Transcript Some terminology:

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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 port
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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
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Inadvertent
administration of a
nonvesicant solution
into surrounding
tissues.
Extravasation
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The inadvertent
administration of a
visicant solution into
surrounding tissue.
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IOM report
CDC & INS standards
◦ “follow your hospital policy”
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 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
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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
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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 ________
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Gauze dressing
Procedure:
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When:
◦ Leaking, infiltration, pain, phlebitis, Dr. order
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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)
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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
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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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