Bloodstream infections, unfortunately, are becoming a problem in the healthcare system. These infections are causing patients to stay in the hospital longer and are costing hospitals billions of dollars each year in unnecessary healthcare costs. In order to prevent bloodstream infections in patients with central lines, PICC, and peripheral IV lines, nurses takes many steps to prevent this from happening.
Many hospitals have protocols that nurses implement daily while caring for patients with peripheral IV, PICC, and central lines. Sometimes these protocols are not followed correctly due to nurses not taking the time to follow them and these lines become contaminated. However, now available to help nurses save time and prevent bloodstream infections is a product called Curos Port Protector.
What is a Central Line?
A central line is a catheter that medical doctors insert into a large vein, such as the subclavian, internal jugular, or femoral vein, to deliver medication and fluids. In addition, the central line can be used to collect blood specimens so the patient avoids being stuck with a needle for lab draws. Central lines are most commonly used in the Intensive Care Unit (ICU). In the medical setting, nurses may call central lines IJs, Subclavian line, Femoral line. Central lines are usually left in place for weeks or months so nurses must provide meticulous care to these lines to prevent infections known as CLABSIs. Note the picture below is a picture of a woman with a left IJ (internal jugular) central line.
What does CLABSI mean?
CLABSI is an acronym for Central Line Associated Bloodstream Infection. CLABSIs are serious infections that invade the bloodstream through central lines. This can be from not following the aseptic process when placing the central line, failure to follow central line maintenance protocols correctly, contamination from the patient or family members due to touching the central lines, or not protecting the central line from getting wet while bathing. According to the CDC, of patients who get bloodstream infections from having a central line up to 1 in 4 die.
What is a PICC Line?
A peripherally inserted central catheter or PICC line is a soft plastic tube that is inserted into a large vein right above the patient’s heart. A PICC line is different from a central line in that it is inserted in a peripheral vein. Many commonly used peripheral veins are the cephalic, basilic, or brachial vein. PICC lines can be used to deliver medications, fluids, and to collect blood specimens. As with central lines meticulous care should be used when inserting and maintaining the line. Consequently, if the proper is not provided a patient care develop a bloodstream infection. Note the picture of what a PICC line catheter looks like.
What is a Peripheral IV Line?
A Peripheral Intravenous (IV) line is most commonly used in the hospital setting. A patient with a peripheral IV is less likely to develop a bloodstream infection compared to a patient with a central or PICC line. A peripheral IV is a short catheter that is inserted by a nurse in a peripheral vein that is usually located on the arm or hand. Peripheral intravenous lines are routinely changed every 4 days (depending on the hospital’s protocol) while the patient is in the hospital. Nurses must provide meticulous care when inserting and maintaining peripheral IVs. If proper care is not follow the patient can develop phlebitis, sepsis, and cellulitis. Note this picture a peripheral IV line in a person’s left hand.
Steps Nurses Take to Prevent Infection in Patients with Central, PICC, and Peripheral IV lines
Nurses are required to follow strict protocols when providing care to patients with any type of line that is inserted into the body. Here are steps nurses follow to prevent infections in patients with central and PICC lines:
- Proper hand hygiene is implemented before touching or using the line.
- Dressings are changed every 7 days and as needed when becoming soiled or wet.
- Caps are changed daily.
- Caps are changed after blood draws and the line is flushed with Normal Saline.
- Each lumen is flushed daily with Normal Saline.
- *Before accessing a lumen or cap on the IV line the nurses “scrubs the hub” for at least 15 seconds with alcohol prep or turned the site scrub 8-10 times before assessing. This prevents any bacteria that is on the hub from entering the blood stream. *Note this a step most neglected by nurses.
- Educate the patient and family members to not touch or get the site wet.
Step Nurses Use for Peripheral IV Maintenance
- Proper hand hygiene is implemented before touching or using the IV.
- IV site is changed out every 4 days (as specified by hospital protocol)
- IV site is routinely flushed daily with normal saline.
- *Before assessing any caps on the IV site or IV line to given medications or flushes the nurse scrubs the cap for at least 15 seconds with alcohol prep. *Note this step is the most neglected by nurses.
- Educate the patient and family members to not touch or get the IV site wet.
Most Common Error Performed by Nurses While Maintaining Intravenous Lines
The most common error that nurses fail to perform while maintaining central lines is to clean the access port for the required amount of time to kill bacteria that is on the access cap. This may be due to because the nurse:
- Does not know how long to clean the site with alcohol prep or site scrub.
- Simply fails to do it because they choose not too or thinks it does not matter.
- Feels that 15 seconds is too long to clean the access port when using alcohol prep and does not know the process of how alcohol kills bacteria.
Cleaning the access port prior to giving a patient a medication or flush is vital in preventing bloodstream infections. Studies have shown that in order for the alcohol to kill the bacteria harboring the access port the site must be exposed to alcohol for at least 15 seconds. If the nurses fails to clean the site for 15 seconds they are increasing the chances of the patient developing a bloodstream infection each time they access the port to give medications or flushes.
Curos Port Protector
A new product is available for nurses to use called Curos Port Protector. Many hospitals who are using this product are finding that Curos Port Protector is decreasing bloodstream infections by huge percentages when used properly.
According to IVERA Medical Corporation (manufacture, maker, and seller of the Curos Port Protector), a study conducted by West Virginia University Health System found the following when using the Curos Port Protector on all of its patient with central lines on a 12 bed Blood and Marrow Transplant unit and 20 bed Oncology Units:
A recent study conducted by a 376-bed academic medical center found Curos more effective than hub swabbing procedures in reducing CLABSI and contaminated blood cultures drawn via central venous catheters, in part, because nurse compliance with Curos is high (greater than 85 percent on average). Researchers saw an 86.2 percent reduction in CLABSI and a 92 percent fall in contaminated blood cultures equating to an estimated annualized cost avoidance of $500,000 (Source: West Virginia University Health System, IVERA Medical Corporation).
How Nurses Use Curos Port Protector
The Curos Port Protector is a green cap that is screwed onto a needless device’s access port found on peripheral IV lines, IV tubing, central lines, Foley catheters, and PICC lines. When this product is screwed onto the access port of a needle less device, the internal pad found inside the green cap that contains 70% Isoporpyl Alcohol that disinfects the port within 5 minutes. It is left on the access port until the port is needed. This in turn protects the access port from germs that could harbor the port from touch or air-borne contaminants.
When the nurse needs to use the access port they simply unscrew the green cap and access the port with a needle less device. If nurses use the Curos Port Protector properly it is not necessary to swab the port for disinfection after removing the port protector. After the nurse is done using the access port they simply screw on a new Curos Port Protector. The Curos Port Protector is good for up to 7 days or when the IV tubing or caps are changed.
This product will save the nurse time, ensure patient safety, and increase disinfection compliance among nursing staff. This new product is simple to use and saves time & money for both the patient and hospital.
This product is getting great reviews from nurses who are using this product. A registered nurse from a level one trauma medical center in Tennessee loves this new product and has this to say about it:
When the rep came around educating us about the product I was immediately impressed. I quickly started implementing it into my practice. I work on a floor where we have a lot of PICC and IV lines and I have found that this product saves times. I love the packaging because our unit carries the Curos Port Protectors that come on a strip. The strip can be attached to an IV pole which makes it easy for application. Also, I love the green color because it is very visible to the eye and makes it easy to spot.-Sarah R. BSN,RN
Bloodstream infections are serious but can be prevented. This product is a great way to help prevent infections that can cause unnecessary hospital stays for your patient.