A PROCEDURAL GUIDE TO MIDLINE CATHETER INSERTION See Also CPG midline catheters for indications, contraindications and post insertion management What is a midline A midline catheter is an 8-12 cm catheter
More informationTITLE: ANTIBIOTIC (ALT) AND ETHANOL (ELT) LOCK THERAPY FOR THE MANAGEMENT OF CENTRAL VENOUS CATHETER-RELATED INFECTIONS
Page 1 of 11 TITLE: ANTIBIOTIC (ALT) AND ETHANOL (ELT) LOCK THERAPY FOR THE MANAGEMENT OF CENTRAL VENOUS CATHETER-RELATED INFECTIONS GUIDELINES: Antibiotic lock therapy (ALT) and ethanol lock therapy (ELT)
More informationPeripheral venous cannulation (PVC) is the commonest method used for intravenous therapy. 20 million catheters inserted annually in the U.S.A.
PERIPHERAL VENOUS CANNULATION Peripheral venous cannulation (PVC) is the commonest method used for intravenous therapy. 20 million catheters inserted annually in the U.S.A. Indications for peripheral venous
More informationUse of tigecycline lock therapy for catheter-related bloodstream infection from KPC-
AAC Accepted Manuscript Posted Online 12 October 2015 Antimicrob. Agents Chemother. doi:10.1128/aac.01855-15 Copyright 2015, American Society for Microbiology. All Rights Reserved. 1 2 Use of tigecycline
More informationPOST-OPERATIVE INFECTIONS: PHYSICIAN S PERSPECTIVES
POST-OPERATIVE INFECTIONS: PHYSICIAN S PERSPECTIVES 1 : 12 B.B. Sarkar, Kolkata Infection is an important arbiter of success or failure of surgical practice and it is the most common form of postoperative
More informationCare of Your Hickman Catheter
Care of Your Hickman Catheter Johns Hopkins Kimmel Cancer Center, Revised 7/11 Contents What is a Hickman Catheter? Page 3 Does the Catheter Limit My Activities? Page 4 How Do I Care for My Catheter? Page
More informationMorpheus SMART PICC CT Insertion Kit
Morpheus SMART PICC CT Insertion Kit Peripherally Inserted Central Catheter INSTRUCTIONS FOR USE ANGIODYNAMICS, INC. 603 QUEENSBURY AVE. QUEENSBURY, NY 12804 U.S.A. TOLL FREE: 800-772-6446 PHONE: 518-798-1215
More informationPreventie en behandeling van hemodialyse gerelateerde bacteriële infecties Workshop
Preventie en behandeling van hemodialyse gerelateerde bacteriële infecties Workshop Prof. Dr. Dirk Vogelaers Dienst algemene inwendige ziekten UZ Gent ORPADT symposium, Affligem, 21.5.2015 1 Antimicrobial
More informationPrevention of CAUTI is discussed in the CDC/HICPAC document, Guideline for Prevention of Catheter-associated Urinary Tract Infection 4.
Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events Introduction: Urinary
More information