These tools will help your unit implement evidence-based practices and eliminate central line-associated blood stream infections (CLABSI). When used with the CUSP (Comprehensive Unit-based Safety Program) Toolkit, these tools dramatically reduced CLABSI rates
in more than 1,000 hospitals across the country. Slide 1. Guidelines to Prevent Central Line-Associated Blood Stream Infections Guidelines to Prevent Central Line-Associated Blood Stream Infections * Sherertz, et al. Ann Intern Med. 2000;132(8):641-648
* Merrer, et al. JAMA. 2001;286:700-7 Slide 8. Risk Factors for CLABSI (cont.)
Slide 9. Risk Factors for CLABSI (cont.)
Image: Drawing of an infection site. There are five main areas from which catheter related infections can originate. Infection can occur hematogenously, from a distant local infection. Contamination of the catheter device prior to insertion, skin organisms, or contamination of the catheter hub can all cause infection. Contaminated infusate can also cause infection. Slide 10. Five Evidence-Based Steps to Prevent CLABSI
Slide 11. Hand Hygiene
Slide 12. Hand Hygiene Works!
Slide 13. Waterless Hand Hygiene Steps
Image to the right of text: Photograph of hands using a waterless hand sanitizer. Slide 14. Hand Washing Steps
Image to the left of text: Photograph of hands washing with water under a faucet. Slide 15. C-VAD Site Selection
Image: Photograph of a shoulder with a subclavian catheter inserted. Slide 16. C-VAD Site Selection: Special Considerations
Slide 17. C-VAD Line Selection
Slide 18. Aseptic Technique: Goals
Slide 19. Aseptic Technique
Image of ChloraPrep applicator. Slide 20. Evidence Supporting Chlorhexidine Use: Skin Prep-Meta Analysis
Image of line chart comparing seven studies conducted between 1991 and 2000 that all support the use of chlorhexidine. From Ann Intern Med meta-analysis. Slide 21. Maximal Barriers Required for C-VAD Insertion
Slide 22. Maximal Barrier Precautions Decrease CLABSI Infections
Slide 23. Caveats: Catheter Insertion
*Ranson. J Hosp Infect. 1990;15(1):95-102. Slide 24. Post Insertion: C-VAD Care
Slide 25. Replacing C-VADs
*Eyer, et al. Crit Care Med. 1990;18(10):1073-9 . Slide 26. Suspected C-VAD Infections
*Mermel, et al. Clin Infect Dis. 2001;32(9):1249-72. Slide 27. Suspected C-VAD Infections (cont.)
Slide 28. C-VAD Line Cultures: Indications
Slide 29. C-VAD Line Cultures: Method
Slide 30. C-VAD Line Cultures: Interpretation
Slide 31. Blood Cultures
Slide 32. Peripheral Blood Cultures: Method
Slide 33. Arterial Line: Site Selection
Slide 34. Arterial Lines: Aseptic Technique
Slide 35. Arterial Lines: Barriers
Slide 36. Special Thanks
Sean Berenholtz, M.D. Roy Brower, M.D. Raphe Consunji, M.D. Sara Cosgrove, M.D. Pamela Lipsett, M.D. Trish Perl, M.D. Peter Pronovost, M.D. Lisa Cooper, R.N. Back to Document Page last reviewed March 2018 Page originally created January 2012
Internet Citation: Appendix 3. Guidelines to Prevent Central Line-Associated Blood Stream Infections. Content last reviewed March 2018. Agency for Healthcare Research and Quality, Rockville, MD. Which action by the nurse will result in contamination of a sterile object or sterile field?The nurse must NEVER lean over a sterile field. The nurse must NEVER have the sterile field below the waist level. Coughing or sneezing over the sterile field contaminates the sterile field. The nurse must maintain a one-inch border around the sterile field that is not sterile.
Which action by the nurse will result in contamination of a sterile object or sterile field quizlet?- A sterile field becomes contaminated if the nurse turns his or her back to it. Any item that comes into contact with a sterile field must be sterile. Reaching over a sterile field contaminates the sterile field. Any items below waist level are considered contaminated.
What actions contaminates a sterile field?Sterile objects can become non-sterile by prolonged exposure to airborne microorganisms. 6. Any puncture, moisture, or tear that passes through a sterile barrier must be considered contaminated.
Which action increases the risk of contamination while applying a sterile gown?Contamination may occur when arms and hands are moved below waist level. Arms should not be folded with the hands in the armpits. This area has the potential to become contaminated by perspiration allowing for strike-through of the gown and, ultimately, contamination of the gloved hands.
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