Reducing blood stream infections during catheter insertion

BACKGROUND

Registered radiologist assistants (R.R.A.s) and other health care providers frequently are responsible for placing peripherally inserted central catheter (PICC) lines. Postprocedure blood stream infections are a potentially costly and medically serious complication.

PURPOSE

To determine the most effective methods for R.R.A.s and other health professionals to reduce blood stream infections related to PICC line insertion and management.

METHODS

Using specific inclusion criteria, the authors searched for scholarly reviewed articles related to PICC lines, infection, and adulthood.

RESULTS

The search produced 2237 articles, from which the authors selected 35 for review, in addition to 6 articles identified in the reference lists of articles not selected. The authors investigated 6 topics related to infection control in PICCs among nonimmunocompromised adults: securement devices, staff education, needleless systems, site preparation, maximum sterile barriers, and antimicrobial patches.

CONCLUSION

In the long run, proactive continuing education is less expensive than the cost of complications caused by postprocedure infections. Although further research is needed, specific strategies reported in the literature included prepping the skin using chlorhexidine and antimicrobial patches to reduce the microorganisms in the area. These steps should be followed by maximum sterile barriers. Needleless connectors and positive-pressure valves were found to be more effective than the alternatives, and proper securement with self-adhesive anchoring devices was found to be more effective than suturing for reducing blood stream infections.

Radiation biology and protection

To protect themselves, their patients and their coworkers, radiologic technologists should regularly refresh and reinforce their understanding of key radiation biology and protection principles. This article reviews the concepts of radiation physics, human biology and radiation protection strategies, with emphasis on how historical events and developing research affect radiation protection understanding and practice.

Patient dose from CT: a literature review

CONTEXT

Computed tomography (CT) exams are increasingly common and account for a significant portion of individuals' mounting exposure to medical radiation.

OBJECTIVE

To explore issues surrounding patient radiation dose, including techniques for minimizing dose and the feasibility of tracking lifetime exposure to medical radiation from CT and other imaging exams.

METHODS

The authors conducted a review of the recent literature to assess current knowledge of dose levels, protocols for minimizing patient dose and possible systems for tracking cumulative dose.

RESULTS

Currently, no regulations are in place to track cumulative patient radiation dose. However, the authors discuss possible means of recording, tracking and storing this data, such as standardizing its inclusion in DICOM headers and transmitting it to electronic personal health records.

CONCLUSION

More research is needed to develop and implement uniform dose tracking procedures and protocols for minimizing patient dose.

Hazards in the radiology department

OBJECTIVE

This article views, collectively, the problems associated with darkroom disease, multiple chemical sensitivity and latex allergy. Each is discussed individually to establish a case definition.

METHOD

Common threads and similarities are identified among the 3 conditions along with potential sources.

RESULTS

A model is proposed to change attitudes among radiographers in individual departments to improve workplace safety.

CONCLUSION

We propose the use of an established health education/disease prevention model to change the attitudes of radiographers toward chemical threats.