Central Line Infection

1. Use of the central line bundle would be appropriate for all of the following types of catheters except:

Subclavian line

Pacemaker wire

External jugular line

Catheter introducer

The central line bundle is a group of measures used to prevent central line-associated bloodstream infections (CLABSIs). It includes proper hand hygiene, maximal barrier precautions during insertion, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of line necessity. While the central line bundle would be appropriate for all types of catheters listed, the pacemaker wire is not a type of catheter. It is a wire used to connect a pacemaker device to the heart. Therefore, the use of the central line bundle would not be applicable to a pacemaker wire.

Explanation

The central line bundle is a group of measures used to prevent central line-associated bloodstream infections (CLABSIs). It includes proper hand hygiene, maximal barrier precautions during insertion, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of line necessity. While the central line bundle would be appropriate for all types of catheters listed, the pacemaker wire is not a type of catheter. It is a wire used to connect a pacemaker device to the heart. Therefore, the use of the central line bundle would not be applicable to a pacemaker wire.

2. Which of the following would not be considered a component of maximal barrier precautions in a central line bundle?

Wearing a nonsterile cap and mask

Wearing sterile gloves

Using a sterile drape to cover the patient's head and body

Wearing nonsterile gloves

Wearing nonsterile gloves would not be considered a component of maximal barrier precautions in a central line bundle because nonsterile gloves do not provide the necessary level of protection against infection. Maximal barrier precautions typically involve the use of sterile gloves to minimize the risk of contamination and infection during the insertion and maintenance of central lines.

Explanation

Wearing nonsterile gloves would not be considered a component of maximal barrier precautions in a central line bundle because nonsterile gloves do not provide the necessary level of protection against infection. Maximal barrier precautions typically involve the use of sterile gloves to minimize the risk of contamination and infection during the insertion and maintenance of central lines.

3. Of the following precautions, which are designed to prevent extraluminal contamination of central lines?

Cleansing of catheter hubs and ports with antiseptic agents such as chlorhexidine or alcohol

Attention to healthcare worker hand hygiene practices before manipulating in-use catheters

Full barrier precautions during catheter insertion, and education of healthcare personnel about proper catheter insertion and site care

Sterile procedures for manufacturing of the infusate

The correct answer is full barrier precautions during catheter insertion, and education of healthcare personnel about proper catheter insertion and site care. This is because using full barrier precautions during catheter insertion helps to prevent extraluminal contamination by reducing the risk of introducing bacteria or other pathogens into the central line. Additionally, educating healthcare personnel about proper catheter insertion and site care ensures that they follow sterile procedures and maintain a clean environment, further reducing the risk of extraluminal contamination.

Explanation

The correct answer is full barrier precautions during catheter insertion, and education of healthcare personnel about proper catheter insertion and site care. This is because using full barrier precautions during catheter insertion helps to prevent extraluminal contamination by reducing the risk of introducing bacteria or other pathogens into the central line. Additionally, educating healthcare personnel about proper catheter insertion and site care ensures that they follow sterile procedures and maintain a clean environment, further reducing the risk of extraluminal contamination.

4. When should antiseptic or anti-infective-coated catheters be used?

When the CLABSI rate exceeds the target goal, even after implementation of practice guidelines

For all high-risk patients, such as bone marrow and solid organ transplant recipients

During an outbreak of resistant bacterial infections in a surgical ICU

For all neonates requiring umbilical artery catheterization

Antiseptic or anti-infective-coated catheters should be used when the CLABSI (central line-associated bloodstream infection) rate exceeds the target goal, even after implementation of practice guidelines. This suggests that standard infection prevention measures are not effective in reducing the infection rate, and additional measures such as using these specialized catheters may be necessary to prevent CLABSI.

Explanation

Antiseptic or anti-infective-coated catheters should be used when the CLABSI (central line-associated bloodstream infection) rate exceeds the target goal, even after implementation of practice guidelines. This suggests that standard infection prevention measures are not effective in reducing the infection rate, and additional measures such as using these specialized catheters may be necessary to prevent CLABSI.

5. The rate of CLABSI is highest in which of the following patient care settings?

Dialysis unit

Cardiac intensive care unit (ICU)

General medical ward

Outpatient dialysis unit

The rate of CLABSI (central line-associated bloodstream infection) is highest in general medical wards. This is because general medical wards typically have a higher number of patients with central lines compared to other patient care settings. Central lines are commonly used in general medical wards for various medical procedures and treatments, making them more susceptible to CLABSI. Additionally, general medical wards may have a higher turnover of patients, increasing the risk of infection transmission.

Explanation

The rate of CLABSI (central line-associated bloodstream infection) is highest in general medical wards. This is because general medical wards typically have a higher number of patients with central lines compared to other patient care settings. Central lines are commonly used in general medical wards for various medical procedures and treatments, making them more susceptible to CLABSI. Additionally, general medical wards may have a higher turnover of patients, increasing the risk of infection transmission.