Preparing Healthcare Professionals for Administering Care to the Growing Elderly Patient Population

Author: Amanda Thornton, CIC, RN, MSN

Categories: General Infection Prevention & Long Term Care September 15, 2021

For the first time in U.S. history, older adults are projected to outnumber children within the next 15 years, according to the U.S. Census Bureau.1 The aging of America will also bring a significant increase in serious diseases, including Alzheimer’s disease and dementia-related diagnosis. Today there are an estimated 6.2 million Americans aged 65 and older living with Alzheimer’s dementia, and the annual number of new cases of Alzheimer’s and other dementias is projected to double by 2050.2

For those in the healthcare field, working with the frail elderly who have comorbidities such as Alzheimer’s disease or dementia can present challenges, especially when administering intravenous infusions or gaining vascular access. This specialized patient population is at a higher risk for complications and infections, such as line-related sepsis, cellulitis, and accidental line removal.

What can healthcare professionals do to be better prepared to work with this population when administering infusion activities and vascular access care?

First, it is important to understand that the aging process significantly affects the structures of the skin, including a decrease in tone, elasticity, and subcutaneous tissue.3 This thinning of the skin puts older patients at risk for skin bruising or tearing and potential infections. Veins may also be potentially unstable, causing them to “roll” or be difficult to access and lead to line-associated infections through peripheral intravenous (IV) or central lines.4

EMTs, ER nurses, and other health professionals should avoid the common method of “vigorously rubbing” the skin of elderly patients using an alcohol wipe to provide antisepsis and make the vein more visible, as it can cause microtears and breaks in the skin. These breaks can lead to infections as they promote the growth and harboring of bacteria under the dressing after insertion of the IV. Instead, the skin should be cleansed with gentle motions and the veins visualized through other methods, such as having patients drop their arm lower than their heart and ensuring the limb being used is warmed.

Additionally, the use of alcohol combined with Chlorhexidine gluconate (CHG) for skin antisepsis has been found to be superior to other methods to prevent surgical site and line-related infections.5 CHG provides persistent antimicrobial activity for up to seven days as it binds to the proteins within the skin and releases slowly over time, even working in the presence of blood or bodily fluids.6 Clinical evidence strongly supports the addition of CHG for cleansing the skin as well as disinfecting the hub of needleless connectors to prevent line-related infections with both peripheral IVs and central lines.7 Learn more about PDI Interventional Care solutions for skin antisepsis, device disinfection, and nasal decolonization to help protect even the most vulnerable patients.

As the population ages, the need for specialized training in caring for these patients with unique needs is increasingly important to improve outcomes and provide the highest quality care possible. More resources and articles on infection prevention can be found on PDI’s Clinical Resources center.

  1. S. Department of Commerce, U.S. Census Bureau. National population projections, 2019.
  2. 2021 ALZHEIMER’S DISEASE FACTS AND FIGURES. Alzheimer’s Association 225 N. Michigan Ave., Fl. 17 Chicago, IL 60601-7633. https://www.alz.org/alzheimers-dementia/facts-figures.
  3. AVA Resource Guide for Vascular Access 1st edition, 2019 ISBN 978-1-7340141-0-5 AVAinfo.org.
  4. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81:1159-1171.
  5. Allegranzi B, Bischoff P, de Jonge S, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 2016; 16: e276–87.
  6. PDI Prevantics® Clinical Compendium 7-day persistence data. Orangeburg, New York. https://pdihc.com/products/interventional-care/prevantics-swab-swabstick-maxi-swabstick/.
  7. Am J Infect Control 2013 Aug;41(8):e77-9. ‘Disinfection of needleless connectors with chlorhexidine-alcohol provides long-lasting residual disinfectant activity”. Haeyeon Hong , Debra Forbes Morrow, Thomas J Sandora, Gregory P Priebe.

Author

Amanda Thornton RN, MSN, CIC, VA-BC
amanda Clinical Science Liaison, PDI West Region

Profile

Amanda has been in nursing for the past 25 years.  She spent nine years as a direct care nurse in many clinical settings. In 2005 she entered into infection control and prevention, where she found a passion for all things related to preventing avoidable HAI’s. She became certified in infection control through the CBIC, and worked as a front line Infection Preventionist until she advanced to be the Chief Clinical Officer of a 68 bed LTAC in Denver Co.

Amanda is also a clinical educator and was an instructor for the LPN and C.N.A. programs through the Unitah Basin Applied Technology College, where she taught the Med-surg, pharmacology, C.N.A. and infection control courses for students.

Amanda is currently a Clinical Science Liaison supporting the West Region.

Contact

Phone: 720-849-1168
Company Website: Pdihc.com
Email: Amanda.Thornton@pdihc.com

Hobbies

Resin geode and fluid Art
Lit RPG fiction
Colorado camping and hiking
Scrapbooking

Education

Master of Science in Nursing – Emphasis in Infection Control and Epidemiology
American Sentinel University, Aurora, Colorado

Bachelor of Science in Nursing, BSN
University of Northern Colorado, Greeley, Colorado

Certification
Certification Board of Infection Control (CBIC) – CIC
Certification Association for Vascular Access – VA – BC

Why I love what I do

I love being a nurse and caring for people.  When I recognized that I could touch many more lives by preventing infections through becoming a Certified Infection Preventionist, I jumped at the chance.  Seeing the impact I can have with patients, families, and staff through sharing my knowledge of infection control has been a highlight of my career. Joining the team at PDI has allowed me to expand my reach even further. At the end of my week, I am so amazed that I have such an awesome opportunity to help protect patients and loved ones from infections through the use of our products, and the proven science behind them!

Areas of Expertise

Infection control and prevention
Environmental disinfection
Ventilator Care
Vascular Access
Long term care
Long term acute care
Dementia care
Infection surveillance technology
Education
Leadership

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