topic 3 dq 1 32

Please respond with a paragraph to the following question, add citations and references:

Article #1

One rural hospitals experience implementing the society for health care epidemiology of America guidelines to decrease central line infections.

This article is from the Journal of Trauma Nursing. The article shows that the latest evidence-based practice change is to teach nurses how to use evidence-based practice to reduce CLABSI’s in the ICU. A weakness noted in this article is that it focuses on one institution instead of gathering evidence from multiple institutions. It did prove that the baseline rate of CLABSIs decreased over 1,000 central line days and improved patient outcomes. The article reviews CLABSI rates and examines the prevention strategies following implementation of the SHEA guidelines. This will help me to develop guidelines for nurses to follow in the ICU.

Article #2

Review of best practices for CLABSI prevention and the impact of recent legislation on CLABSI reporting.

This article is from SAGE Open. The focused of this article is on the new federal legislations such as the ACA. They use incentives and penalties when a CLABSI is reported. Each hospital is assessed, funded or penalized for CLABSI infections reported. Studies show how affective this method is at achieving the goals of better CLABSI rates. Pay-for-performance, focuses on rewarding hospitals who are successful at reducing their HAI rates, they hold funds to those that are unsuccessful. This article will help me to educate stuff on the cost and penalties of CLABSI. Nurses are the key roles to save lives and reduce hospital costs by implementing best practices to decrease the incidence of CLABSI. During my research one noted that a weakness in this article is that the extrinsic factors such as recent enacted legislations and mandatory reporting has not been closely examined in relation to the rates of HAI.

Article # 3

Effect on chlorhexidine bathing in preventing infections and reducing skin burden and environmental contamination: A review of literature.

The article explains how chlorhexidine bathing reduces pathogens on the skin. In this literature review evidence shows that chlorhexidine prevents colonization and infection with HAI’s and reduces dissemination in the environment and the hands of personnel. This will be efficient in the practice change. Evidence shows that chlorhexidine bathing may be beneficial, this practice is now becoming routine in many facilities, especially in ICU. By using this article, I plan to educate nurses on the importance and benefits of chlorhexidine baths in patients with central lines to reduce CLABSI’s. Upon reading this article one noted that a weakness is not a detailed checklist of how frontline staff will use the bath cloths and what patients to avoid.

Article # 4

Improving central line maintenance to reduce central line-associated blood stream infections.

This article explains how the central line maintenance kit (Bundle) would improve adherence and reduce CBLASI’s compared with a standard, non-kit-based method of performing central line maintenance. This study was completed in an ICU setting which will show evidence and benefit my practice change. The results of this study proved that a human factor engineering-based kit improved adherence to best practices during central line maintenance. The number of CLABSIs reduced during the post implementation period. One noted that the bundle kit supply list wasn’t mentioned and if it was approved by the CDC guidelines. One would consider this a weakness.

Article # 5

Preventing central line-associated bloodstream infections: A qualitative study of management practices.

The article proves through evidence that there are some variances associated with CLABSI prevention program outcomes, some are management practices. In my practice change I will develop management checklists for nurses to follow that will help reduce CLABSI rates in the ICU setting. This article will benefit my practice change by providing evidence that a management bundle may provide critical guidance to frontline staff, physicians, clinical managers and hospital leaders to prevent health care- associated infections such as CLABI’s. During the research one noted that all factors was identified on what makes a facility low or high performing, however it didn’t explain what interventions they would take to improve their performance.

Article # 6

Facilitating central line-associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff.

The articles explain how the ICPs play a critical role in implementing and managing CLABSIs where are frontline staff are responsible for delivering direct and ongoing patient care. In my practice change I will use this article to work with frontline staff and ICPs to develop checklists that includes all perspectives. This article will be helpful in finding a solution to CLABSI rates by having frontline staff and ICPs to collaborate and work together as a team in the ICU. The article did not mention what program would be developed to help ICPs and frontline staff to take into accountable of each other’s perspectives.

References:

Curlej, M. H., & Katrancha, E. (2016). One rural hospital’s experience implementing the society for healthcare epidemiology of America guidelines to decrease central line infections. Journal of Trauma Nursing, 23(5), 290-297. doi: 10.1097/JTN.0000000000000235

Donskey, C. J., & Deshpande, A. (2016). Effect of chlorhexidine bathing in preventing infections and reducing skin burden and environmental contamination: A review of the literature. American Journal of Infection Control, 44(5), e17-e21. Retrieved from https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic.2016.02.024

Drews, F. A., Bakdash, J. Z., & Gleed, J. R. (2017). Improving central line maintenance to reduce central line-associated blood stream infections. American Journal of Infection Control, 45(11), 1224-1230. dio: 10.1016/j.ajic.2017.05.017

McAlearney, A. S., & Hefner, J. L. (2014). Original article: Facilitating central line-associated blood stream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff. American Journal of Infection Control, 42(10), s216-s217. Retrieved from https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic.2014.04.006

Scheck, M. A., Hefner, J., Robbins, J., Harrison, M., & Garmen, A. (2015). Preventing central line-associated bloodstream infections: A qualitative study of management practices. Infection control and Hospital Epidemiology, 36(5), 557-563. doi: 10.1017/ice.2015.27

Woodward, B., & Umberger, R. (2016). Review of best practices for CLABSI prevention and the impact of recent legislation on CLABSI reporting. SAGE Open, 6(4). doi: 10.1177/2158244016677747

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