Infection Control Measures in IV

Drug Administration

Dr. VINEETH V
GTBH AND UCMS
DELHI
Objective
Every member of hospital staff involved with
intravenous therapy will be able to apply the
correct infection control precautions to this
procedure
Introduction
Vascular access devices is vital for administering
various fluids and drug therapies. it's critical to
maintain an appropriate infection control
measures to save lives and money and reduce
healthcare burdens.
Types of intravenous devices:
1. Peripheral cannulas :
placed into a peripheral vein

2. Peripherally inserted central catheters (PICC)

Central line that is placed via the peripheral
vasculature. Its tip terminates in the superior
vena cava
3. Peripheral midline catheters :
Shorter version of the PICC, Its tip terminates in
the axilla
4. Skin tunneled cuffed central catheters (Hickman
lines)
Central venous catheter most often used for the
administration of chemotherapy
 Expected Intravenous Catheter Complications

Phlebitis:
• Inflammation of a blood vessel
Thrombophlebitis:
• Similar to phlebitis but a thrombus (or clot) is in addition
involved
Local Infection (abscess):
• A microscopic organism may use the tiny hole in the
skin created by the IV catheter to find its way into the
body, and cause an infection
 CONTINUES
Infiltration :
• This occurs when the catheter unintentionally
enters the tissue surrounding the blood vessel
and the IV fluid go into the tissues.
Hematoma:
• collection of blood caused by internal bleeding.
Hypothermia:
• When large amounts of cold fluids are infused.
Rapid temperature changes occurs and may
precipitate ventricular fibrillation.
Infectious Micro-organisms associated
with IV therapy
• Staphylococcus epidermidis
• Staphylococcus aureus
• Enterococcus .
• Klebsiella
• Pseudomonas
• E. Coli
• Candida
 Reservoirs
• Patients Skin – resident microflora
• Equipment
• IV Solutions & drugs
• Environment
• H c provider Hands
 INFECTION CONTROL MEASURES
1.Collect all required equipment, checking
expiry date and the correct catheter size for
the purpose and length of infusion
2. Confirm patient identity and provide
explanation
3. Hand washing
Should be performed before
and after inserting, replacing , repairing, or
dressing an intravascular catheter
4. Wearing gloves
Wear clean gloves, rather than sterile gloves, for the
insertion or changing the dressing of peripheral
intravascular catheters. Sterile gloves should be worn
for the insertion of arterial, central, and midline
catheters.
5. Patient skin preparation
Alcohol swab to remove bacteria prior to insertion and
allow it to dry; this doesn’t protect the patient for a
longer period. Chlorhexidine Gluconate with 70%
alcohol gives longer duration of protection
6.Securing Catheter insertion site.

7.Disposing of contaminated or soiled equipment

and linen appropriately .
8. Safe disposal of sharps .
9. Stay with your patient for 5 to 10 minutes to
detect early signs and symptoms of
hypersensitivity, such as sudden fever, joint
swelling, rash, urticaria (hives), ronchospasm,
and wheezing.
10.Documentation
 signs of infectioN
• Redness (erythema) and warmth with some
fever
• Pain or burning along the length of the vein
• Swelling (edema)
• Purulent discharge
• If any of these signs are noted, the IV catheter
must be removed immediately .
 Types of Phlebitis
Bacterial phlebitis
• is usually an indication to an infection at the insertion
site.
Chemical phlebitis
• is most commonly seen with peripheral IV devices
when medications or solutions irritate the endothelial
lining of the small peripheral vessel wall, for example:
erythromycin
tetracycline
vancomycin
Large doses of potassium chloride
multivitamins
Mechanical phlebitis
occurs when the size of the cannula is too big for
the selected vein causing unnecessary friction
on the internal lining of the vein leading to
inflammation
• Fighting Phlebitis
1 . Phlebitis is most common after continuous
infusions, developing 2 to 3 days after the vein is
exposed to the drug or solution.
2. Phlebitis is more common in distal veins than
in veins close to the heart.
 Steps to Prevent Phlebitis:
• Use proper venipuncture technique.
• dilute drugs correctly.
• Monitor administration rates.
• Observe the I.V. site frequently.
• Change the infusion site regularly according
to policy.
 Conclusion
REMEMBER !
• Adhering to aseptic technique during insertion, dressing
changes, preparing medications will minimize the risk of
infection
• Cannula site rotation and using the appropriate Cannula
size
• Adequate securement of the IV device
• Patients should be closely monitored for signs of infection
• Patient education of the signs and symptoms of phlebitis
• Good documentation is essential and it should be Daily as
evidence that assessment has been carried out