Frequent Broviac Infections - eek!

[Baboosh123]

Hello,

I'm a pretty new nurse and I am currently doing home care nursing while I wait for this dismal economy to bounce back so I can get a hospital job. (Still holding my breath...) Anyway, I have a pediatric patient with an indwelling Broviac catheter. The child has had a lengthy history of catheter infections/other infections before I started to care for her, and I have gathered that they had been occurring about once a month! I am no expert, but that definitely seems too frequent. For the past 5 months, she has been admitted to the hospital one time, and again in early April. She also developed an infection under the care of another nurse in January. So that makes 3 hospital admissions in the past 5 months, 2 of them while being under my care. I know that central venous catheters, (especially those used for TPN administration like my patient's) get infected regularly, but are these numbers too high? Is she just prone to infection?

[NicuGal, MSN, RN]

I agree, I would explain to mom that the infection rate is very high and you would like to see how she is changing the dressing. Does she use a biopatch? We only change our dressings every 7days unless soiled, loose or wet. The less you mess with the dressing, the better. Also, does mom access the line? That is actually the number one mode of infection. Make sure she is scrubbing that hub well for 30 seconds and letting it dry....that is the key. And wiping it after disconnecting it.

Good luck and don't criticize, just say, hey, let's go over this again, I know you do it all the time, but let's see if we can come up the something better so that she doesn't get sick so often :)

[Baboosh123]

These are all really great suggestions and thoughts. Thank you everyone for your input. It's obvious to me that 1) I should go look at what mom is doing during dressing changes and 2) I think I need to talk to the doctors about this as well and bring up the suggestions said here to form some type of plan of action. And as I said before, I'm going to be ultra careful when I access her line from now on...

To answer some of your questions:

1.Chloroprep is used and Mom does access the line on days I am not working.

2.She is immunosuppressed but not because she is a transplant patient. She just seems to get colds and viruses easily.

3. The line was changed and I believe is changed every time she is admitted.

I wouldn't even want to imagine that this child is a victim of Munchausen by proxy...urgh. Are there any signs that I could look out for?