S = SCRUPULOUS HAND HYGIENE

1. Julie M. Weldon, Joan Bishop, Paul Blackburn, Lauren Blough, Mike Brazunas, Lois Davis, Mary Deschneau, Ann Marie Parry, Carol Olson, Andrea Owens, Evelyn Perez-Rojas, Deborah Phelan, Timothy Royer, and Penny Williams. (representing the AVA Education Committee) jweldon@mercydesmoines.org PURPOSE: This initiative revised a successful infusion nursing education tool to promote individual accountability, critical thinking, and evidence-based care to reduce catheter related blood stream infections and other complications. • I= Implement Insertion, Care and Maintenance Bundles • I am accountable for the care of my patient’s line! • Insertion Bundle • Hand Hygiene • Maximum Barrier Precautions • Site Selection • Daily Review of Line Necessity • Maintenance Bundle • Implement “SAVE” principles • Change tubing, add-ons, dressings and needleless connectors. • Site care with skin antisepsis, dressing changes, securement device, and Chlorhexidine. • S = SCRUPULOUS HAND HYGIENE • Practice good hand hygiene before and after contact with any vascular access device. • Use antimicrobial soap and water or alcohol based hand scrub. Rub vigorously for at least 15 seconds. • Failure to perform appropriate hand hygiene is considered the leading cause of hospital acquired infections (HAIs). • A = ALWAYS DISINFECT EVERY NEEDLELESS CONNECTOR • Disinfect the needleless connector, catheter hub or Y-site before accessing using friction with an appropriate disinfectant, such as 70% alcohol. • Active disinfection includes scrubbing for at least 15 seconds. • Passive disinfection includes using an alcohol soaked cap. • Allow the alcohol to dry prior to connection to promote the best bacterial kill. • V= VEIN PRESERVATION • Choose the best site and the best vascular access device to complete the needed therapy and reduce the risk of infusion complications: • Duration of therapy • Vessel and catheter size • Fewest number of lumens • pH, osmolality, and chemical properties of the infusate, • Individual needs of the patient. • Patient Education • E = ENSURE PATENCY • Check for brisk blood return for each lumen, prior to flushing following institutional protocol. • Brisk blood return is considered 3 mL return in 3 seconds. • If sluggish or lack of blood return, troubleshoot per institutional protocol. • If inability to flush, troubleshoot per institutional protocol. * REFERENCES AVAILABLE UPON REQUEST http://www.avainfo.org/website/article.asp?id=40777