PowerPoint Presentation

[Virtual Presenter] This module will give you an understanding of the best practices for central line insertion and maintenance of neonatal patients. It will help you reduce the risk of infections. This module will teach you about central line insertion and maintenance through animated videos interactive worksheets and discussion points..

[Audio] This module will explore how healthcare providers can lower the risk of infection for newborn babies through improved central line practices and care. Learners will gain an understanding of central line bundles their components the indications for central venous access different forms of central lines the concepts of stopping and escalating a line and the process of central line documentation..

[Audio] Providers can gain an understanding of the central line bundle which is a group of evidence-based practices encompassing pre-insertion insertion and maintenance activities. These practices help reduce the risk of infection in newborns by providing an environment safe for fluids medications and parenteral nutrition. By adhering to these guidelines healthcare providers are able to provide comprehensive and safe care to newborns and reduce the risk of infection..

[Audio] I'd like to bring up the Neonatal Central Line Bundle which is a set of five essential components designed to decrease the chance of infections in newborns receiving critical care. Hand hygiene maximal barrier precautions skin antisepsis ideal site selection and daily review of line necessity are the components that comprise this bundle. By following these components it is possible to protect newborns and lower the likelihood of infections..

[Audio] Central venous access is an essential procedure to mitigate the risk of infection for newborns. It is commonly used in medical situations such as administering fluids and parenteral nutrition long-term antibiotic therapy obtaining accurate hemodynamic measurements frequent blood sampling transfusions and accessing intravenous lines when peripheral ones are difficult to obtain. It is also quickly used in emergency situations to deliver fluids and medications. This module offers healthcare providers information and resources to efficiently and securely optimize central line practices and care to decrease the likelihood of infection for newborns..

[Audio] This module provides healthcare providers with resources to improve central line practices and care that will lower the risk of infection in newborn babies. Central lines are used in the Neonatal Intensive Care Unit (N-I-C-U-) and there are three primary types. The Umbilical Arterial Line (U-A-C--) aids in drawing blood or monitoring blood pressure whereas the Umbilical Venous Line (U-V-C--) is utilized to administer nutrition fluids medications and blood transfusions. The third type is the Peripherally Inserted Central Catheter (P-I-C-C-) which gives access to larger veins in an infant's arms or legs for delivering nutrition fluids and medications. With the resources provided by this module healthcare providers can manage and reduce the infection risk of newborns more effectively..

[Audio] This module helps healthcare providers to ensure the safety of newborn babies by providing guidelines for optimized central line practices and care. The central line insertion bundles are a crucial part of this as they guide healthcare providers on how to minimize potential risks of infection or other complications. These bundles consist of establishing a central line cart performing strict hand hygiene and using maximal barrier precautions such as sterile gowns sterile gloves surgical masks hats and sterile drapes. Following these guidelines can help ensure the best possible care and safety of newborn babies and reduce the risk of infection..

[Audio] When inserting a central line for newborn babies healthcare providers must take extra care. This is why this module provides the tools to optimize these practices. It is essential to ensure the proper skin disinfection with the recommended cleaning agents such as Povidone Iodine for U-A-C and U-V-C lines and Chlorhexidine 2% and Isopropyl Alcohol 70% for picc. Additionally a sterile transparent and permeable dressing or sterile gauze must be used to cover the insertion site in order to prevent accidental dislodgement or migration of the central line..

[Audio] Document the insertion site and dressing status in EPIC The module focuses on the importance of maintenance bundles in order to reduce the risk of infection in newborn babies. Maintenance bundles combine hand hygiene evaluation of the catheter and dressing site and documentation of insertion site and dressing status in EPIC. Hand hygiene should be performed at least once before and after catheter access and the catheter and dressing site should be evaluated on an hourly basis. Lastly the insertion site and dressing status should be documented in EPIC. By following these protocols healthcare providers can ensure the safety of newborn babies and better treatment for them..

[Audio] In this slide we are discussing the Neonatal Central Line Bundle which is an important part of providing optimal patient care. If the picc line dressing is damp visibly soiled or loose it is important to notify the charge nurse and reinforce the dressing until the picc RN is available to change the dressing. Further it is necessary to adhere to the unit protocol when changing intravenous tubing and scrubbing the hubs for optimal patient care..

[Audio] Emphasizing the importance of daily multidisciplinary review of central line necessity and the need for prompt removal when it is no longer needed x-ray follow-up is required to verify the catheter tip is in the correct location. For Ben Taub the x-ray should be performed 48-72 hours after insertion whilst for L-B-J it should be done daily for three consecutive days..

