Evidence Based Practice

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Discuss how evidence-based practice is applied in your practice setting and describe the desired patient outcome achieved through this approach. I worked for a dialysis clinic where I did acute and chronic hemodialysis. I preformed treatment in the hospital and in the clinic. Almost all acute patients had central lines and some of the chronic patients did as well due to fistulas and grafts occluding or getting infected or etc. Unfortunately evidence shows hemodialysis is the most common factor for contributing to bacteremia in patients. That is why fistulas and grafts are preferred over catheters in patients with CRF. Evidence based recommendations were given to us for preventing infections and decrease the number of patient with catheters. We had in-services to improve our knowledge on how to assess and care for central venous catheters. Areas of emphasis included using fistulas or graft instead when able, use barrier precautions when assessing and accessing site, use chlorhexidine for site disinfectant, promptly remove unnecessary CVC, and each patient having their own box containing all necessary supplies. We would have monthly statistics of catheters (infection, insertion, removal, and occlusion) in our clinic and we always had a goal we would try to meet each month. Following these guidelines our numbers did decrease each month for the most part. Of course there was always circumstance that could not be avoided. If you have ever worked in a dialysis facility things move rather quickly, you have to turn over the machines fast when patients are done to be able to get the next on. Many mistakes can be made if you are not careful.