CVME Insider: Nursing Knowledge That Matters

The CDC 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections CDC Recommendations In patients not receiving blood, blood products or fat emulsions, replace administration sets that are continuously used, including secondary sets and add-on devices, no more frequently than at 96-hour intervals, [ 177 ] but at least every 7 days [ 178–181 ]. Category IA No recommendation can be made regarding the frequency for replacing intermittently used administration sets. Unresolved issue No recommendation can be made regarding the frequency for replacing needles to access implantable ports. Unresolved issue Replace tubing used to administer blood, blood products, or fat emulsions (those combined with amino acids and glucose in a 3-in-1 admixture or infused separately) within 24 hours of initiating the infusion [ 182–185 ]. Category IB Replace tubing used to administer propofol infusions every 6 or 12 hours, when the vial is changed, per the manufacturer’s r...

Retraction Notice--It was brought to our attention that this article had been published with an error and as such we have retracted the original article and replaced it with this article that has the current and up to date information.  If you would like a copy of the previous article with the errors to compare, please contact us at info@central-valley-med.com Infusion Therapy is an awesome wonder when it comes to saving a patient’s life.  Is it really necessary to give a patient a Colloid versus a Crystalloid? Trauma burns or surgery can cause people to lose large amounts of blood. Fluid replacement, giving fluids intravenously (into a vein) to replace lost blood, is used to try to maintain blood pressure and reduce the risk of dying. Blood products, non-blood products or combinations are used, including colloid or crystalloid solutions. Colloids are increasingly used but they are more expensive than crystalloids and there are many scientific studies that show no e...

  Needleless devices are used for connecting to IV catheters , administration sets, and/or syringes.   They were introduced in the 1990s for the purpose of reducing the risk of needlestick injuries among health care providers.    However, in 2000 the Needlestick Safety and Prevention Act mandated that all employers provider these devices as they have shown to reduce needlestick injuries significantly.   On the other hand; their use has been associated with an increase in complications such as catheter-related bloodstream infection (CRBSI) and catheter lumen occlusion. The reason for these complications are not totally understand and efforts to study their design, user knowledge, poor clinical practices have gotten underway to help reduce or eliminate these complications. The Food and Drug Administration is requiring nine companies to conduct a post market study on positive displacement needleless conne...

3.8 million central venous catheters (CVCs).... 2 million peripherally inserted central catheters (PICCs)..... and 310 million peripheral intravenous devices sold yearly in the US......   "Based on average salary and benefits for an RN, the average time of 36 minutes for a nurse to trouble shoot and restart a PIV translates to a labor cost of an estimated $22.79 per incident ( Rosenthal, 2005 )."   Vascular access and Infusion Therapy  is clearly a high priority and nurses take a lot of time performing these procedures for our patients. Getting the right vascular access device placed early in the hospital stay can speed treatment and patient discharge while minimizing cost as well as restarts.   Maintaining the health of our patients veins and arteries has become an important issue as patients now come to hospitals more acutely ill, living longer, often having chronic conditions. According to the Centers for Disease Control (CDC) selection of the...

  A Huber Needle is a specially designed hollow needle used with implanted ports. A Huber needle has a long, beveled tip that is inserted through the patients skin as well until it accesses the silicone septum the implanted port's reservoir. The beveled tip of a Huber needle will not remove a core of silicone from implanted port as this is the way it is designed.   This design will allow as much as 2000 needle sticks into the implanted port’s reservoir without having to be changed. Dr. Ralph L. Huber , a dentist, designed the sharp, beveled, directional needle tip and Dr. Edward B. Tuohy, an anesthesiologist, refined it for use in spinal catheters. Huber needles are used to access ports implanted under the skin of patients who may be suffering from a chronic illness, such as cancer, pancreatitis, or has the need for repeated access to veins for blood withdrawal.   These patients often need the implanted port for infusion of medication , nutritional solutions, blo...

  Protect Against It Yahoo news report “The Law Offices of Kenneth A. Wilhelm uses expert testimony to prove medical negligence in the case of a day-old infant who suffered permanent injuries as a result of improper IV administration. The Law Offices of Kenneth A. Wilhelm, a New York personal injury law firm, has successfully obtained an $800,000 verdict on behalf of their client, a day-old infant, who suffered permanent scarring and injury Extravasation malpractice case: Law firm secures $800,000 verdict. The child was admitted to the Montefiore Medical Center in the Bronx on Jan. 13, 2006, a day after he was born. The law firm filed a complaint in the Supreme Court of the State of New York, Bronx County (Index # 8785/2007) against the hospital alleging that the child, who was scheduled to undergo spina bifida surgery the following day, was not properly monitored by nurses at the hospital while he was receiving intravenous fluid in preparation for the sur...