CNA345 Transfer of Care Case Study

Running head: CASE STUDY OF JOSEPH
Case study of joseph
Name of the student:
Name of the university
Author note:

1CASE STUDY OF JOSEPH
Introduction:
CVAD (central venous access device) is a device that installed for into the body of
patients who require severe fluid intake (Martin et al. 2017). CVAD is inserted in the patient
who required the large amount of the intravenous fluid such as blood product or reduction,
administration of the hyperosmolar drugs such as Noradrenaline, long-term access for prolonged
applications and monitoring central venous patients of the patients (Sasaki et al. 2016). However,
the insertion of CVAD may result in the infection. The infection is called central line-associated
bloodstream infection where CVAD is a potential source of microorganism, which causes
bloodstream infection (Joseph et al. 2016). The case study represents health issues of Joseph who
was admitted o the hospital due to the state of unresponsiveness. Since Joseph was not
conscious, a three-lumen central venous catheter into Joseph’s right subclavian vein using
surgical aseptic technique and Inotropes in the form of IV noradrenaline was administrated.
However, after monitoring it was observed that CVAD was the source of infection that caused
bloodstream infection. Later occlusions occurred due to the infection which affected his health.
This paper will illustrate the action plan for the management and prevention of CVAD associated
bloodstream infection and occlusion.
CVAD bloodstream infection and prevention:
In clinical practice, the central venous access device is a life-saving therapy for treating
many patients. However, in the majority of cases it becomes a source of bloodstream infection
due to aseptic insertion of the CVAD in patient’s body. An intravenous catheter is integral part

2CASE STUDY OF JOSEPH
of modern practice, which is inserted in the critically ill patients for administrating fluids
(Mardegan et al. 2016). However, due to aspect handling of the intervenes cathedral and
negligence in following proper protocol for intensive care patient, it becomes a potential source
of the nosocomial infection bacteraemia and septicaemia (Gavin et al. 2018). Buckley et al.
(2018), suggested that the risk of developing CVAD bloodstream infection with CVAD is 64 the
time huge than peripheral cathedral insertion. Gavin et al. (2018), stated that approximately 12%
to 25 %the death rate because of nosocomial infection is associated with the CVAD bloodstream
infection which also increases the ICU staying of the patients. The associated risk factors of the
infection are including presence of multi-luminal catheter, catheter-related thrombosis,
anatomical site of insertion and hospital lasting before insertion. a randomized trail control
suggested that the main pathogen for giving rise to the CVAD bloodstream infection are
Staphylococcus aureus, Enterococcus sp, Candida sp., Klebsiella pneumonia. S. aureus is
coagulase negative gram-negative microorganisms that colonize at the catheter tip. When it
inserted in the patients for fluid, transmitted to the bloodstream and causes infection. The
catheters are mainly contaminated by the hands of the health professionals with the intraluminal
dissemination up to the catheter tip (Kovacevich et al, 2018). However, these microbes also
present in the cutaneous layers, nasal mucous and insertion may provide the opportunity to
access the bloodstream (Colvine, Thomson and Duerksen 2017). As observed in this case study,
Joseph was suffering from the CVAD blood infection due to CVAD insertion due to his health
issues when he arrived at the hospital. Diagnosis test confirmed the infection and further, it gives
rise to the occlusion. Majority of these microbes shows the resistance towards braid spectrum
antibiotics and require narrow-spectrum antibiotics.
The prevention method: