Essay on Central Venous Catheter and Venous Access Device

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Reducing Central Venous Line Infection
Eileen D. Ibanez Medical Careers Institute

Introduction Central venous access devices are used to administer chemotherapy, long-term antibiotics, parenteral nutrition, fluids and blood transfusion therapy. It is used for treatment of patients requiring long-term treatment for various health care disorders (WebMd, n.d.). Central venous catheters can also increase the risk of hospital-acquired bloodstream infections, which in turn will increase the length of hospital stay, total costs of care and risk of mortality (Hatler, Buckwald, Salas-Allison & Murphy-Taylor, 2009). The lack of use in consistent protocols for central venous access devices accrue an approximately 250,000 bloodstream infections in U.S hospitals yearly (Hatler et al., 2009). An estimated 90,000 deaths a year result from these bloodstream infections associated with intravascular catheters (Hatler et al., 2009). The health care system averages $25,000 to $40,000 per incidence (Mathers, 2011). The identification of proper and/or improper practice and application of evidence-based practice protocols is essential to keeping catheter patency and prevention of infections.
Definition of Topic Stated by the authors of Evidence-based Practice to Reduce Central Line Infections, “a catheter related blood stream infection is defined as a positive blood culture with clinical or microbiologic evidence that strongly implicates the catheter as the source of infection” (Render et al., 2006, p. 254). What, besides what we already are taught to perform, can be further done to reduce the percentage of blood stream infection in central venous catheters and access devices? Existing practices used for infection control of central line placement include maximal barrier precautions, which consists of strict compliance with hand hygiene, wearing a cap, mask, sterile gown, and gloves, and use of an ant-infective coating for the catheter. Nursing care includes dressing site care, aseptic port handling and prompt removal of central access device to maintain infectious free catheters (Hatler et al., 2009). Ways to help improve education is to develop a consistent and valid check off list that can be used to standardize aseptic practice with evidence-based guidelines and to determine how an educational program on central venous access care can affect nurses’ overall knowledge (Labeu et al., 2008).
Relevance and Significance
Doctors and nurse practitioners insert central venous lines, but the responsibility for the care of the central venous access devices and lines lies primarily with nurses. The priority nursing goal is prevention of infection (Scales, 2011). Using standardized protocols, including the removal of betadine in central kits, a larger drape to allow for a more sterile field and a checklist for sequential line insertion improve accuracy (Render et al., 2006). By ensuring the knowledge and skills necessary to prevent harm, nurses can focus on patient care and live up to the trust those patients and their families instill in their nurses (Scales, 2011).
Evidence Findings In the research associated with Mather’s Evidence based practice: improving outcomes with patients with a central venous access device, is focused towards continued education on standardized flushing protocols. In-hospital services were provided for a regional medical facility in Williamsport, Pennsylvania (Mathers, 2011). Data for the research was attained through a knowledge based questionnaire and direct observation. Data was taken prior to education series to allow for baseline analysis. The research analysis was comprised of a questionnaire containing content knowledge questions relating to central venous access device flushing and a tool used to evaluate nurses’ central device flushing technique. The tool was comprised of a yes or no survey administrated by a research proctor. Analysis shows that an significant increase from
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