A nurse is caring for a client receiving IV therapy. Which action is essential to prevent catheter-related bloodstream infections (CRBSIs)?
A.
Administering IV fluids through the largest available catheter.
B.
Changing the IV catheter dressing daily.
C.
Using sterile technique during IV insertion and care.
D.
Frequently accessing the IV catheter for blood draws.
The Correct answer and Explanation is:
The correct answer is C. Using sterile technique during IV insertion and care.
Explanation:
Catheter-related bloodstream infections (CRBSIs) are serious complications associated with intravenous (IV) therapy. They occur when bacteria or other pathogens enter the bloodstream through the IV catheter. These infections can lead to sepsis, prolonged hospital stays, increased healthcare costs, and in severe cases, can be life-threatening.
Sterile technique during IV insertion and care is essential to prevent CRBSIs. This involves several critical steps:
- Hand Hygiene: The nurse must perform thorough hand hygiene before and after any contact with the IV catheter. This reduces the risk of transferring microorganisms from the nurse’s hands to the catheter or insertion site.
- Sterile Gloves and Equipment: Sterile gloves, a mask, and sterile equipment must be used during the insertion of the IV catheter. The catheter and related equipment should be maintained in a sterile environment until the insertion is complete.
- Skin Antisepsis: Proper skin antisepsis using an appropriate antiseptic solution, such as chlorhexidine, at the insertion site is crucial. The antiseptic must be allowed to dry completely before catheter insertion to maximize its effectiveness.
- Dressing Maintenance: The IV site should be covered with a sterile, transparent dressing that allows for inspection of the site while protecting it from contamination. While regular dressing changes are necessary, they are typically done every 5-7 days or sooner if the dressing becomes damp, loosened, or visibly soiled, not daily.
- Catheter Care: During the course of IV therapy, maintaining sterile technique while accessing the catheter (e.g., for medication administration) and ensuring that the catheter hub is properly disinfected before each use are crucial in preventing CRBSIs.
Options A, B, and D do not directly address the prevention of CRBSIs:
- A. Administering IV fluids through the largest available catheter: This is not related to infection prevention; it is more about fluid administration rates.
- B. Changing the IV catheter dressing daily: While dressing changes are important, they should not be done daily unless necessary, as excessive handling may increase infection risk.
- D. Frequently accessing the IV catheter for blood draws: This increases the risk of infection rather than preventing it. Accessing the catheter should be minimized and performed under aseptic conditions.
In summary, the use of sterile technique during IV insertion and care is the most critical action to prevent catheter-related bloodstream infections. It ensures that the insertion site and the catheter remain free from contamination, significantly reducing the risk of infection.