Are those instructions specific to using the PowerPICC for power
injection of contrast agents? If so, they may be making this
suggestion to improve the rate of injection. The injection cap would
offer some resistance to infusion, and removing it would eliminate
this one source of resistance.
All hub manipulation will increase the chance of introducing
organisms into the lumen. I am not aware of any studies that have
assessed which is the least risk - injecting through a cap or removing
the cap and injecting hub-to-hub. Removing the cap would add the
chance for air to enter the line.
The standards for CT techs are available at www.asrt.org and they
are responsible for assessing line patency and injecting contrast
agents. So I would think injecting saline and heparin to flush would
be within their scope also. If not, I can see loads of lumen
occlusions if this has to be done by the primary case nurse after the
patient returns to the unit. Many rad depts have nurses that may do
these flushing procedures instead of the techs. Lynn
At 11:30 AM -0700 5/15/06, Marilyn Patterson wrote:
More questions along the same line:
The manufacturer's (Bard) recommendation for using a power injector with Power PICCs includes instructions to remove the injection cap prior to use. I know the CT techs infuse through the injection caps on peripheral IVs, why the difference?
Does anyone have experience with CT techs doing this? Doesn't that open yet another door for introducing infections?
Do the CT techs heparinized them after use, or do the floor nurses do this?
As always, thanks in advance for sharing all your expertise and experience.
Marilyn Patterson
Olympic Medical Center
Port Angeles, WA
[EMAIL PROTECTED]
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Monday, May 15, 2006 7:31 AM
To: Janousek, Patricia; [EMAIL PROTECTED]
Subject: Re: "breaking the system"
The literature on catheter-related bloodstream infection is filled with information about hub manipulation being a major source of the organisms that lead to infection. Opening the system and anything done to the catheter hub should be kept to a minimum by:
1. extending the tubing from 72 to 96 hours - both CDC and INS state "no more frequently than 72 hours"
2. changing fluid container and tubing at the same time
3. limiting the number of times the line is opened for any reason. I would not consider opening the line for the patient to shower to be a valid reason. Neither is it acceptable to disconnect the tubing to change gowns. The fluid container and all tubing should be run through the sleeve just like the arm.
Lynn
At 12:07 PM -0500 5/12/06, Janousek, Patricia wrote:
Hi, Does anyone know of any supporting literature for NOT disconnecting IV fluids from an IV site for the "convenience" of the patient so that they can shower, and/or go to Xray? We recently had a BSI related to a PIV on a long-term patient (high-risk OB), that Epidemiology was able to track it back to the management of the line being broken many times for the patient to shower without being connected to the IV fluids. We would like to change the practice. Thanks, Patty
Patty Janousek, BSN, CRNI
Team Leader, IV Team
Methodist Hospital
8303 Dodge Street
Omaha, NE 68114
(402)354-8760
FAX: (402)354-5266
PAGER: (402)577-9527
EMAIL: [EMAIL PROTECTED]
This message and any included attachments are from Nebraska Methodist Health System and its affiliates and are intended only for the addressee. The message may contain privileged, confidential and/or proprietary information intended only for the person(s) named. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Nebraska Methodist Health System and its affiliates in Omaha, Nebraska, U.S.A at (402)354-2280.
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
