...Rees Grand Canyon University: NRS-433V March 28, 2015 Abstract Central line-associated bloodstream infection is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of, or within 48 hours, prior to the onset of symptoms and the infection is not related to an infection from another site. Central line-associated bloodstream infections (CLABSIs) occur when germs enter the bloodstream through a central line. A central line is a tube that is placed in a large vein to give fluids, blood, medications, or nutrition. CLABSI continues to be one of the most deadly and costly hospital-associated infections in the United States. Many lives have been saved in the past decade due to improvements. However, these infections continue to occur and more occur in other areas of the hospital outside of the ICU. One in four patients die with CLABSI complications. These serious infections usually cause a prolonged hospital stay with an increased cost. The average CLASBI cost an additional 0.6-2.7 billion every year. Some patients may be at higher risk for developing a CLABSI due to their length of hospitalization before catheterization, duration of catheterization, underlying medical conditions, location of catheter placement, or other factors. It is important that both the patient and the healthcare providers take the appropriate steps to help prevent an infection. Rutkoff, G. S. (2014). The Influence of an Antimicrobial Peripherally Inserted Central...
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...CLABSI accounts for 3.64 CLABSIs per 1000 line days in ICUs equivalent to 43,000 CLABSIs Cite. This translates to over 6000 lives lost and millions of dollars spent in hospital costs that could have been saved from an avoided and preventable infection. ICUs can greatly benefit from VBP as they contribute to the hospitals mortality rates and ICU length of stay. Working collectively with hospital ICUs to create and establish effective ICU CLABSI protocols and guidelines that must be adhere to can tremendously effect the broader spectrum of the CMS initiative. Implement this plan can directly address care outcomes and resource use in ICUs to improve quality of care. It will address ICU length of stay and drastically reduce hospital costs and reduce the hospital’s mortality and morbidity...
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...Research Critique Part 1 1 Research Critique Part 1 CLABSI in the Pediatric Oncology Population Cathy Frederick Grand Canyon University NRS-433V Introduction to Nursing Research October 11, 2015 Research Critique Part 1 2 Purpose of the Research This paper will perform a research critique on a qualitative research study published in the Infection Control and Hospital Epidemiology, March 2013, Vol. 34, No.3. The study was presented with contributions from multiple individuals, Dr. A. Gaur, Dr. D, Bundy, C. Gao, PhD, Dr. E. Werner, Dr. A. Billett, Dr. J. Hord, Dr. J. Siegel, Dr. D. Dickens, C. Winkle, RN., and Dr. M. Miller. The research was to identify the host and organism characteristics of the hospital-acquired condition, central line-associated bloodstream infections (CLABSIs) in pediatric hematology/oncology patients. Problem Statement CLABSIs increase the risk for increased mortality and morbidity, extended hospital stays, and raises the overall cost of healthcare. Children’s Hospital Association Hematology-Oncology Quality Transformation Collaborative Project (CHAHQTCP), was a qualitative research project that began on November 1, 2009 and ended July 31, 2011. This project was initiated to identify the contributing factors to blood stream infections (BSI) in pediatric hematology patients. The goal of this research was to reduce CLABSIs by 50%. To be included, the CLABSI needed occur 48 hours after being hospitalized or within 48 hours...
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...Running head: BEING ACCOUNTABLE: UTILIZING EVIDENCE-BASED Being Accountable: Utilizing Evidence-Based Research Grand Canyon University NRS 430V Professional Dynamics August 27, 2011 Being Accountable: Utilizing Evidence-Based Research Merriam-Webster defines accountability as “an obligation or willingness to accept responsibility or to account for one’s actions” (Merriam-Webster, n.d.) What does this term mean from the global healthcare perspective? In the healthcare arena, it is a legal, moral, and ethical term used to describe healthcare providers’ obligation to themselves, their patients, and to society as a whole. The nurse is an integral part of the healthcare team that contributes to accountability realm. How does this concept translate into everyday professional nursing practice? According to the American Nurses Association, “accountability means to be answerable to oneself and others for one’s own actions. The nurse acts under a code of ethical conduct that is grounded in moral fidelity and respect for the dignity, worth and self-determination of patients.” (p. 9). The ANA developed the Code of Ethics for Nurses as a tool or guideline for the nurse to “carry out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession” (ANA, n.d.). Nurses have a responsibility for the care they provide during their nursing practice. To whom is the professional nurse responsible and accountable? Nurses are...
