Presentation on theme: "Use of Central Line Insertion Checklist"— Presentation transcript:
1 Use of Central Line Insertion Checklist Mount Auburn Hospital
2 MAH Central Line Insertion Program Line placement teams include an observer who watches for breaches in aseptic technique and stops the procedure if one occursAll team members are empowered to stop the procedure if aseptictechnique is brokenUse of a standardized kit with all components required to complywith known infection prevention practices will be availableUse of a check list for use during placement of all central lines thathighlights aseptic technique requirementsDocumentation of compliance with aseptic technique by placementof checklist in medical recordHandoff procedure to highlight when line placed under less than ideal conditions i.e. no monitor present to complete checklist (line must be discontinued within 24 hours of insertion)
3 Procedure for Using Checklist Coordinate time for line placement with patient’s nurse orother designated monitorConfirm consent presentComplete “Time Out/Universal Protocol” per MAH policyObserver: Observe sterile technique during set up andplacement of central lineObserver: Complete the central line insertion checklistMD and RN sign completed checklistCourtesy and team work is expected and required fromall members of the team
4 Who is the Observer Any RN can be an observer. The observer watches for breaches in theaseptic technique and stops the procedureif one occurs.The observer educates the patient on theprocess and what to expect.
5 Talking with the MDI am working with you to make sure that we maintain sterile technique throughout the procedure. The things I will be looking for are that: • you've used hand sanitizer (Cal Stat) or antimicrobial soap just before the procedure • you've disinfected the site with chlorhexidine, • the patient is draped from head to toe and that everyone involved in the procedure are wearing cap, sterile gown and gloves, and protective gear (faceshield) • the line is flushed and capped before the drapes are removed and • any blood is removed with chlorhexidine before the sterile dressing is placed. • If a break in sterile technique is observed, I will ask you to repeat a portion of the procedure.
6 Standard Aseptic Technique • Hand hygiene with alcohol-based hand rubBefore glovingAfter removal of gloves• Site preparation with chlorhexidine30 second friction rubMust allow to air dry• Maximum sterile barrier techniqueHat and mask for everyone in roomSterile gloves & sterile gown for all operatorsFull body drape (head to toe)• All equipment maintained on a sterile field & replaced ifcontaminated• Sterile occlusive dressing applied following placement of theline.
7 Communication Regarding Line Status • Place the checklist in the patient’s medical record. It is helpful reference for making decisions regarding the circumstances of line placementAny line without a checklist should be assessed for potential replacement within 24 hoursCommunicate this in any handoff
8 Example of MAH Checklist Sources: The checklist can be found on the central line insertion cart or downloaded.Destination:The completed checklist should be placed in the invasive procedures section of the medical record.
9 Breaks in Sterile Technique The Observer or any other team memberwill state that there is a break in technique• The procedure will stop• The team will agree upon correctiveactions• The procedure will resume
10 Handling Breaks in Sterile Technique Appropriate ActionGuide wire tip touches non sterile objectRemove contaminated wire from field and replace it with a new wireGloved hand touches non sterile object but no other part of field is contaminatedRemove glove & replace with new sterile glovePatient becomes agitated & sterile drapes are dislodgedTake down all drapes & equipmentAttend to the patients needs, then start overNon sterile object falls or isdropped onto sterile fieldSterile field & all associated equipment must bereplacedOperator uses hand hygiene prior to entering the room,repositions the bed & sidetable, then dons sterileglovesRemove glovesRepeat hand hygiene immediately before donningsterile gloves