Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)
Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)
Kerry Sean Murphy
Direct Practice Improvement Project Proposal
Doctor of Nursing Practice
Grand Canyon University
Phoenix, Arizona
Prevention of Central Line-Associated Bloodstream Infections (CLABSIs) 1
Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)
June 26, 2019
Appendix A
Ten Strategic Points
Comments or Feedback
Broad Topic Area
1. Broad Topic Area:
The topic is the Prevention of Central Line-Associated Bloodstream Infections (CLABSIs). Comment by Kathryn Flynn: Kerry, Your new submission does not have the corrections made. I am sending the corrections again. Please modify and only resubmit when corrections are done.
Literature Review
2. Literature Review:
a. Background of the problem/gap:
· There arises an urgency to intervene and develop effective measures to curtail the incidence of CLABSIs (Yaseen, et al., 2016).
· The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections (Dick et al., 2015).
· The nurses need to have significant knowledge associated with evidence-based practices for the prevention of central line-associated bloodstream infections (CLABSIs). Their attitude towards the guidelines and the utilization of the hygienic measures for the Central Venous Catheter in adult Intensive Care (ICU) units with (CVC) patients needs to change for the better (Kadium, 2015).
· Research has shown the existence of variations in the practice of nursing regarding the prevention of CLABSI, thus stressing the need for monitoring and education/training (Elbilgahy et al., 2015).
· There is a need for implementation of educational interventions to deal with the practice and knowledge gaps about CLABSIs prevention as well as ensuring that nurses apply prevention interventions which are evidence-based (Esposito et al., 2017).
· The Quality Health Outcomes Model (QHOM) Investigating Prophylactic measures to eradicate the incidence of Central line-associated bloodstream infections (CLABSIs), based on the opinions of the experts as well as the analysis of the research literature (Hentrich et al., 2014)
b. Carrying out a review of literature topics with a key theme for each one.
c. Prevention of Central Line Associated Blood Stream Infection (CLABSI) (Masse, Edmond, & Diekema, 2018).
· The Quality Health Outcomes Model (QHOM) is used to study healthcare quality and outlines relationships existing between interventions, characteristics, and outcomes of patients, and the characteristics of the healthcare system. This model/framework has been used by various researchers to test the effectiveness of infection prevention measures (Gilmartin & Sousa 2016).
· The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) developed uses Standardized Infection Ratios (SIRs). Clear Lake regional Medical Center (“NHSN | CDC,” 2018) uses SIRs and this study will also utilize SIRs for measuring the effectiveness of preventivive CLABSI maintance bundles (“SIR Report | HAI | CDC,” 2019).
Setting
· Adult ICU (Elbilgahy, et al., 2015).
· The incidence of Catheter-Related Infections (CRIs) in cancer patients at the hospital (Hentrich et al., 2014).
Summary
· Gap/Problem: There is a need to implement evidence-based methods of improving health outcomes and CLABSIs prevention through nursing education (Dombecki, Vercher, Valyko, Mills, & Washer, 2017). Comment by Kathryn Flynn: Kerry, An education program alone is not enough, per AQR. Include in the lit review info about other DPI interventions you will include in the project to bring it up to a doctoral level. Other questions you’ll need to incorporate; nurses are already trained. Why is their current training not enough? Justify why extra interventions are needed to improve patient outcomes.
· Quantitative application: the Quantitative project is to establish a relation between the occurrence of CLABSIs and staff training, reinforcement, and proper hygiene for Central Venous Catheters (CVCs) inserted in the hospital setting. There seems to be a problem regarding the training and education regarding the procedures which should be followed when carrying out catheter-related procedures (Dombecki, Vercher, Valyko, Mills, & Washer, 2017). The objective of this study is to address this issue. Comment by Kathryn Flynn: Vague, what study does ‘this’ refer to? Avoid using this, their, those..
· Significance: The use of proper hand hygiene and skin aseptic techniques over the insertion site are necessary for preventing microbial infections. Therefore the necessity to maintain insertion site hygiene consistently is determined to be the best practice in preventing infections that can lead to sepsis and septicemia (Yaseen, et al., 2016).
2.
a. Background of the problem/gap:
Even though earlier CVCs were associated with mechanical complications such as leaks, air embolisms, and hub separation, CLABSIs quickly became a serious problem when it came to the use of catheters. A study by Owings et al. (2017) indicates that elementary infection control steps may reduce incidences of CLABSIs significantly.
a. Theoretical Foundations (models and theories to be the foundation for the project). Specifically, the model proposed is the Quality Health Outcomes Model (QHOM), which is used to study healthcare quality and outlines relationships existing between interventions, characteristics, and outcomes of patients, and the characteristics of the healthcare system (Gilmartin & Sousa, 2016). Comment by Kathryn Flynn: How does this relate to your project specifically?
The theoretical model is associated with the strategies deployed and operational processes linked to the prevention of Central Line Association Bloodstream Infection. This is demonstrated through a meta-analysis review of randomized control and quasi-experimental studies (Moody, 2019).
b. Review of literature topic
Rapid Dissemination of Universal Decolonization in Adult Intensive Care Units (ICUs) reduces healthcare-associated (HA) central line-associated bloodstream infections (CLABSI) in over 100 Community Hospitals (Hickok et al., 2015).
a. Single Healthcare System
c. Prevention of Central Line Associated Blood Stream Infection (CLABSI).
