Central Line Education 2012



Annual 2013 Adult Central Line EducationDirections for Completion of EducationRead the Adult Central Line Education 2013, which begins on the next page of this document, before proceeding to the posttest. Once you have read and understand the information, exit the education page and complete the posttest which is final step of this education. Remember, no attendance record is needed. Completion of the posttest will be sent electronically to your EduTracker record once a 100% is achieved.Print the Certificate of Completion for your records. If you have any questions about this information, please contact your manager or a member of the Device Associated Infection Performance Improvement Team.Adult Central Line Education 2013ObjectivesIdentify elements for central line bundle compliance.Empower the observer to stop line insertion if any element of the central line insertion bundle is not followed.Identify strategies to prevent central line associated infections through proper maintenance and prompt removal.SLUHN DataNetwork Acute CareNumberCY2009CY2010CY2011CY2012SLB23131310SLAC0520SLRA00SLQ1002SLM0000SLW2122Total26191714683895-635000Network Critical CareNumberCY2009CY2010CY2011CY2012SLB8555SLAC1101SLRA02SLQ0000SLM0000SLW0210Total9868Indications for Central Lines Medications which require central line use Hemodynamic monitoring No peripheral accessMultiple ports neededHome IV therapy (e.g. chemotherapy, TPN, antibiotics)Treatment/therapy (e.g. hemodialysis, plasmapheresis)Patient EducationEducate patients about necessity/risks of central lines using materials from Krames On-Demand?.Remember to document patient education.Central Line Insertion Bundle ElementsAppropriate hand hygiene.Maximum barrier precautions. Use of chlorhexidine skin preparation prior to insertion and allow the prep agent to dry per manufacturer’s instructions prior to insertion.Avoid using the femoral vein for central venous catheters in adult patients.Daily review of line necessity with prompt removal of unnecessary lines.Ensure an empowered observer is present during procedure. This observer must be empowered to stop the line insertion if any element of the central line insertion bundle is not followed!Central Line MaintenanceDoes the patient really need a central line?? Remember to ALWAYS assess and reassess the patient for ability to insert peripheral access.Follow Network Daily Device Assessment Process The prompt removal of unnecessary central lines is the most crucial element of patient safety Hand hygiene before and after accessing a central line.Use aseptic technique when accessing the line.Scrub the hub with alcohol: vigorous scrub using twisting motion; allow alcohol to dry.Change IV solutions and tubing per IV Therapy Policy.Patients with TPN infusions may be at increased risk of infection. Please refer to “Parenteral Nutrition and Fat Emulsion” policy: Each bag of TPN must not hang for more than 24 hours.IV medications and fluids should not be infused through the same port/lumen that is being used to administer TPN.Parenteral nutrition needs to run through a dedicated line or port/lumen of a multi-lumen device. With the exception of piggy-backed fat emulsions, no IV push or IV piggyback medications may be added to these lines. TPN tubing change should occur every 24 hours.Maintain dressings intact. Change dressings per policy and anytime the integrity of the dressing is compromised.When changing dressings, please remember to wear a mask and sterile gloves for the procedure. Address catheter occlusions promptly.DocumentationFor departments that do not document in Care Manager:Receiving RN will ensure insertion form is completed and document in care manager. Care Manager charting:Insertion date, time, hour, and line typeInsertion bundle Document patient education “Line necessary” needs to be documented daily Document date central line was discontinued Please Note: Insertion date, time, hour and bundle should only be documented ONE time on day of pletion of the Invasive Device Daily Assessment – Physician Order FormRN completes:DateTimeIdentifies Central Line TypeCentral line dayInsertion datePhysician: Continues or discontinues per indicationsIf continues, identifies reason(s) for continuing lineSigns, date and time on bottom of formRN: RN signs, dates and times bottom of form to verify orderThis process is a collaborative effort to remove all unnecessary central lines and decrease the risk of infection associated with central lines.For additional details, please refer to “Central Venous Access Devices – Care and Maintenance, Blood Collection & Removal of” policy. CDC Guidelines: Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011 ................
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