1. Have you ever….. Re-attached a dressing that has become loose instead of changing it? What should you do? You should change the dressing if it becomes loosened, damp or soiled. Perform hand hygiene before dressing changes Perform dressing changes using an aseptic technique Change transparent semi permeable dressings as required or at least every 7 days Infection Control Team, St. James’s Hospital September 2007

2. Have you ever….. Taken blood cultures from a central line only ? What should you do? A peripheral blood culture should be taken at the same time Overuse of antibiotics leads to antibiotic resistance Peripheral and central blood cultures can establish Catheter related bloodstream infection and whether antibiotic therapy is needed The diagnosis of Catheter related bloodstream infection cannot be made based on a positive central line culture alone Infection Control Team, St. James’s Hospital September 2007

3. Remember ….. To always use an aseptic technique when preparing and administering TPN What should you do? Inspect the site daily and record findings in nursing notes or care plan Use a designated lumen and specific TPN needleless device Remember to use sterile gloves, one pair for priming the IV tubing and another pair for attaching the IV line Strict aseptic technique must be used for all manipulations of the TPN line Remember to remove the line when no longer needed Infection Control Team, St. James’s Hospital September 2007

4. Changing central venous catheter site dressings What should you do? 3. Using personal protective equipment remove old dressing. Examine site for redness, oozing and catheter displacement 2. Prepare sterile field 1. Perform hand hygiene 4. Perform hand hygiene again and put on sterile gloves 5. Clean insertion site from inside out using Chlorhexadine in Alcohol and allow to air dry for 30 seconds 6. Clean length of catheter from insertion site 7. Apply semi-permeable transparent dressing 8. Clean lumens from needleless device to junction and aseptically change needleless device 9. Date dressing and document in nursing notes Infection Control Team, St. James’s Hospital September 2007