Welcome Community Partners

Michelle Nelson

Infection Prevention UpdateDarcy Minter RN CCRN, CIC

Objectives Review of Multi Drug Resistant

Organisms

Discuss issues regarding care and maintenance of lines in non-acute setting

Recognition of bed bugs, prevention, and treatment

Multi-Drug Resistant Organisms any organism can become resistant

Commonly thought of as MRSA, VRE and Extended Spectrum Beta Lactamase (ESBL)

More recently included… CRE, C. diff, A. baumannii, MTB, and GC

MDRO Prevention Hand Hygiene

Utilization of PPE

Environmental cleaning

Adherence to medication regimens

Care and Maintenance of lines

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Impact of CLABSI 250,000

CLABSI’s/year 30,665

deaths/year from CLABSI

$45,814/infection

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Mechanisms Leading to CLABSI

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Line care and maintenance GUIDELINES:

Hand hygiene compliance Scrub access port or hub immediately prior to each

use with appropriate antiseptic (70% IPA, CHG, provodineiodine)

Access catheters with only sterile devices Dressing care. Replace wet, soiled or dislodged (using

aseptic technique with clean or sterile gloves) Replacement of administration sets and needleless

connectors Perform daily assessments to determine need for CVL

Line care and maintenance Challenges with

keeping lines clean: Pets Cleanliness of

environment Patient non

compliance Lack of education

or experience

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Protection of lines

70% IPA in a cap To be placed on any

swabable, luer-activated device

To disinfect and act as a physical barrier between accesses when not in use

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Bed BugsCimex lectularius

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Bed BugsBed bugs, a problem worldwide, are resurging, causing property loss, expense, and inconvenience. The good news is that bed bugs do not transmit disease. The best way to prevent bed bugs is regular inspection for signs of an infestation.

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10 Bed Bug facts Adult bed bugs are around 5-7 mm long and

expand up to 3x their size after feeding. Bed bugs are a parasite and primarily feed on

the blood of humans Ordinarily the bugs are active at night but will

adjust to the hosts sleeping pattern The scientific name for bed bugs is Cimex

Lectularius The saliva of the bed bug contains anesthetic

which makes the host unaware they are being bitten.

10 Bed Bug facts The bed bugs are attracted by the carbon dioxide

that comes from the breath of the host Bed bugs can lay between 1 and five eggs per day

and over five hundred in their lifetime. Bed bugs can go over a year without feeding by

entering a hibernation state. The bed bug has six life stages broken up into 5

nymph stages and the adult stage. The parasite gets gradually bigger with each phase.

Bed bugs are not a sign of unhygienic surroundings, they can thrive in both clean and dirty conditions.

Bed Bug Bites/Rash

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Bed Bug Mating All bed bugs mate by

traumatic insemination.  After feeding the adult male becomes very interested in mating.  He literally grabs on to the female and stabs his needle-like reproductive organ thru the abdomen wall into a specialized organ (Organ of Berlese) located on her right side.  The sperm then migrates to her ovaries and fertilizes the eggs. 

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Prevention and treatment Look for signs of

infestation the bed bugs’ exoskeletons

after molting, bed bugs in the fold of

mattresses and sheets, rusty–colored blood spots due

to their blood-filled fecal material that they excrete on the mattress or nearby furniture, and

a sweet musty odor.

Avoid placing bags on beds or carpeted areas

Bites Avoid scratching Apply antiseptic

lotion or cream AntihistaminesEnvironment Professional pest

control

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Resources http://

www.cdc.gov/hicpac/mdro/mdro_4.html The Joint Commission. Preventing Central Line–Associated

Bloodstream Infections: A Global Challenge, a Global Perspective.Oak Brook, IL: Joint Commission Resources, May 2012. http://www.PreventingCLABSIs.pdf

http://www.cdc.gov/parasites/bedbugs/