Management of Invasive Devices and Infection Prevention · Management of Invasive Devices and...

Management of Invasive Devices and Infection Prevention

Alexander Anderson Clinical EducatorEmma Franklin Clinical Effectiveness FacilitatorEmma Franklin Clinical Effectiveness Facilitator

NHS Lothian Infection Prevention and Control Study Day | On a mission... to prevent transmission | 24 April 2016

Familiar?

PVC...Potentially Very Costly

Patient

Health service O l ibi i Loss of earnings

Worried about paying bills Worried about childcare Time away from family Missed family celebration Pain and being unwell

Oral antibiotics GP appointment Attended OPAT Admitted to RIDU for 4 days

(swabs for microbiology, blood tests, medical care, nursing care, AHP input, meals,

) Pain and being unwell Loss of trust in health service

linen...you get the picture) Oral antibiotics (again)

Remember these lists are NOT exhaustive


Visual Infusion Phlebitis Scale(Jackson, 1998)

Skin Cleansing

• Decontaminate the site using a 2% hl h idi i l h l l ti fchlorhexidine in alcohol solution for a

minimum of 30 seconds(DH, 2007).

• Using a circular motions while moving outward from the insertion siteoutward from the insertion site.


Care of a PVC

• Securement device(s)

• PVC stabilisation.

• Transparent, semi-permeable dressing offers clear visualisation of the PVC insertion site.

Care of a PVC

### Video Removed from Presentation ###

Video of 3M™ Tegaderm™ Transparent I.V. Dressing, 1633 Application and Removal shown during study day presentation.

Available from YouTube www.youtube.com/watch?v=N_y09xfFlKo


What do the guidelines say?

• Clinical need for PVC reviewed and documented each day.

• The need for IV drugs is reviewed daily by medical staff and switched to oral as soon as possible.possible.

• Hand hygiene is performed prior to line access.

What do the guidelines say?• PVC site is assessed using VIP score and removed

where phlebitis and infection are clinically indicated.

• PVC dressing is in tact.

• 70% isopropyl alcohol is used to clean access ports for at least 15 seconds prior to access.

• Remove after 72-96 hours unless clinically indicated sooner or if there is limited venous access it may be left in longer.

• (Health Protection Scotland, 2012) and Department of Health (2011)


Removing a PVC

• Caring for the wound • Cotton wool lucky dip!

Documenting PVC careUsing a Bundle prompts a full assesment of the PVC

(if you’ve forgotten what you’re looking for) and (if you ve forgotten what you re looking for) and allows you to record this easily.

Still required In for ≤72hours or rationale for prolonged use documented VIP of 0 or 1 Dressing clean, dry and intact

& if it isn’t documented......it didn’t happen


Resources

www.vipscore.netwww.vipscore.net

www.ihi.org/onescotland

www.scottishpatientsafetyprogramme.scot.nhs.uk


References• Nursing and Midwifery Council (NMC)(2008). The Code: Standards of conduct, performance and

ethics for nurses and midwives. [Online]. Available at http://www.nmc-uk.org/Documents/Standards/nmcTheCodeStandardsofConductPerformanceAndEthicsForNursesAndMidwives_LargePrintVersion.PDF. Last accessed 18th April 2016_ g p

• Nursing and Midwifery Council (NMC)(2011). Guidance on professional conduct for nursing and midwifery students. [Online]. Available at http://www.nmc-uk.org/Documents/Guidance/Guidance-on-professional-conduct-for-nursing-and-midwifery-students.pdf. Last accessed 18th April 2016

• Department of Health (DH) (2011). High Impact Intervention: Peripheral intravenous cannula care bundle. [Online]. Available at http://webarchive.nationalarchives.gov.uk/20120118164404/hcai.dh.gov.uk/files/2011/03/2011-03-14-HII-Peripheral-intravenous-cannula-bundle-FIN%E2%80%A6.pdf. Last accessed 10th April 2016.

• Health Protection Scotland (HPS)(2012). Targeted literature review: What are the key infection prevention and control recommendations to inform a peripheral vascular catheter (PVC) maintenance care quality improvement tool? . [Online]. Available at http://www.documents.hps.scot.nhs.uk/hai/infection-control/evidence-for-care-bundles/literature-reviews/pvc-maintenance-review pdf Last accessed 18th April 2016reviews/pvc maintenance review.pdf. Last accessed 18th April 2016

• Mbamalu, D. and Banerjee, A. (1999). Methods of obtaining peripheral venous access in difficult situations. British Medical Journal. 75 (1), 459-462.

• Webster, J., Osborne, S., Rickard,C. and Hall, J. (2010). Clinically-indicated replacement versus routine replacement of peripheral venous catheters. [online]. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007798.pub2/abstract;jsessionid=413365C35E9C80A14D687D75F744079F.d01t03. Last accessed: 18th April 2016

Thank you, do you have any questions?

Alexander Anderson Clinical Educator [email protected]

Emma Franklin Clinical Effectiveness Facilitator [email protected]

We understand that your need for a break may be greater than all other needs so please contact us by e-mail if you do not want to delay coffee!


Management of Invasive Devices and Infection Prevention · Management of Invasive Devices and...

Documents

Transcript of Management of Invasive Devices and Infection Prevention · Management of Invasive Devices and...