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Aseptic Technique and Insertion of Peripheral Venous Catheters

Aseptic Technique and Insertion of Peripheral Venous Catheters . Reducing the risk of Staphylococcus Aureus Bacteraemia’s (SAB’s). Learning Outcomes. On completion of this resource you should be able to

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Aseptic Technique and Insertion of Peripheral Venous Catheters

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  1. Aseptic Technique and Insertion of Peripheral Venous Catheters Reducing the risk of Staphylococcus Aureus Bacteraemia’s (SAB’s)

  2. Learning Outcomes • On completion of this resource you should be able to • Describe how Peripheral Venous Catheters (PVC) can cause bloodstream infections and Staphylococcus Bacteraemia • Explain the implications of PVC related bloodstream infections and how PVC Insertion and Care and Maintenance Bundles can improve PVC care • Describe how to apply an effective Aseptic Non-Touch Technique to inserting a PVC

  3. Peripheral Venous Catheters PVC can cause blood stream infections by enabling micro-organisms to gain direct access to the blood stream. Micro-organisms come from hands of healthcare workers, the patient’s skin at the insertion site, contaminated hubs/ connections, contaminated drugs/ infusions. Risk factors for increasing the risk of blood stream infections include:- 1. Use of a PVC 2. Use of a PVC for drugs that irritate the vein and causing phlebitis 3. Having a pre-existing infection 4. Excess duration of PVC use – longer than 72hours

  4. Peripheral Venous Catheters and asepsis PVC are inserted directly into the circulatory system, it is essential that the principles of asepsis are maintained while inserting and manipulating the device. Development of PVC Insertion and Care Bundles to assist practitioners deliver more reliably safe patient care Patient groups more susceptible to developing a bloodstream infection include the immuno-compromised, elderly and those with invasive devices National HEAT targets have been developed to drive a reduction in the number of Staphylococcus Aureus Bacteraemia by at least 30%

  5. PVC Care Bundle - Insertion The PVC Insertion Bundle outlines the key elements:- A PVC is clinically indicated for this patient Hand Hygiene is performed prior to and following touching the patient Alcohol based antiseptic is applied to the skin and is allowed to dry Don’t touch critical parts Date and time of insertion recorded

  6. PVC Care Bundle - Maintenance The PVC Care Bundle outlines the key elements: - Perform hand hygiene prior to and following all interventions with PVC Is the PVC insitu still required? Are there signs of inflammation or extravasation? Is so remove the PVC Consider removing PVC which has been insitu for 72 hours or longer Check that PVC dressing is dry and intact – consider replacing

  7. Aseptic Non-Touch Technique for PVC Insertion Following explanation of the procedure to the patient, prepare a clean dry surface Gather the following equipment:- PVC Insertion pack (if available) Tourniquet (disposable/ single patient use if available) Antiseptic wipe (alcohol based) PVC if not available in a pack Non-sterile gloves Sterile IV dressing Sharps box Waste disposal bag

  8. Perform Hand Hygiene Create a sterile field Open and prepare the sterile equipment without touching the critical parts Ensure patients skin is visibly clean – if not wash with soap and water and wash your hands again. Aseptic Non-Touch Technique for PVC Insertion(1)

  9. Don non-sterile gloves Apply tourniquet and palpate vein – you will not be able to palpate following disinfection Apply alcohol-based antiseptic to patient’s skin and allow to dry for 30 seconds – DO NOT RE-PALPATE For complicated PVC insertion you may require to re-palpate the vein. It is therefore essential that you ensure that sterility of the insertion site is maintained. Hold the PVC without touching the part of the catheter that is inserted into the patient, or underneath the cap Aseptic Non-Touch Technique for PVC Insertion(1)

  10. Following insertion release tourniquet, remove insertion needle and secure PVC with sterile dated and timed IV dressing Discard sharps in sharps box, discard gloves in appropriate waste bag Perform hand hygiene Complete PVC insertion sticker/ documentation and place in patients case notes Aseptic Non-Touch Technique for PVC Insertion(1) Date & time Transparent dressing Parallel securing tapes

  11. Bibliography NHS Quality Improvement Scotland, Health Protection Scotland. Peripheral Vascular Catheter Insertion. Driver Diagram, Implementation Framework, Priority Elements Checklist, Data measurement tool and Measurement Plan. Working Draft. Scotland: NHS QIS/HPS. 2011 version 1.0 2. World Health Organisation (2009) WHO Guidelines on Hand Hygiene in Health Care. Fist global Patient Safety Challenge: Clean Care is Safer Care. WHO, Geneva Further references and bibliography can be found in the teaching notes

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