some terminology:
DESCRIPTION
Some terminology:. Hub (IV catheter) Maintenance (or primary) solution TKO (KVO) rate Parenteral Mechanical gravity devices EID: electronic infusion device NAD: needleless access device NAP: needleless access port. Complications - systemic. Septicemia (CRSI) - PowerPoint PPT PresentationTRANSCRIPT
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Hub (IV catheter) Maintenance (or
primary) solution TKO (KVO) rate Parenteral Mechanical gravity
devices EID: electronic
infusion device NAD: needleless
access device NAP: needleless
access port1
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Septicemia (CRSI) Fluid overload & pulmonary edema Catheter embolism Air embolism Speed shock
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Phlebitis ◦Mechanical or Chemical
Infiltration/ Extravasation Local infection Hematoma/ecchymosis Thrombophlebitis Thrombosis (catheter) Venous spasm
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Discontinue infusion at the first sign of phlebitis
Notify physician Apply warm or cold compresses to
affected site Notify infection control if part of
agency policy
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Infiltration Extravasation Inadvertent
administration of a nonvesicant solution into surrounding tissues.
The inadvertent administration of a visicant solution into surrounding tissue.
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IOM report CDC & INS standards
◦“follow your hospital policy” – Changing IV admin sets IV dressings
◦How does this contribute to patient safety?
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Change IV administration sets Dressing changes Changing NAP Cleanse access port with new alcohol swab
for 15 seconds.
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Easily converts to/from intermittent 3 types Capped, resealable diaphragm
◦ Blunt cannula split septum◦ Luer access – neg. displacement ◦ Luer access – pos. displacement
Negative pressure or positive pressure? ◦ Flushing technique is different!!!
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Does it have a small extension tubing?◦ Yes: only need alcohol swabs & NS◦ No: prime extension tubing; get new dressing
Gauze pads Chux pad Hemostats Normal Saline
◦ Bacteriostatic 0.9% vs Preservative-free
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TSM = transparent semipermeable membrane◦ Tegaderm is one brand out of many◦ Change ________
Gauze dressing Procedure:
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When:◦ Leaking, infiltration, pain, phlebitis, Dr. order
Supplies: gloves, 2x2 gauze, bandaid How: Phillips, Procedure 6-4 Greatest risk: catheter embolism
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Power switch “enter” Numbers keyboard
◦ Set rate (in ml/hr)◦ Set volume to be infused (VTBI)
Check volume infused hold/run button
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Run/hold indicator display screen alarms door to put in tubing Safety mechanism when door shut Visual -battery, or electrical power. Alarm Cause
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Upstream occlusion Downstream: Air Infusion complete Door/cassette open Low battery Error code _____
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INS standard:“…shall be legible, accessible to qualified
personnel, and readily retrievable. The protocol for documentation should be established in organizational policies and procedures.”
“Shall reflect continuity, quality & safety of care”
INS standards, 2011
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Patient/family participation Site condition & appearance
◦ Does facility have standardized assessment scales?
◦ Dressing, type of stabilization, pain Type of therapy: drug, dose, rate Daily assessment of need for VAD
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Multiple sites or lumens: what is infusing where
Discontinuation of therapy patient tolerance
◦ “tolerated well”: NO, NO, NO NO◦ What are assessments that you made to come to
that conclusion? (C. Madsen)
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