PICC Infection Prevention & Complication Management 4

Question 1

A PICC nurse is performing a blood culture draw from a PICC in a febrile patient. Which technique is required to correctly differentiate CRBSI from other bacteremia sources?

Accepted Answer

Draw paired blood cultures simultaneously from the PICC and a peripheral vein

Answer

Paired simultaneous blood cultures — one through the PICC and one from a peripheral vein — are required to calculate differential time to positivity (DTP) for CRBSI diagnosis.

Question 2

What differential time to positivity (DTP) threshold, when the PICC culture turns positive earlier than the peripheral culture, is diagnostic for catheter-related bloodstream infection (CRBSI)?

Accepted Answer

≥2 hours

Answer

A DTP of ≥2 hours — the central line culture turning positive at least 2 hours before the peripheral culture — is the accepted diagnostic threshold for CRBSI.

Question 3

Which organism is most commonly responsible for CLABSI in patients with long-term PICCs receiving home infusion therapy?

Accepted Answer

Coagulase-negative Staphylococci

Answer

Coagulase-negative Staphylococci, particularly S. epidermidis, are the most common organisms causing CLABSI, especially with long-term indwelling catheters, due to their strong biofilm-forming capacity.

Question 4

A patient's PICC site has a transparent semipermeable membrane (TSM) dressing that is visibly lifting at the edges and has moisture under it. The correct action is to:

Accepted Answer

Change the dressing immediately using aseptic technique

Answer

A compromised dressing with lifting edges and moisture underneath must be changed immediately, as moisture under the dressing significantly increases CLABSI risk.

Question 5

Which intervention is most effective in preventing biofilm formation on PICC lumens used for prolonged therapy?

Accepted Answer

Using antimicrobial-impregnated or antibiotic lock solutions in high-risk patients

Answer

Antimicrobial lock solutions (e.g., ethanol, minocycline-EDTA, or taurolidine) have demonstrated efficacy in reducing biofilm-associated CLABSI in high-risk or recurrent-infection patients.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC Infection Prevention & Complication Management 4