Healthcare Assignment: Case Study Analysis
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Added on 2020-05-28
Healthcare Assignment: Case Study Analysis
Added on 2020-05-28
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Running head: CASE STUDY ANALYSISCASE STUDY ANALYSISName of the StudentName of the universityAuthor’s note
1CASE STUDY ANALYSISCASE STUDYCentral venous access can be linked with adverse events that can be hazardous to thepatient, and can also increase the rate of hospital readmissions (Ullman et al. 2015). Infection isthe main complication in most of the intravascular catheters in critically ill patients. Bloodstream infections due to catheters are found in 3 to 8 % of the inserted catheters and have beenone of the main causes of the nosocomial blood steam infections in the intensive care unit(Gillanders et al. 2014). This essay focuses on the central line associated blood stream infection,the strategies to prevent the blood stream infection, probable strategies to manage occlusion, andthe ways to maintain skin integrity in patients with CVAD.Central line associated blood stream infection (CLABSI) is a blood stream infection thatis laboratory confirmed blood stream infection that indirectly indicates the quality of care (Sweetet al. 2012). As seen from the case study, Jim Kares had been a central line for a period of 48hours. Infection might have occurred while inserting the three lumen central venous catheter into the right subclavian vein of Jim (Ogston-Tuck 2012). It is evident from the case study that thetechnique involved aseptic on touch technique, hence the infection would not have occurred,Further more infection could have spread by the insertion of a new CVC in to the left internaljugular vein. As stated by (Chopra et al. 2012), which belongs to the level of evidence II, Centrallines can get contaminated leading to infection by the following ways- Contamination of thecatheter may occur before the insertion. Pathogenic skin organisms might migrate from the siteof insertion to the cutanous catheter tract, leading to the colonization of the microbes at the tip of
2CASE STUDY ANALYSISthe catheter. Hence in case of Jim Karas the pathogens might have contaminated the catheter tipor might have inoculated the site of insertion in the above mentioned ways. Catheter can be contaminated by direct contact with hands or contaminated devices.Catheters can become contaminated with other sources of infection through the bloodstream.Another contamination can occur through IV fluid contamination (Ralls et al. 2012). CVADinsertion site should be checked every shift for any early signs of infection, hence in case of Jimit was necessary to check his site of insertion of the CVC every now and then. If any tendernessfound at the site of infection suggesting blood stream or local infection the dressing has to beremoved for the thorough examination of the site (Chopra et al. 2012). Aseptic techniques haveto be maintained while managing the CVAD. In order to reduce the risk of contamination, sterilegloves and aseptic fields are required. According to Ogston-Tuck (2012) CVAD infection can beprevented by following the five moments of hand hygiene. The different moments of the handand hygiene are relevant as the paper belonged to number one evidence. Clinicians should beable to evaluate the risk of exposure of the body fluid while caring for the patient having aCVAD (Ge et al. 2012). One has to wear sterile gloves for the insertion of the peripheralintravascular catheters. It is advisable not to touch the access site after the application of the skinantiseptics (Ogston-Tuck 2012). It is important to wear sterile and clean gloves for the insertionof central catheter as in case of Jim. This can be prevented by the use of gloves, face shields andaprons. It is evident from the case study that there had been some mistake from the clinician'sside which led to a blood stream infection. This indicates the inferior quality of care that hereceived in this respect. According to Ge et al. (2012), hand and hygiene should have beenmaintained before touching of the patient; just before the procedure, after touching the patient'ssurroundings, after the procedure, after touching the patient and after touching the patient's
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