Safer Healthcare Now Prevention of Central Line Infections The LHSC experience Feb.5, 2008 Deb McAuslan
CLI Prevention Teams at LHSC Oncology and Interventional Radiology Team CCTC Team ICU Team
Prevention of Central Line Infections Insertion Hand hygiene Maximal barrier Chlorhexidine 2%/70% alcohol Optimal placement Maintenance Daily review Dedicated TPN line Chlorhexidine prep Check for inflammation with drsg changes
Equipment o Dressing tray or sterile towel o Sterile gloves- 1 pair o Non sterile gloves- 1 pair o 2% Chlorhexidine/ 70% alcohol swabs- 2 or more o Steri strips- 2 pkgs o Sterile transparent dressing o Primed Injection port caps o Hand sanitizer o Wash HandsY N o Position Patient appropriately to allow good visualization and access Y N o Using non-sterile gloves remove dressing with care, observe site for catheter migration. Discard dressing and gloves Y N o Assess insertion site for inflammation, redness & exudates Y N o Assess integrity of skin beneath dressingY N o Wash/ Sanitize handsY N o Cleanse site with swabs in back/forth, up/down scrubbing motion with friction Y N o Allow site to dry for at least one minuteY N o With sterile gloves apply steri stripsY N o Apply sterile transparent dressing to cover site, leaving the connection hub(s) Y N o Change capsY N o Connect tubing or lock as indicatedY N o Document procedure and observations on appropriate record Y N Essential Steps PICC Line Dressing Procedure-RN to RN Check List
Oncology/Radiology CLI Infections
CCTC Central line infections
UH ICU CLI
What helped? LHSC Senior leadership stated their support Communication to leadership Resource support
What helped… SHN Trailblazer support Toolkit, fact sheet, bibliography Communities of practice Audit tools
Key Learning's Engagement - Compelling reason Champions - Passion Engage your resources Encouragement Don’t give up – keep momentum