...Preventing Central Line Associated Bloodstream Infections Angie 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)...
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...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 nurse who take decisions and practice on the basis of those ethical values will always be in favor of the patient, no matter what is his/her professional level. Methods The Healthcare-associated infections. In a patient care situation as a...
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...Executive Summary - Infection Control and Prevention Current Compliance Status for Joint Commission Accreditation Nightingale Community Hospital is committed to providing healthcare excellence, a healing environment and to be the choice for patient care. In order to continue to provide quality healthcare services in accordance with our values of safety, community, teamwork, and accountability Joint Commission Accreditation provides guidelines and standards for the Priority Focus Areas (PFA) for the welfare and quality of patient care. Infection control and prevention extends beyond treating the patient. It encompasses all who work and visit the facility including medical staff, administrative staff, volunteers, vendors, and visitors. Implementing activities and programs to control, treat, prevent and identify sources of infection will help ensure the overall satisfaction and quality of patient care. Based on previous fiscal year data Joint Commission has identified Infection Control as one of the PFAs. In order to be in compliance with the standards and guidelines of Joint Commission Accreditation five areas of Infection Control and Prevention have been identified: 1. The hospital implements its infection prevention and control activities, including surveillance, to minimize, reduce, or eliminate the risk of infection. 2. Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization...
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...This chapter presents the results of a Qualitative Analysis of Central and Midline care in Medical/Surgical setting. The key words for the study are central line bloodstream, infection, medical-surgical, phenomenology and qualitative. The study identified medical-surgical nurses having a limited understanding of the complexities involved in the prevention of central line-associated bloodstream infections (CLABSIs). The study was conducted to thoroughly look at the phenomenon of central line care to develop an understanding of the experience as relates to nursing care. The design that was applied for this particular study is a qualitative phenomenological framework. This design was preferred due to the amass of information, which was necessary if a diversified range of response was to be obtained. Through the use of this design, respondents would be free to express their experiences without being restricted to yes or no questions. According to Morrison, it was the best design to be applied for a study of this nature considering the sensitivity of the phenomenon under study. The setting takes place in a seasonally fluctuating 400-600 bed community hospital located in Southwest Florida. To increase reliability of results, the researchers in this study decided on this particular hospital with a purpose of obtaining information during times when there were many patients in the hospital and times when there were few patients in the hospital. A sample of 15 full-time, medical-surgical...
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...Running head: HOSPITAL ACQUIRED INFECTIONS, EMERGENCY DEPARTMENT Hospital Acquired Infections XXXXXXXXXX Grand Canyon University Family-Centered Health Promotion NRS-429V Laura Campbell August 25, 2012 Emergency department (ED) nurses save lives every day by utilizing their skills and knowledge to assist the physician in providing emergent care to patients who arrive via ambulance or by private auto. Nurses are aware of their responsibilities to respond to the patient's needs quickly and efficiently to provide life-saving interventions and care. However, are ED nurses aware that they contribute directly and indirectly to a large percentage of patient's demise through the insertion of foley catheters, peripheral intravenous starts, and other invasive procedures. Their carelessness may have serious consequences for a patient during their hospital stay due to a hospital acquired infection that may cause a urinary tract infection, a phlebitis or a bloodstream infection that may be resistant to the usual antibiotics used. According to Hillary Mitchell, RN, the most important step that the ED nurses can make is to realize that they are in control of making or breaking the infection pattern for the patient. In an article published in the ED Nursing Journal in February 2010, Will your next emergency patient obtain a hospital acquired infection?, many clinical guidelines are given in order to promote infection prevention by the ED nurses as well acting...
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...Reducing Central Venous Line Infection Eileen D. Ibanez Medical Careers Institute Introduction Central venous access devices are used to administer chemotherapy, long-term antibiotics, parenteral nutrition, fluids and blood transfusion therapy. It is used for treatment of patients requiring long-term treatment for various health care disorders (WebMd, n.d.). Central venous catheters can also increase the risk of hospital-acquired bloodstream infections, which in turn will increase the length of hospital stay, total costs of care and risk of mortality (Hatler, Buckwald, Salas-Allison & Murphy-Taylor, 2009). The lack of use in consistent protocols for central venous access devices accrue an approximately 250,000 bloodstream infections in U.S hospitals yearly (Hatler et al., 2009). An estimated 90,000 deaths a year result from these bloodstream infections associated with intravascular catheters (Hatler et al., 2009). The health care system averages $25,000 to $40,000 per incidence (Mathers, 2011). The identification of proper and/or improper practice and application of evidence-based practice protocols is essential to keeping catheter patency and prevention of infections. Definition of Topic Stated by the authors of Evidence-based Practice to Reduce Central Line Infections, “a catheter related blood stream infection is defined as a positive blood culture with clinical or microbiologic evidence that strongly implicates the catheter as the source of infection” (Render et...
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...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 have been proven to be...
