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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/