Paper Example on CVC-related Infection

PATHOPHYSIOLOGY OF CVC RELATED INFECTION

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In the first question, the respondents were asked to state the most common route for contamination. Only15 (68.2%) out of 22 doctors and 11 (21.6%) out of 51 nurses answered that the most common route for contamination is colonization of catheter tip and migration of skin organisms at CVC insertion site. The percentages for the incorrect answer were 31.8% (n=7) for the doctors and 76.5% (n=39) for the nurses. 1 (1.4%) nurse said that he/she did not know the answer. In total, 26 (35.6%) out of the total participants (n=73) got the correct answer. The percentage of the participants who got the incorrect answer was 63.0% (n=46). The percentage of the total participants whose answer was not known is 1.4% (n=1).

For the second question, the accumulation of organisms on the catheter tip can be defined as catheter colonization. Only17 (73.3%) out of 22 doctors and 30 (58.8%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 13.6% (n=3) for the doctors and 37.3% (n=19) for the nurses. 2 (9.1%) doctors and 2 (3.9) nurses said that they did not know the answer. In total, 47 (64.4%) out of the total participants (n=73) got the correct answer. The percentage of the participants who got the incorrect answer was 30.1% (n=22). The percentage of the total participants whose answer was not known is 5.5%.

DIAGNOSIS OF CV INFECTION

The correct answer for the third question is that high blood pressure is not a criteria used for the diagnosis of CVC related infection. 21 (95.5%) out of 22 doctors and 42 (82.4%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 4.5% (n=1) for the doctors and 13.7% (n=7) for the nurses. 2 (3.9%) nurses said that they did not know the answer. In total, 63 (86.3%) out of the total participants (n=73) got the correct answer. The percentage of the participants who got the incorrect answer was 11.0% (n=8). The percentage of the total participants whose answer was not known is 2.7% (n=2).

The correct answer for the fourth question is that a definitive diagnosis of central venous catheter related infection requires blood culture taken from peripherally and all lumen of CVC. Only 17 (77.3%) out of 22 doctors and 29 (56.9%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 22.7% (n=5) for the doctors and 39.2% (n=20) for the nurses. 2 (3.9%) nurses said that they did not know the answer. In total, 46 (63.0%) out of the total participants (n=73) got the correct answer. The percentage of the participants who got the incorrect answer was 34.2% (n=25). The percentage of the total participants whose answer was not known is 2.7% (n=2).

CATHETER INSERTION

The answer for question 5 is that the tip of the CVCs lies in the lower one third of the superior vena cava. Only 15 (68.2%) out of 22 doctors and 30 (58.8%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 22.3% (n=6) for the doctors and 31.4% (n=16) for the nurses. 1 (4.5%) doctor and 5 (9.8) nurses said that they did not know the answer. In total, 45 (61.6%) out of the total participants (n=73) got the correct answer. The percentage of the participants who got the incorrect answer was 30.1% (n=22). The percentage of the total participants whose answer was not known is 8.2% (n=6).

The correct answer for question 6 is that the PICC tip position must be confirmed by CXR unless a specialist nurse using ECG placement method inserts it. None (0.0%) out of 22 doctors and 4(7.8%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 90.9% (n=20) for the doctors and 86.3% (n=44) for the nurses. 2 (9.1%) doctor and 3 (5.9%) nurses said that they did not know the answer. In total, 4 (5.5%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 87.7% (n=64). The percentage of the total participants whose answer was not known is 6.8% (n=5).

The correct answer for question 7 is the Huber needle can remain in an implanted port for 7 days. None (0.0%) out of 22 doctors and 44(86.3%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 50.0% (n=11) for the doctors and 3.9% (n=2) for the nurses. 11 (50.0%) doctor and 5 (9.8%) nurses said that they did not know the answer. In total, 44(60.3%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 17.8% (n=13). The percentage of the total participants whose answer was not known is 21.7% (n=16).

The correct answer for question 8 is that it is recommended to use 2% chlorhexidine gluconate in 70% isopropyl alcohol to decontaminate the skin at the insertion site and allow drying before inserting a vascular. Only 13 (59.1%) out of 22 doctors and 38(74.5%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 22.7% (n=5) for the doctors and 13.7% (n=7) for the nurses. 4 (18.2%) doctors and 6 (11.8%) nurses said that they did not know the answer. In total, 51(69.9%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 16.4% (n=12). The percentage of the total participants whose answer was not known is 13.7% (n=10).

