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BSI prevention.pptx
- 1. BLOOD STREAM INFECTION &PREVENTION Dr. Soha Al Marsafy INFECTION CONTROL CONSULTANT MD, EBIC , PDIC ,CBIC, DHAM
- 2. ◦Why BSI important ◦Bundle of prevention of CLABSI ◦Case definition of BSI /CLABSI
- 3. What is bloodstream infection? Bloodstream infections (BSI) defined by the presence of viable bacterial or fungal microorganisms in the bloodstream (later demonstrated by the positivity of one or more blood cultures) that elicit or have elicited an inflammatory response characterized by the alteration of clinical, laboratory
- 4. Why BSI ◦An estimated 250,000 bloodstream infections occur annually, and most are related to the presence of intravascular devices. In the United States, the CLABSI rate in intensive care units (ICU) is estimated to be 0.8 per 1000 central line days.
- 5. WHAT IS A BUNDLE ????? A bundle is a group of procedures based on best practices , when applied together can reduce incidence of HAIs
- 7. Bundle of prevention of CLABSI ◦ Insertion bundle ◦ Maintenance bundle
- 8. Insertion Bundle: ◦Hand Hygiene ◦maximal sterile barrier precautions ◦skin preparation ◦selection of the insertion site
- 9. ◦Hand Hygiene by surgical scrubbing or rubbing ◦Scrubbing both hands and arms above the elbow by around 5 cm ◦Keep your arms at a high level until gowning and gloves
- 14. ◦ Proper skin preparation with antiseptic chlorhexidine 2% for at least 30 seconds and must be allowed to dry before making the skin puncture. or povidone iodine (betadin 10%) with contact time 2min then wiped out ◦ Disinfection in one direction with sterile gauze
- 15. ◦ Proper selection of site of insertion ◦ Use non-tunneled cath in adult ◦ jugular or subclavian avoid femoral site ◦ The disadvantage of the femoral site is that it presents a field that is potentially contaminated because of its proximity to the perineal area. ◦ The head and neck area is also potentially contaminated by excessive secretions in the critically ill patient who is intubated or has undergone a tracheostomy for airway access
- 17. Maintenance Bundle ◦ HH ◦ Care of insertion site ◦ Dressing change ◦ Scrub the hub ◦ Maintenance closed system ◦ Daily assessment and early removal
- 18. ◦ Hand hygiene ◦ must be Performed prior to any catheter manipulation ◦ alcohol-based product or antiseptic soap and water ◦ Use of gloves does not obviate hand hygiene.
- 19. Care of insertion site ◦ (alcoholic70%+ chlorhexidine >0.5% )as a first- line antiseptic in catheter care. ◦ insertion site should be cleaned with alcohol first ◦ then to be disinfected with ( alcohol 70%+chlorhexidine 0.5%) ◦ if its not available use betadin 10% but be caution not to paint the lines with betadin ◦ The line should be wiped in one direction with alcohol only
- 20. Care of insertion site (Replace dressings that are wet, soiled, or dislodged) Transport change every 7 days Semi-transparent every 2 days
- 21. ◦Scrub the access port or hub: ◦immediately prior to each use with(70% alcohol) for 15 seconds
- 22. ◦ Maintain closed system ◦ Daily assessment and early removal
- 23. WHAT IS NEW ◦ For patients aged 18 years and older Chlorhexidine- impregnated dressings are recommended to protect the insertion site of short-term, non-tunneled central venous catheters ◦ NOT recommended under aged 18 years nor for pediatric patients CDC update July 2017
- 25. CASE DEFINITION
- 27. THANK YOU