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Infection control measures in iv drug administration

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infection control measures in IV therapy

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Infection control measures in iv drug administration

  1. 1. Infection Control Measures in IV Drug Administration Prepared by : Dr. Ahmed Kholeif General Practitioner Date : 12th November,2012
  2. 2. Objective: Every member of SHHC staff involved with intravenous therapy will be able to apply the correct infection control precautions to this procedure .
  3. 3. Introduction: Vascular access devices is vital for administering various fluids and drug therapies. it's critical to maintain an appropriate infection control measures to save lives and money and reduce healthcare burdens.
  4. 4. Types of intravenous devices: 1. Peripheral cannulas : placed into a peripheral vein 2. Peripherally inserted central catheters (PICC) Central line that is placed via the peripheral vasculature. Its tip terminates in the superior vena cava
  5. 5. Types of intravenous devices: 3. Peripheral midline catheters : Shorter version of the PICC, Its tip terminates in the axilla
  6. 6. Types of intravenous devices: 4. Skin tunneled cuffed central catheters (Hickman lines) Central venous catheter most often used for the administration of chemotherapy
  7. 7. Expected Intravenous Catheter Complications  Phlebitis: Inflammation of a blood vessel  Thrombophlebitis: Similar to phlebitis but a thrombus (or clot) is in addition involved  Local Infection (abscess): A microscopic organism may use the tiny hole in the skin created by the IV catheter to find its way into the body, and cause an infection
  8. 8. Expected Intravenous Catheter Complications  Infiltration : This occurs when the catheter unintentionally enters the tissue surrounding the blood vessel and the IV fluid go into the tissues.  Hematoma: collection of blood caused by internal bleeding.  Hypothermia: When large amounts of cold fluids are infused. Rapid temperature changes occurs and may precipitate ventricular fibrillation.
  9. 9. Infectious Micro-organisms associated with IV therapy  Staphylococcus epidermidis  Staphylococcus aureus  Enterococcus spp.  Klebsiella  Pseudomonas  E. Coli  Candida
  10. 10. Reservoirs  Patients Skin – resident microflora  Equipment  IV Solutions & drugs  Environment  Health care provider Hands
  11. 11. INFECTION CONTROL MEASURES 1.Collect all required equipment, checking expiry date and the correct catheter size for the purpose and length of infusion 2. Confirm patient identity and provide explanation 3. Hand washing Should be performed before and after inserting, replacing , repairing, or dressing an intravascular catheter
  12. 12. INFECTION CONTROL MEASURES 4. Wearing gloves Wear clean gloves, rather than sterile gloves, for the insertion or changing the dressing of peripheral intravascular catheters. Sterile gloves should be worn for the insertion of arterial, central, and midline catheters. 5. Patient skin preparation Alcohol swab to remove bacteria prior to insertion and allow it to dry; this doesn’t protect the patient for a longer period. Chlorhexidine Gluconate with 70% alcohol gives longer duration of protection
  13. 13. 6.Securing Catheter insertion site. 7.Disposing of contaminated or soiled equipment and linen appropriately . 8. Safe disposal of sharps .
  14. 14. 9. Stay with your patient for 5 to 10 minutes to detect early signs and symptoms of hypersensitivity, such as sudden fever, joint swelling, rash, urticaria (hives), bronchospasm, and wheezing. 10.Documentation
  15. 15. Function of the dressing To protect the site of venous access To stabilize the catheter in place Prevent mechanical damage Keep site clean
  16. 16. Catheter Site Dressing Regimens 1. Use sterile, transparent, semipermeable dressing to cover the catheter site it allows continuous visual inspection of the catheter site and require less frequent changes. 2. Replace catheter site dressing if the dressing becomes damp, loosened, or visibly soiled 3. No need to replace peripheral catheters more frequently than every 72 (even in the absence of signs of infection), the new catheter should be inserted into a separate site.
  17. 17. Catheter Site Dressing Regimens 4. For patients not receiving blood, blood products or fat emulsions, replace administration sets after 72 hours if clear fluids are used 5. For short-term CVC sites change dressing every 2 days for gauze and every 7 days for transparent dressings 6. Do not use topical antibiotic ointment or creams on insertion sites.
  18. 18. signs of infection  Redness (erythema) and warmth with some fever  Pain or burning along the length of the vein  Swelling (edema)  Purulent discharge If any of these signs are noted, the IV catheter must be removed immediately .
  19. 19. Types of Phlebitis  Bacterial phlebitis is usually an indication to an infection at the insertion site.  Chemical phlebitis is most commonly seen with peripheral IV devices when medications or solutions irritate the endothelial lining of the small peripheral vessel wall, for example:  erythromycin  tetracycline  vancomycin  Large doses of potassium chloride  multivitamins
  20. 20. Types of Phlebitis  Mechanical phlebitis occurs when the size of the cannula is too big for the selected vein causing unnecessary friction on the internal lining of the vein leading to inflammation
  21. 21. Fighting Phlebitis 1 . Phlebitis is most common after continuous infusions, developing 2 to 3 days after the vein is exposed to the drug or solution. 2. Phlebitis is more common in distal veins than in veins close to the heart.
  22. 22. Steps to Prevent Phlebitis:  Use proper venipuncture technique.  dilute drugs correctly.  Monitor administration rates.  Observe the I.V. site frequently.  Change the infusion site regularly according to policy.
  23. 23. Conclusion REMEMBER !  Adhering to aseptic technique during insertion, dressing changes, preparing medications will minimize the risk of infection  Cannula site rotation and using the appropriate Cannula size  Adequate securement of the IV device
  24. 24. Conclusion  Patients should be closely monitored for signs of infection  Patient education of the signs and symptoms of phlebitis  Good documentation is essential and it should be Daily as evidence that assessment has been carried out
  25. 25. Questions !
  26. 26. THANK YOU !

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