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...Nursing Quality Committee Inter-professional team leadership plays an important part when creating strategies to solve issues and obtain a positive outcome (DeNisco and Barker, 2016). Central Line Associated Bloodstream infection (CLABSI) is one of the main issues that hospitals have in common. However, nurses and leaders can work together to establish a committee which focus on CLABSI. The committee will help nurses to transform their frustrations into accomplishments and the collaborative team of healthcare professionals will assist to find the solutions of the problems (DeNisco and Barker, 2016). A team of nurses should participate in the committee to obtain knowledge and share their experiences with previous cases of CLABSI. The team will discuss...
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...lasts longer. It is difficult to insert these lines in newborn and premature infants and takes several attempts, thus making them more prone to infections, especially nosocomial infections which are very common in neonatal intensive care units. The most common infection is the central line associated blood stream infection (CLABSI). The risk is greater when the central intravenous line is in place for a longer duration, prolonged use of antibiotics, parental nutrition, low birth weight infants, low immune system, and lack of staff education. Inserting a central intravenous line is a sterile procedure so it is a nurse’s responsibility to minimize the risk of infections. Health care-associated infections increase the length of hospitalization, hospital cost, patient discomfort, and morbidity and mortality rates (O'Grady & Pearson, 2002). Thus, it is important for health care professionals to be responsible for knowing their roles and using maximum sterile barriers while placing and caring for central venous catheters. According to the Agency for Healthcare and Research Quality (AHRQ), there are many practices healthcare professionals should follow to prevent CLABSI (Marschall, 2008). The use of maximum sterile barriers are one of the essential practices observed in a patient care scenario that occurred in the neonatal intensive care unit. Jenkins is a former 30 weeks-premature male infant born with respiratory distress and placed on a ventilator. He later developed bowel distention...
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...identify one example of descriptive statistics, identify one example of inferential statistics, explain data at each of the four levels of measurement and describe the advantages of accurate interpretation of statistical information to improve decision making. The purpose of infection prevention and control is to put into place policies and procedures that minimize the spread of infections, especially in the hospital setting. The primary function of infection prevention and control surveillance is to reduce the occurrence of infections by using risk factors and implementation of risk-risk reduction measures and the effectiveness of interventions (Centers for Disease Control, 2012). Central line associated blood stream infections, (CLABSI) and catheter related urinary tract...
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...Initiating Smart Goals Jennifer Clay Chamberlain School of Nursing Mary Thomas NR 447 Collaborative Health Care Introduction Smart goal #1; nursing will assess for appropriate use of indwelling catheters every shift in order to prevent CAUTI, nursing will obtain an order for discontinuation if no longer needed, this will be audited weekly in order to reach the goal of zero UTI’s on a monthly basis. This smart goal was developed to insure nursing is doing everything possible to prevent CAUTI. The goal steers toward patient safety and because Medicare and Medicaid do not reimburse for UTI’s acquired while hospitalized any longer. Smart goal #2; there will be 100% compliance in doing CVAD assessments, dressing changes, and the use of 70% isopropyl alcohol caps (CURO’s) in order to decrease the rate of CLABSI’s in the Medical-Surgical unit. This goal is to insure nursing is doing proper assessments, dressing changes, proper hand hygiene, using CURO’s caps and handling techniques in order to prevent contaminating the line. Goal 1: Preventing CAUTI Prevention of Hospital-acquired UTI’s should be a goal for every acute care setting to prevent the high cost of treatment, each episode of symptomatic CAUTI cost at least $600. It is not surprisingly the most common of health care associated infections accounting for about 40% of HAI’s. (Saint Et.al) This goal is to develop a way for nursing to assess the use of indwelling catheters and discontinue them if not needed to...
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...Introduction This paper explain the Accountability of a nursing professional based on an evidence report from Agency for Healthcare Research and Quality Assessment(AHRQ) , the report is " Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 6: Prevention of Healthcare–Associated Infections)" under the head Quality Improvement and Patient Safety What is Accountability? In Fundamentals of Nursing it says “The ability and willingness to assume responsibility for ones’ actions and accepting the consequences of one's behavior.” Accountability of nursing professional is a legal obligation; for a professional nurse it is relating to ethics and moral responsibility. Within the kingdom of professional accountability, there are many factors. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for nursing judgment and actions. A professional nurse has the responsibility to take decisions and practice within the scope of care, calling upon his/her information and skills to make judgments in favor of the patient. A professional nurse is accountable to their profession, their patients, employer, and other health care team members and to themselves. Nurses are accountable to provide safest care for their patient based on evidence based practice and safe nursing interventions. Nursing profession as a whole is build up on accountability, unselfishness, integrity and social justice. A professional...
