TITLE: PERIPHERAL INTRAVENOUS CATHETER SITE INFECTION PRESENTING AS ENDOCARDITIS- A PREVENTABLE COMPLICATION
Abstract:
Nosocomial infections pose a global safety concern for hospitalized individuals as well as health care providers. About 10 to 30% of patients acquire nosocomial infection according to Hospital Infection Society, India. Common hospital-acquired infections are respiratory, urinary tract, surgical wound infections and infections associated with intravascular catheters. We discuss here a case of a 35-year-old woman who had an intravenous cannula inserted at her right wrist at the time of her laparoscopic cholecystectomy. She developed fever along with redness and tenderness at the catheter insertion site on 4th postoperative day.
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Endocarditis or septic thrombophlebitis should be suspected if blood cultures remain positive for more than 48 hours after the device has been removed (Hovarth R et al., 2003). As per the Infectious Disease Society of America (IDSA) guidelines, Trans Esophageal Echocardigraphy (TEE) should be done for patients with CRBSI who have persistent bacteremia or fungemia and/or fever 13 days after initiation of appropriate antibiotic therapy and catheter removal; and any case of S. aureus CRBSI in which duration of therapy less than 4–6 …show more content…
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The evaluation will include a regression model to measure the central line associated bloodstream infections (CLABS) using evidence – based practice norms to identify variations which allows the unit to improve and reduce CLABS. The plan also includes training the oncology pediatric nurses in safe administration of chemotherapeutic agents and passing the Oncology Nursing Society (ONS), Oncology Nursing Certification Corporation (ONCC) to meet national standards. To further improve the implementation of the indicator measurement process in treatment guidelines, it is recommended that the quality improvement and infection control teams will improve assessments using the QAPI worksheet to meet the CMS requirements for safe and quality outcomes, and reimbursement (Legal Information Institute, Cornell Law School,
MEDSURG Nursing, 23(3), 187-188. Farber, J., Illiger, S., Gartner, F. B., Lutz, v. M., Lohmann, C. H., Bauer, K., . . . Geginat, G. (2017). Management of a cluster of Clostridium difficile infections among patients with osteoarticular infections. Antimicrobial Resistance and Infection Control, 6 doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1186/s13756-017-0181-4 Wang, J., Quan, K. A., Tjoa, T., Yim, J., Dickey, L., Chang, J., ... & Gohil, S. K. (2016, December).
The morality of Healthcare acquired infections has increased tremendously whereas; both inpatient and outpatient clients have been infected during a hospital visit. These infections has weaken the sick which may lead to additional medications, or surgery, and extended hospital stay. According to (CDC 2002), healthcare acquired infections are result of unhygienic practices in medical field. This includes ambulatory surgical centers, hospice center, nursing homes and rehabilitation centers.
Staphylococcus epidermidis is an opportunistic pathogen, meaning that they can cause infection more frequently and more easily in persons’ with a weakened immune system such as, HIV patients (CDC, 2015). This organism is seen primarily in nosocomial infections, also known as, hospital-acquired infections (Bukhari, 2004). This means that the organisms favors the hospital environment and is easily passed to a person while they are in the hospital. Ways that a person can get a Staphylococcus epidermidis infection is through IV’s, more commonly in drug users, catheters, and artificial equipment (Bukhari, 2004). Skin-to-skin contact can also be a form of getting this type of infection.
Practice Dimension/ Ethics/ Resource Utilization: Ms. Cabral applies the nursing process to systems or processes at the unit/team/work group level to improve care. She is the primary nurse for five of our chronic dialysis patients promoting safe high quality care. She involves the patient and their families in monthly interdisciplinary care plan meetings to promote self-efficacy and quality of life. She continually evaluates the patient 's health status. The effectiveness of her patient 's plan of care is reevaluated on a regular basis and changes are made for continuous improvements.
Central line associated bloodstream infections (CLABSIs) in 2009 were amongst 23,000 infections in the inpatient population of US hospitals. (Sweet, Cumpston, Briggs, Craig, & Hamadani, 2012) These infections increase morbidity of patients, mortality, and increase cost. Those that are at risk are the population with central venous catheters. This infection is commonly due to improper hub care and consequently provides the direct introduction of the bacteria into the blood stream. A fairly new intervention to prevent this morbid infection is the implementation of alcohol impregnated protective caps, otherwise known as the brand name Curos caps in addition to others.