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...Nosocomial central line bloodstream infections are becoming one of the lead causes of death within hospitals (Smith, Egger, Franklin, Harbrecht & Richardson, 2011, p.1038). A blood stream infection is defined as having a positive blood culture while central venous access is in place without any further evidence of infection related to the patient’s comorbidities (Smith, et al., p. 1038). Organisms that are known to cause these infections include staphylococcus aureus and enterobacteriaceal (Curry, Honeycutt, Goins & Gilliam, 2009, p.151). It is concluded that one in ten patients experience an adverse event such as a central line bloodstream infection during their stay at the hospital (McPeake, Cantwell, Malcolm & Malcolm, 2012, p. 123). Furthermore, it has also been researched that over fifty percent of those cases could have been avoided if there were increased patient safety processes that were followed strictly and routinely evaluated for effectiveness (McPeake, et al., p. 123). Recent changes in government and insurance reimbursement suggests the elimination of payment for central line bloodstream infections especially when proven to be obtained during their hospital stay (Duane, Brown, Borchers, Wolfe, Malhotra, Aboutanos & Ivatury, 2009, p.1166). Hospital charges for central line infections increase the cost of stay nearly threefold (Duane, et al, p. 1166). The invasive nature of the catheters insertion predisposes patients to infection and it is healthcare...
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...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 prevent CAUTI. Peer Reviewed Article Translating Health Care- Associated Urinary Tract Infection Prevention Research into Practice via the Bladder Bundle, an article from the US National Library of Medicine National Institutes of Health focuses on preventing CAUTI by continual assessment and removal of catheter as soon as possible, especially if the use of it is not clearly indicated. This...
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...Catheter-Associated Bloodstream Infection Surveillance Variability Kochurani Thomas Grand Canyon University NRS-433V May 1, 2011 Bloodstream infections are the most common hospital-associated infection (HAI) in intensive care units (ICU) and a significant source of in-hospital deaths, increased length of stay and added medical costs. Both adult and pediatric patients who have catheters inserted into their blood vessels face increased risk of an infection developing along the invasive plastic devices which can become life-threatening as they spread into the bloodstream. According to Centers for Disease Control and Prevention (CDC), an estimated 248,000 blood stream infections are reported per year (CDC, June 2010), and mortality rate of 12%-25 %( CDC, 2011) .This dangerous lethal medical complication can be prevented by proper management of the catheter insertion and strict aseptic technique during care. Even though CDC has recommended standard catheter associated blood stream infections (CA-BSI) prevention strategies, the study shows areas of variability in the surveillance. A central line is an intravascular catheter that terminates at or close to the heart or in one of the great vessels which is used for infusion, withdrawal of blood, or hemodynamic monitoring. The Aorta, pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic veins, internal jugular veins, subclavian veins, external iliac veins, common iliac veins, common femoral veins...
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...a specific department identified as infection prevention or infection control. Infection control/prevention uses research and statistics to facilitate standardized care by implementing best practice measures through evidenced based practice. “Statistical information that is gathered is then used to help compare present and past performance, as a guide for planning future development, appraisal of work performed by healthcare staff, hospital or clinic finding, and research ( International Federation of Health Information Management Associations, 2012). The purpose of this assignment is to identify how statistics are utilized within the infection control and prevention department at Sierra View Medical Center, 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...
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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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...The Centers for Disease Control and Prevention estimate that approximately 1.7 million hospitalized patients acquire infections while being treated for other medical conditions. In 2011, there were an estimated 722,000 hospital acquired infections (HAIs) in United States Acute Care Hospitals. Additionally, about 75,000 patients with hospital acquired infections died during their hospitalization (CDC, 2018). (Note: To ensure consistency, we will use HAIs when referring to nosocomial infections, please refer to the definition section for further understanding of the terms) More than half of all the incidents occurred within the intensive care unit. HAIs can be associated with the devices used in medical procedures, such as central line-associated...
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...Diversity MRSA infections can affect anyone of any age, race, culture, and socio-economic status. However there is a higher incidence in people in areas of poverty, mainly because of poor hygiene practices and people over 65 years of age. High risk venue can include gyms, correctional facilities, and anywhere conditions exist that include close skin to skin contact, people with poor hygiene, and overcrowded living conditions (CDC, 2010). Treatments The treatment for skin infections is drainage of wounds with purulent drainage as well as antimicrobial medications. Obtaining wound and blood cultures are recommended to ensure proper antimicrobial therapy. It is also very important to teach patients not to attempt to drain wounds themselves, and to return if the infection worsens without improvement over 48 hours after treatment is started. As a health care provider it is your responsibility to be familiar with MRSA. Educating the community as well as the patients you treat is the key to prevention. * Proper hand washing techniques. * Avoid contact with other people’s wounds such as skin to skin contact and towels. * Disinfect all exercise equipment before use. * Only prescribing necessary antimicrobials. * Teaching patients to wash clothes in warm or hot water as well as drying clothes in a dryer and not air drying because heat kill bacteria. If you want more information you should contact Centers for Disease Control and Prevention 1600 CliftonRd...
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...resource team aimed at keeping all patients safe throughout the course of their hospitalization. This paper will identify how statistics are utilized in the infection prevention setting, 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 in the workplace. 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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