[Audio] Medication administration is a vital part of making sure newborn babies are safeguarded. Adhering to the 'Eight Rights of Medication Administration' is important when using a central line as is obtaining the needed supplies and properly doing hand hygiene. Moreover scrubbing the medication hub with a Chlorhexidine swab with a twisting and rubbing motion should be done to decrease the risk of infection. It is essential to take these measures in order to guarantee the security of the infant..

[Audio] It is critical for healthcare providers to follow a strict protocol when it comes to central line practices and care for newborn babies to ensure safe and effective care. This includes scrubbing the hub and allowing the port to completely air dry using a new syringe for flushing after administering medication and replacing the medication tubing every 24 hours. Furthermore labels must be attached to the tubing at all times..

[Audio] Regarding central line care it is essential to have proper picc line dressing in order to maintain asepsis and avoid complications. An effective picc dressing is one that adheres well to the skin entirely covering the area of insertion. On the contrary a loose dressing can be detected by its edges that are raised diminishing the seal and leaving the insertion site exposed. In the Neo I-C-U attention to detail of this kind is essential..

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[Audio] It is essential to document the status of a central line placement in a patient's electronic medical record for accurate patient records and better optimization of central line practices and care. There are two types of central line insertion: Scheduled Insertion and Emergent Insertion. Scheduled Insertion involves the planned and intentional placement of a central venous catheter at a predetermined time typically during hospital admission while Emergent Insertion is an immediate placement of a central line in response to an acute need. Proper documentation of these insertion processes is important to provide optimal care and reduce the risk of infection for newborn babies..

[Audio] Healthcare providers can use this module to help reduce the risk of infection for newborn babies. It provides tools to make sure all components of central line insertion are comprehensively documented. This includes data such as Placement Date and Time Line Insertion Status Hand Hygiene adherence Time Out Protocol compliance usage of Sterile Barriers Skin Prep and drying maintenance of Sterile Fields central line location Catheter Size inserter's identity and role in the neonatal team insertion attempts securement type Insertion Depth application of sterile connectors to all ports and identification of personnel clearing the central line for use. By doing this healthcare providers can better guarantee newborn babies' safety and health..

[Audio] 'Stop the Line' is an important strategy for healthcare providers when it comes to newborn safety. All personnel involved in healthcare have the authority to immediately halt any procedure if they witness a non-compliance of a R-E-D rule or central line bundle. Thus any existing safety concerns must be thoroughly examined and taken seriously before any further procedures can be resumed. Should a safety concern persist it must be brought to the attention of leadership..

[Audio] Healthcare providers routinely audit to prevent central line-associated bloodstream infections or CLABSI in newborns. These audits include L-D-A documentation dressing tubing and site assessment and aim to detect any differences from established best practices that could lead to infection. This module furnishes healthcare providers with the resources to improve central line practices and care to lower the risk of infection for newborn babies..

REFERENCES. The Joint Commission. Preventing Central Line—Associated Bloodstream Infections: Useful Tools, An International Perspective Nov 20, 2013. Accessed [8/3/15]. http : / (www.j ointcommission.org/CLABSIToolki. "Statewide NICU Central-Line-Associated Bloodstream Infection Rates Decline After Bundles and Checklists." American Academy of Pediatrics, 10 Dec. 2010. Web. 3 Aug. http:((pediatrics.aappublications.org/content(127/3/436.full.pdf. 2015. "Umbilical Catheter Blood Specimen Collection." Umbilical Catheter Blood Specimen Collection. 1 May 2012. Web. 18 Aug. 2015. <http://www.slideshare.net/wcmc/umbilical- catheter-blood-specimen-collection>. "Medworxx Intranet." Medworxx Intranet. BC Women's Hospital and Health Centre, 18 Féb.GGSÄ&eb. 18 Aug. 2015. bccwhcms.medworxx.com Site Published bcw document render.a x?docum entRender.IdType=29&documentRender.GenericField=1&documentRender.I Walsh, K. "Blood Sampling through a Central Venous Access Device (Closed System): Pediatric Patient." Nursinq Reference Center. EBSCO Host, 24 Dec. 2014. Web. 19 Aug. <http:Ldweb.a.ebscohost.com/nrc/pdf?sid=52411fac-frfd-4dfe-9899- 2015• C. "Umbilical Catheter Placement and Care: Performing." Nursing Reference Center. EBSCOhost, 13 Sept. 2013. Web. 20 Aug. 2015. <http:(/T3ÄGÜohost.com/nrc.