CLABSI Reduction: Culture, Education and Evidence-Based Practice

Topics: Central venous catheter, Nursing, Best practice Pages: 17 (2802 words) Published: September 28, 2014


CLABSI Reduction: Culture, Education and Evidence Based Practice

June 29, 2014

Table of Contents
Abstract…………………………………………………………………………………………4 Introduction and Background…………………………………………………………………...5 Problem Statement………………………………………………………………………………5 Purpose Statement and Aims…………………………………………………………………….5 Research Questions and Hypothesis……………………………………………………………..6 Review of Literature with matrix………………………………………………………………………………………….6-12 Evidenced Based Practice Model…………………………………………………………………………………………….13 Study Design and Sampling Method…………………………………………………………….13

Setting and Study population…………………………………………………………….14
Sources of Data & Collection Method…………………………………………………...14
Data Analysis Plan……………………………………………………………………….14
Ethics and Human Subjects Protection…………………………………………………..14
Timeframe………………………………………………………………………………..14 Conclusion……………………………………………………………………………………….15 Personal Reflection………………………………………………………………………………15 References……………………………………………………………………………………….16

Abstract
Central venous catheters (CVCs) that are a result of central line blood stream infections (CLABSI) many times increase healthcare cost in regards to hospital hospital length of stay but most times result in poor patient outcomes. While CLABSI is one hundred percent preventable, it has been estimated that 250,000 cases of CLABSI are reported annually (Kusek 2012). The extended length of stay increases cost for each infection upwards of $36,000, totaling at least $9,000 annually (Clancy 2009). The key to CLABSI reduction does not involve a state of the art monitoring device, it is a very cost effective intervention/care process that is supported by evidence based practice (EBP). Prevention of CLABSI directly aligns with Patricia Brennar’s Novice to Expert Theory when implementing the use of central line bundle practices. The theory acknowledges that learning is based on the instructor’s awareness and planning of knowledge deficits and needs. The research shows that education is the first line of defense in prevention of CLABSI and that implementation depends on the culture, educational understanding and individual compliance to be effective.

Introduction and Background
Central venous catheters (CVCs) have become indispensable in healthcare today. CVCs are used for hemodynamic monitoring and dialysis, medication administration and also help to deliver total parenteral nutrition. Insertion of these catheters alter the skin integrity which is the body’s first line of defense for fighting infection. Central line blood stream infections (CLABSI) are known to be the most frequent cause of nosocomial infections (Han 2010). As nosocomial (hospital acquired) infections have become more commonly included in care sets that deem quality of care prevention and implementation of such interventions take on added significance. The risk factors for developing a CLABSI involve factors including but not limited to the device type, selection of insertion site consistent compliance to preventive measures. Bundling (evidence based practice) has been is the most common recommendation in CLABSI reduction/prevention methods, however education and safety culture drives implementation and consistency to care practices. Evidence based practices are as valuable as CLABSI reduction rates from their implementations, however, the ideal alone is not beneficial if the behavior, culture and education of the personnel remains the same (Kusek 2012). The Joint Commission of Healthcare Organizations has also listed CLABSI as a National Patient Safety Goal (NPSG) for hospitals under accreditation. Problem Statement

Central line associated blood stream infections (CLABSI) are the most frequent cause of infection in healthcare (Kusek 2012), these infections are significant in the increase of morbidity, mortality, length of hospital stay and healthcare cost. Researchers have shown that CLABSI is preventable and measures sets have been developed...

References: Clancy, C.M. (2009). Reducing Central Line-Related Infections. AORN-Association of perioperative Registered Nurses Journal, 89(6), 1123-1125. Retrieved from
Kusek, L., MPH, RN, CIC. (2012). Preventing Central Line-Associated Bloodstream Infections. Journal of Nursing Care Quality, 27(4), 283-287. doi: 10.1097/NCQ.0b013e31825733d1
Richardson, J., MS, RN, CNS-BC, CCRN, CNRN; Tjoelker, R., MS, RN, CNS-BC, CIC. (2010). Beyond the Central Line-Associated Bloodstream Infection Bundle: The Value of the Clinical Nurse Specialist in Continuing Evidence-Based practice Changes. Clinical Nurse Specialist, 26(4), 205-211. doi: 10.1097/NUR.0b013e31825aebab
Stevens, T.P., Schulman, J. (2012). Evidence-based approach to preventing central line-associated bloodstream infection in the NICU. ACTA PEDIATRICA, 11-16. doi: 10.111/j.1651-2227.2011.02547.x
Schmidt, N. and Brown, J. (2012).  Evidence-based practice for nurses: Appraisal and application of research (2nd ed.). Sudbury, MA: Jones & Bartlett LEARNING.
Cherifi., S, Gerard, M., Arias, S., Byl, B. (2013). A multi-center quasi-experimental study: impact of a central line infection control program using auditing and performance feedback in five Belgian intensive care units. Antimicrobial Resistance & Infection control. 2(33) doi: 10.1186/2047-2994-2-33. Retrieved from: http://aricjournal.com/content/2/1/33
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