2023 Non-Licensed CLABSI Prevention

Updated 2023

PREVENTION for non-licensed staff

CLABSI

START

vASCULAR ACCESS

OBJECTIVES

CLABSI

By the end of this module, the learner will be able to:

• Identify key measures to preventing CLABSI from the point of view of the non-licensed staff member such as:
• Central line care
• CLABSI bundle
• CHG bathing

CLABSI

• What is a CLABSI?
• CLABSI stands for Central Line Associated Blood Stream Infection
• Many of our patients at VUMC have central lines, and while they are very beneficial in many ways such as giving medications, fluids, and drawing blood, they put the patient at great risk for infection. CLABSIs can be very serious, and can even lead to death.
• This kind of infection is what is referred to as a "never" event. We must all work together to do everything we can to prevent CLABSI in our patients, and that includes you!

CLABSI

CLABSI PREVENTION: YOUR ROLE

• What is your role in CLABSI prevention as a Care Partner or other non-licensed staff member?
• As a non-licensed staff member, you are not involved in the direct access or care of the central line itself. However, you do play an integral role in CLABSI prevention.
• Ways you can help:
• General adherance to standard and enhanced precautions like hand hygiene and proper use of PPE
• CHG bathing
• Reporting if you see anything abnormal like redness or if the dressing is damaged or falling off

CLABSI

What can you do to prevent CLABSI?

Flush and access the central line daily

Change the dressing using sterile technique

Report anything abnormal like redness or dressing falling off

clabsI

Rationale: Ways you can help prevent CLABSI include hand hygiene, proper use of PPE, CHG bathing, and reporting if you see anything abnormal like redness or if the dressing is damaged or falling off

CORRECT!

clabsi

CLABSI PREVENTION: CHG BATHING

• What is it?
• A skin antiseptic that helps prevent the spread of bloodstream infections and the spread of antibiotic resistent bacteria
• Who receives this in Acute Care & Stepdown:
• All patients with a central line or midline, hemodialysis catheters, and/or accessed ports receive this daily
• Who receives this in ICU areas:
• All patients admitted or transferred to ICU areas receive this daily

CLABSI

CLABSI PREVENTION: CHG BATHING

• How To Key points:
• Apply CHG to dry skin AFTER regular bath or shower
• Use ONLY CHG compatible lotions and other products when patient is receiving CHG bathing
• Requires gentle scrubbing to remove bacteria
• Use a new cloth for each step
• Does not replace regular bath, this is in addition to

• Exclusion Criteria:
• Patients who have an allergy to CHG

CLABSI

CLABSI

Skin may feel sticky for a few minutes. Do NOT wipe off. Allow to air dry.

1. Neck, shoulders, chest
2. Both arms and hands
3. Abdomen then groin/perineum
4. Right leg and foot
5. Left leg and foot
6. Back of neck, back, then buttocks

CLABSI PREVENTION: CHG BATHING

CLABSI

• EPIC Nursing Flowsheets
• Self Care (ADL) interventions
• If patient is allergic, also document here
• Document exact time of bath

CLABSI PREVENTION: CHG BATHING

All patients with a central, midline, or hemodialysis catheter, or accessed port must receive a daily CHG bath.

Only inthe ICU

True

False

clabsi - prevention basics

Rationale: While every patient receives a daily CHG bath in the ICU, Acute Care and Stepdown patients with central, midline, hemodialysis catheters, and access ports are the only patients requiring daily CHG baths.

CORRECT!

clabsi

At what time should the CHG bath be documented?

It doesn't need to be documented

The time the bath is actually completed

1000 and 2200

CLABSI

Rationale: Any intervention or care should be documented on a patient at the time it is completed, not the time it is due.

CORRECT!

clabsi

CLABSI PREVENTION: DRESSINGS & TUBING

• Check:
• Double check to make sure the dressing is intact, clean and secure. If it is coming loose, dirty, or is dated more than 7 days ago notify the nurse ASAP.
• Double check ports that aren't being used to make sure the swab caps (usually orange or blue) are on
• If tubing has been disconnected from the patient by the nurse, make sure the end of the tubing has a red cap
• Bathing:

• Make sure to not get the dressing wet when bathing patients or helping perform ADLs. If it does, notify the nurse immediately.

CLABSI

clabsI

While giving a patient a CHG bath, you notice the dressing is lifting and blood is seeping out. What should you do?

Notify the nurse immediately

Attempt to clean it up

Change the dressing yourself

Rationale: Never attempt to clean or change a dressing. Notify the nurse if anything concerns you and they will take care of it.

CORRECT!

clabsi

CLABSI BUNDLE: WHAT IS IT

• What is it?
• It is a set of guidelines that help prevent CLBASIs in our patients.
• The nurses have steps to follow themselves OR delegate to you to work together to prevent CLABSIs
• Which steps affect you?

• CHG bathing
• Swab caps
• Keep eye out for loose or damaged dressings
• Keep central line secure when performing any ADLs or helping your patients in any way

CLABSI

A special thanks to the following contributers:

• Pam Bull, RN, MSN, CPEN
• Original creator of this module
• Nursing Education Specialist
• Mary DeVault, MSN, RN, CIC
• Director, Infection Prevention
• Katie Wilkerson, RN, CIC
• Infection Preventionist

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