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...of the following paper is to discuss the use of statistics within Mercy Medical Center located in Des Moines, Iowa by using examples and explanations of terms used in statistics such as descriptive and inferential statistics and the four levels of measurement. Within Mercy Medical Center, nursing care is centered around the use of evidence based research thus making it important to understand the basic use of statistics in evaluating research. Hospitals must monitor for the amount of infections which occur in various units continuously since an infection can adversly afffect a patients treatment and may possibly lead to death. One of the infections which can occur is central line acquired blood stream infections (CLABSI). The raw data that is gathered from CLABSI is an example of descriptive statistics. The term descriptive statistics is given to the analysis of data which helps to describe, show, or summarize data in a meaningful way so that patterns may emerge from the data making it easier to visualize the information (Lund Research, 2013). There are two types of statistics which are used to describe data, measures of central tendency and measures of spread. With measures of central tendency, this is a way of describing the central position of a frequency distribution for a collection of...
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...How Are Statistics Used in Your Workplace There are many uses for statistical application in the field of infection prevention and control. The purpose of infection prevention and control is to put into place policies and procedures that minimize the spread of infections, especially in the hospital setting. The primary function of infection prevention and control surveillance is to reduce the occurrence of infections by using risk factors and implementation of risk-risk reduction measures and the effectiveness of interventions (“Center for Disease Control”, 2012). Two examples of how statistics are utilized are the hospital-wide surveillance of central line associated blood stream infections (CLABSI) and catheter related urinary tract infections (CAUTI). Infection rates of CLABSI and CAUTI are reported to senior leadership on a monthly basis; if an increase in infection rates is noted...
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...control officer that did not exist before. And we have line care on our mind much more.” He credits nurses with doing most of the work, including training new unit staff and also the float nurses. “Doctors can be most involved in reducing line entries,” he says, “following the standard work orders to ask every day with every patient, what can we do to reduce line entries?” Before QTN: Limited Data, No Analysis As for data collection, a rigorous requirement of QTN, Hord admits, “Before joining, we did not have good ongoing data collection about line days in our inpatient unit, much less elsewhere. Now, we have built a system to track line days of our entire patient population anywhere.” When a central line-associated bloodstream infection (CLABSI) occurred, the unit did not have any particular follow-up, much less the root cause analysis required by QTN. “Now, when a positive culture comes back, the team receives an email notification, and nurses involved in the care of the patient are quickly interviewed,” says Hord. “Two or three days later, the team convenes for the root cause analysis, and we go through a checklist of questions.” He cites a case of a positive culture for a bone marrow transplant patient. These patients need to be bathed to get the chemo off their skin, so the infection could have been from a waterborne pathogen. During the root cause analysis, the question...
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...discussed at length, along with ways to improve the nurse’s role in support of the organization’s agenda. The first question asked was how important is the nurse’s role in clinical outcomes. Jennifer stated that the impact that a nurse has on clinical outcomes is “huge,” due to the fact that nurses are responsible for all patient outcomes. Care of the patient in the hospital usually begins and ends with the nurse. With public hospital reporting, the fact that nurses play an instrumental part in a hospital organization’s strategic agenda is very evident. Hospital boards are also looking into how nurses support the organization and how they can improve frontline nursing care in respect to core measures such as never events, falls, CLABSI (Central Line Blood Stream Infections) and all other nursing indicators. The next...
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...Change in Practice: Preventing Hospital Associated Infections April Shannon Walden University NURS 4000 Section 04, Research and Scholarship for Evidence-Based Practice November 18, 2012 Change in Practice: Preventing Hospital Associated Infections Benjamin Franklin was quoted as saying “an ounce of prevention is worth a pound of cure.” With the increasing costs of healthcare and the emergence of multi-drug resistant organisms this truth still resonates today. Hospital associated infections (HAIs), have been a complication in hospitals for many years. The purpose of this assignment is to address this problem in nursing practice, and discuss evidence on practices that will address this issue. The problem Hospital associated infections (HAIs) can be defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. An infection occurring in a patient in a hospital or other healthcare facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility (central line associated bloodstream infections, catheter associated urinary tract infections, surgical site infections, ventilator associated pneumonia, etc.) (World Health Organization, 2002). HAI’s have become one of the leading caused of hospital related deaths in the United States. However, these infections...
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...in which the hospitals service are putting patients at risk, because the data shows that the hospital are below the National Healthcare Safety Network in preventing bloodstream infections. Because rules have changed for reporting this sort of data from hospitals for reimbursement purposes, previous years could have yield more infections. There has not been strong reaction from the community that shows either of the two hospital admissions or patient seen, numbers dropping significantly. One hospital has changed its surveillance methodology and has become more aggressive in the hospital surveillance and investigative approach to central line bloodstream infections. The other hospital that is one of the first research institutions to show CLABSI could be prevented has implemented a 30-step grid for its medical staff and nurses to follow. Dr. Peter...
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