Reducing Infection and Injury

IV therapy is regarded as a high risk area of clinical practice due to complications of infection -with increased possibilities of bacteria/virus directly entering the bloodstream which may result in life threatening situations.

Practitioners involved in IV therapy are required to understand that infections are avoidable if they adhere to good practice throughout the IV procedure.

What you are up against- Terminology

Micro-organisms include bacteria and viruses:

Bacteria:

Can live on the skin and the digestive track (often referred to as 'good bacteria')

Can thrive in warm- moist environments - water pool, sinks, pimples (often referred to as 'bad bacteria')

Viruses:

Organisms that invades the boy, hijacks healthy cells, then replicates - family of virus include norovirus, HIV, 

Endogenous organisms:

Already present on the patients' body 

Exogenous organisms:

Developed from outside the patients' body

The majority of infections associated with healthcare intervention are endogenous organisms entering the body through intrusive procedures including needle intrusion involved in IV therapy

Consequences of patient acquiring healthcare associated infections:

  • Longer patient stay in hospital (increased costs to NHS)
  • Negative patient experience
  • Increased morbidity and mortality rates

Avoiding infections

When you administer IV therapy imagine you are opening up a motorway for unwanted micro- organisms to enter the body. Factors that will increase the risks are:

  • Poor hygiene (hand hygiene specifically)
  • Multiple cannulation insertions
  • Touching of the skins after cannulation infecting the skins and surrounding tissue (re-palpation)
  • Time cannula is in situ
  • Type of cannula used

Therefore -wash hands thoroughly and regularly especially before IV therapy commences

(useful link on washing hands in medicine)

Chain of Infection

Infection occur when six elements are present in sequential order:

  1. Causative agents: Any micro-organism capable of producing disease (bacteria, fungi, viruses)
  2. Reservoir: Supports the causation chink in the chain allowing micro-organisms to survive and multiply- in healthcare reservoirs include patients, staff, visitors, medical equipment etc)
  3. Portal of exit: Allows the infection agent to leave the reservoir (leaves via fluids - blood, saliva, urine etc)
  4. Mode of transmission: Micro-organism moves from reservoir to new host either through direct or indirect contact
  5. Portal of entry into the host: In Iv therapy, puncturing of skin facilitates portal for micro organisms to directly enter the body
  6. Susceptible host: Usually defined by patients or health workers are greater risk.

Therefore clean, disinfect and sterilise.

useful link here on how to eradicate chain of infection

Sepsis

Sepsis is a bacterial infection in the bloodstream of body tissue occurring after a localised infection or injury. The most common sites for sepsis include:

  • The lungs
  • urinary tract
  • abdomen
  • pelvis

Symptoms of sepsis include:

  • Chills
  • Elevated temperature
  • Fast breathing rate
  • Tachycadia

If not treated quickly symptoms can progress to septic shock:

The RCN has created sepsis crib cards to understand the symptoms, evaluation and treatment of sepsis 

download the RCN SEPSIS LINK

Needles

When inserting needles or cannula stylets, take great care - not only with body fluids and associated micro organism risks - but also the effective management of sharp medical instruments. With over 40,000 incidents reported each year within the NHS, it's imperative healthcare works pay particular attention to care when fulfilling IV therapy.

Disposing of 'sharps' if also effective at minimising injury and infection:

  • Don't overfill sharps bins
  • Only use rigid tray when administering medication using a sharp device  do not use the disposable pulp (paper) trays
  • DO NOT uncover or unwrap the sharp object until it is time to use it.
  • Keep the object pointed away from yourself and other people at all times.
  • Never recap or bend a sharp object.
  • Keep your fingers away from the tip of the object.
  • If the object is reusable, put it in a secure, closed container after you use it.

For further reading guideline from the NHS

How should I dispose of used needles or sharps?

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