Examkin

Soru

Zorluk: OrtaInfection Control and Hospital-Acquired Conditions

A 52-year-old man is admitted to the intensive care unit with septic shock secondary to a perforated viscus. The critical care team determines that a central venous catheter is required for the administration of vasopressors and hemodynamic monitoring. The physician prepares to insert a catheter into the right internal jugular vein. Which of the following interventions is the most effective evidence-based measure to prevent a central line-associated bloodstream infection (CLABSI) during this procedure?

  1. A
    Application of a 10% povidone-iodine solution for cutaneous antisepsis at the insertion site
  2. Utilization of full-body sterile drapes along with a sterile gown, cap, mask, and gloves by the operatorCevap
  3. C
    Administration of a single dose of intravenous vancomycin 30 minutes prior to catheter insertion
  4. D
    Utilization of the femoral vein as the preferred insertion site over the subclavian vein
  5. E
    Routine scheduled exchange of the central venous catheter over a guidewire every 7 days

Cevap

Utilization of full-body sterile drapes along with a sterile gown, cap, mask, and gloves by the operator
Maximum sterile barrier precautions, which include the use of a sterile gown, cap, mask, sterile gloves, and a full-body sterile drape, are a critical and mandatory component of the central line insertion bundle. This practice has been proven to significantly reduce the risk of central line-associated bloodstream infections (CLABSIs) compared to standard precautions (e.g., using only sterile gloves and small drapes).

Adım Adım Çözüm

1
Identify the clinical goal presented in the vignette.
The physician is preparing to insert a central venous catheter and needs to implement the most effective measure to prevent a central line-associated bloodstream infection (CLABSI).
Understanding the objective directs the focus toward evidence-based infection control guidelines for invasive procedures.
2
Recall the components of the standard CLABSI prevention bundle.
The bundle includes strict hand hygiene, maximum sterile barrier precautions, chlorhexidine skin antisepsis, optimal catheter site selection (subclavian vein preferred), and daily review of line necessity.
These specific bundled interventions have been proven to synergistically reduce the incidence of hospital-acquired bloodstream infections.
3
Evaluate the given options against the established prevention bundle.
Full-body sterile drapes with a sterile gown, cap, mask, and gloves represent maximum sterile barrier precautions, which is the only correct standard among the choices provided.
The other options represent outdated practices, incorrect site preferences, or inappropriate antimicrobial stewardship.

Anahtar Kavram

Prevention of central line-associated bloodstream infections (CLABSI) requires strict adherence to an insertion bundle, which mandates maximum sterile barrier precautions, chlorhexidine-based skin antisepsis, and avoidance of the femoral vein.
Bu soruyu puanla

Konular

Infection Control and Hospital-Acquired Conditions

Bu konudan daha fazla soru