Power Hour Breakout

B1 — Does the Exit Site Matter in Terms of Bacterial Load and Risk?

Saturday, September 15
2:00 PM - 3:00 AM
Location: C161-162
Presentation CE Credits: 1

Skin microorganisms may contribute to the development of vascular access device (VAD) infections. Baseline skin microorganism type and quantity varies between body sites, yet there is little evidence to inform choice of VAD site selection. This observational study had three phases: (i) skin swabs of four sites (mid-neck; base neck; chest; upper arm) from 48 hospital patients), (ii) skin swabs of five body sites (mid-neck; base neck; chest; upper arm; lower arm) from 10 healthy volunteers, (iii) paired skin swabs (72) under and outside of transparent dressings from 36 hospital patients (16 mid/base neck, 10 chest; upper arm). Specimens were cultured for 72 hours, species identified and colony forming units (CFU) counted. Ordinal logistic regression compared CFU categories between variables of interest. The chest and upper arm were significantly associated with fewer microorganisms compared to neck or forearm (Odds Ratio [OR] = 0.40, 95% CI 0.25 to 0.65, p<0.05). CFU levels under transparent dressings were not significantly different than outside (OR = 0.57, 95% CI 0.22 to 1.45). Staphylococci were predominant at all sites. Other significant (p<0.05) predictors of higher CFU count included prolonged hospitalization, and medical/surgical patient status. Skin microorganism load was significantly lower at upper arm or chest, compared to the mid or base neck. This may impact VAD site selection and subsequent infection risk.

Learning Objectives:

Nancy Moureau, RN, PhD, CPUI, CRNI®, VA-BC™

Chief Executive Officer
PICC Excellence, Inc.

A well-known friend and active participant with AVA Dr. Nancy Moureau is an internationally recognized speaker and expert in the field of peripherally inserted central catheters and vascular access practice. A nurse for more than 30 years Nancy performed 10 years of clinical work most recently as staff member on the PICC/IV team at Greenville Memorial Hospital in Greenville, SC and now working in outpatient settings with Infinity Infusion Nursing. Recipient of the Herbst Award for excellence Nancy is constantly involved in the vascular access specialty working in conjunction with many individuals and companies to perform research and publish results. An adjunct associate professor with Griffith University and member of the AVATAR group Alliance for Vascular Access Teaching and Research Nancy strives to contribute to the development of evidence for vascular access. As the owner and CEO of PICC Excellence, an online education and certification provider, Nancy consults with hospitals to provide education to clinicians and with companies to develop and improve products. PICC Excellence established the only PICC Certification process, Certified PICC Ultrasound Inserter, where those who meet qualifications gain and maintain the credentials CPUI. She is happy to be a resource and can be reached


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B1 — Does the Exit Site Matter in Terms of Bacterial Load and Risk?

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