The correct answer for question 9 is that the aseptic technique should be used for insertion and maintenance of invasive devices, infusion of sterile fluids and medication and care of wounds and surgical incisions. 20(90.9%) out of 22 doctors and 48(94.1%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 22.7% (n=5) for the doctors and 3.9% (n=2) for the nurses. 1 (4.5%) doctor and 1 (2.0%) nurses said that they did not know the answer. In total, 68(93.2%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 4.1% (n=3). The percentage of the total participants whose answer was not known is 2.7% (n=2).

FREQUENCY OF CVC CHANGES

The correct answer for question 10 is that it is recommended to replace CVCs on when indicated. 12 (54.5%) out of 22 doctors and 42 (80.4%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 18. % (n=5) for the doctors and 21.6% (n=11) for the nurses. 5 (22.7%) doctors and 10 (19.6%) nurses said that they did not know the answer. In total, 42(57.5%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 21.9% (n=16). The percentage of the total participants whose answer was not known is 20.5% (n=15).

CVC DRESSING

For question 11, it is recommended to cover the CVC insertion site with a dressing that is characterized by transparent and semi-permeable. 12 (54.5%) out of 22 doctors and 30 (58.8%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 18.2% (n=4) for the doctors and 17.6% (n=9) for the nurses. 6 (27.3%) doctors and 1 (2.0%) nurses said that they did not know the answer. In total, 53(72.6%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 17.8% (n=13). The percentage of the total participants whose answer was not known is 9.6% (n=7).

For the case of question 12, the preferred dressing to use if the CVC insertion site is bleeding or oozing is sterile gauze and change to transparent, semi-permeable as soon as possible. 9 (40.9%) out of 22 doctors and 36 (70.6%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 9.1% (n=2) for the doctors and 17.6% (n=9) for the nurses. 11 (50.7%) doctors and 6 (11.8%) nurses said that they did not know the answer. In total, 45 (61.6%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 15.1% (n=11). The percentage of the total participants whose answer was not known is 23.7% (n=17).

FREQUENCY OF DRESSING CHANGES

For question 13, replacing dressings of the CVCs should be at least for every 7 days. Only 6 (27.3%) out of 22 doctors and 37 (72.5%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 54.5% (n=10) for the doctors and 15.7% (n=8) for the nurses. 6 (27.3%) doctors and 6 (11.8%) nurses said that they did not know the answer. In total, 43 (58.9%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 24.7% (n=18). The percentage of the total participants whose answer was not known is 16.4% (n=12).

After decontaminating the needle-free CVC connector, healthcare workers should wait 30 seconds for it to dry to ensure the decontamination process is complete. 14 (63.6%) out of 22 doctors and 42 (82.4%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 22.7% (n=5) for the doctors and 13.7% (n=7) for the nurses. 3 (13.6%) doctors and 2 (3.9%) nurses said that they did not know the answer. In total, 56 (76.7%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 16.4% (n=12). The percentage of the total participants whose answer was not known is 6.8% (n=5).

USE OF ANTIBIOTIC/ANTISEPTIC OINTMENTS

It is not recommended to administer routine systemic antimicrobials before or during CVC insertion to minimize the development of antimicrobial resistance. Only 6 (27.3%) out of 22 doctors and 17 (33.3%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 59.1% (n=13) for the doctors and 49.0% (n=25) for the nurses. 3 (13.6%) doctors and 9 (17.6%) nurses said that they did not know the answer. In total, 23 (31.5%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 52.1% (n=38). The percentage of the total participants whose answer was not known is 16.4% (n=12).

CVC CARE

Replacing CVC routinely is not an important factor in reducing CVC-related infection. 12 (54.5%) out of 22 doctors and 33 (64.7%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 27.3% (n=6) for the doctors and 25.5% (n=13) for the nurses. 4 (18.2%) doctors and 5 (9.8%) nurses said that they did not know the answer. In total, 45 (61.6%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 26.0% (n=19). The percentage of the total participants whose answer was not known is 12.3% (n=9).

It is recommended to use a CVC coated or impregnated with antiseptic agent, if it is expected to remain in place for more than five days. Only 2 (9.1%) out of 22 doctors and 11 (21.6%) out of 51 nurses got the correct answer. The percentages for the incorrect answer were 36.4% (n=8) for the doctors and 31.4% (n=16) for the nurses. 12 (54.5%) doctors and 24 (47.1%) nurses said that they did not know the answer. In total, 13 (17.8%) out of the total participants (n=73) got the correct answer. The percentage of the total participants who got the incorrect answer was 32.9% (n=19). The percentage of the total participants whose answer was not known is 49.3% (n=36).

When lipid containing parental nutrition is administered through a CVC, the administration set need replacing every 24 hours. Only 2 (9.1%) out of 22 doctors and 43 (84.3%) out of 51 nurses got the correct answer. The percentages for th...