From January 2011 to July 2013, 112 pacemakers were implanted at the ICL, Hospital Queen Elizabeth II. The longer duration of the pacemaker implantation or the hardware change procedure took was associated with an increased risk of pacemaker infection. The choices of antibiotic before and after the procedure will also play role in protecting the patient from infection. In addition, we found that the use of cefazolin after implantation procedure may reduce the risk of getting infected compared to the other antibiotics. Contrarily, age, preoperative antibiotic choices and gender were not associated with a risk of pacemaker infection.
The study population included 832 patients hospitalized in five different ICUs (Keten et al, 2014, 277). A hundred and one patients who developed 126 attacks of catheter associated urinary tract infections (CAUTI) were accounted for in the study sample. Out of the 101 patients, 85 experienced at least one attack of CAUTI, 7 experienced two attacks of CAUTI, and 6 experienced three or more attacks of CAUTI. Out of the 101 patients who developed a CAUTI, 49 (48.5%) were female and 52 (51.5%) were male. About 54.5% of the patients were aged 65 years or older (Keten et al, 2014,
Identify current patient safety goals for one health care setting NPSG.07.06.01 Use proven guidelines to prevent infections of the urinary tract that are caused by catheters. Managing indwelling urinary catheters according to established guidelines is crucial for patient safety. It is important that health care providers are securing catheters for unobstructed urine flow and drainage, maintaining a sterile system for urine collection, and replacing the system when required. These things, along with collecting urine samples, are all examples of how to implement the evidence-based guidelines to ensure safety and quality health care to patients (The Joint Commission, 2015).
The spread of infection towards immunocompromised patients are definitely directly cost and quality oriented. The cost of treatment of the infection with its complications which lead to prolonged the hospital stay of patients. Not only protecting the individual workers but also the patients who exposed to. I appreciate and motivate my colleagues for getting
The primary prevention is the best way to eliminate the potential for exposure. Since hand washing is the most effective mean of spread of infection, it would be my primary goal to increase the compliance of hand hygiene among healthcare workers, but also an extensive education of patients and family members on hand washing before and after touching the patient as well as afar any contact with any potentially contaminated materials (surface, body fluids or respiratory secretions). Mandatory education of patients, visitors and healthcare workers, across the system as well as cross department compliance practices are single best mean of preventing the spread of infection. For example, every patient and family member can be educated about hand hygiene, use of PPE-personal protective equipment (face mask, gowns and gloves). Although, the practices are already being utilized, I believe the compliance is poorly monitored.
A coordinated plan should be followed by health care facilities which are located in the same region especially when they fight against antibiotic-resistant organisms and C. difficile. First, we will discuss Central line-associated bloodstream infections. A central line is a catheter that is placed in one of the major veins in the body, usually in the neck (internal jugular vein), or in the groin (femoral vein). Through it, blood can be collected, medications & fluids can be given.
Heads the Surgical team in ensuring the safe movement of sterile supplies; monitoring of appropriate temp and humidity in the OR Core; and facilitating a smooth transition to operational process. Facilitates the movement of sterile supplies from the OR suites and IR/Cath Lab to the OR Core. Monitored the execution of process efficiently minimizing the risk of compromised supplies and eventually wastes. Ms Fernandez directs nursing, cath lab team, logistics and EMS in addressing concerns and employing appropriate communications and actions. This resulted in the absence of compromised supplies, surgical and procedural cases were conducted as scheduled after the project.
Can an increased hand washing practices by health care provides reduce the rate of catheter associated urinary tract infection (CAUTI)? 3. Between hand washing and the use of alcohol which is a more potent way to prevent hospital acquired infections. 4. Which is better?
Today is my fourth clinical assignment here at Salt Lake Regional Medical Center; this will be my second week in the Telemetry Unit (TELE), which is associated with the Intensive Care Unit (ICU). I had the opportunity again to work alongside Lauren. Last week was increasable, I was able see and have great deal more of direct patient care. However, this week was most serious, I was allow to sit in a family care meeting to discuss end of life care and to discover the patient’s goals for further treatment for a 72 male, suffering from Parkinson’s and resent diagnosis of MRSA infection, in which he is unaware of at this point was transferred from the Rehab to TELE unit do to Atrial fibrillation.