Post an explanation of how you could apply key interventions supported by the scholarly research evidence to potentially help resolve the issue in measurable ways.

. Continue to  collaborate with the selected individuals in your practice environment  as needed in the development of the Practice Experience Project, and  share this information with your group.

Post an explanation of how you could apply key interventions supported by the scholarly research evidence to potentially help resolve the issue in measurable ways. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practicum Project, and share this information with your group.

CLABSI is a serious infection that occurs when bacteria or viruses enter the bloodstream through the central line (Healthcare). These lines are very common to see in an intensive care unit, which is the setting that I currently work in. The following interventions at our facility have helped decrease the CLABSIs rate for central lines; weekly dressing changes, changing a soiled or dirty dressing dressing, proper use of curos caps, maintaining sterile dressing changes and the removal of the line when it is no longer necessary or removal on the day it expires. Hand hygiene is the utmost important role that should continuously be provided in order to prevent CLABSIs. A before-and-after study showed how education on hand hygiene has decreased CLABSI from 3.9 per 1,000 catheter day to 1.0 per 1,000 catheters day (Chopra). I definitely believe that the use of curos caps have helped tremendously in reducing infections. Curos caps contain a 70% idoptopyl alcohol (IPA) saturated sponge that scrubs the valve’s surface and bathes the connector in IPA, eliminating disinfection technique variability and killing organisms that are associated with catheter related bloodstream infections (Cantrell, 2013). Cantrell explains how a studies done by the BYU college of Nursing found that CLABSIs rates were significantly decreases, blood-culture contaminations rates showed moderate decrease, and an impressive net cost saving of $683,030 with the use of curos caps (Cantrell). A simple intervention of the use of curos caps on all hubs when a central line is in place could potential save a hospital a lot of money to avoid the risk of obtaining a CLABSI. However, it is important that those using the curos caps are educated on the proper use of them. Nurses are known to be lazy and take short cuts, but nurses really need to make the time to do the proper job for the patients.

I’ve also stressed upon educating and how important it is for the patient. However, I also believe that educating healthcare personnel to become more aware of the indications for catheter use, proper maintenance, and appropriate infection control measures to prevent any catheter-related infection is very imperative. Occasionally, healthcare providers should demonstrate competent management of accessing central venous catheters along with proper dressing changes. These demonstrations should consist of proper knowledge and adherence to guidelines when caring for a CVC. While preforming dressing changes, maximal sterile precautions should always be utilized. Dressings should be changed if it becomes damp, loosened, or visibly soiled. Dressings should be changed at least every seven days. The necessity for CVCs should be assessed daily and promptly removed when the site is no longer essential. According to Wilder, Wall, Haggard, and Epperson (2016) a line-rounding audit tool promoted to track the number of daily central lines, reasons for dressing change recommendations and plans for central line removal. Continual education of healthcare workers, patients and family members has been shown to decrease the incidence of CLABSIs in CVC (Wilder el al, 2016). Educating staff of the importance the removal of these lines when they are no longer required is very important to the patient’s overall health.

If these steps were taken serious by health care workers and everyone truly provided appropriate care to central line catheters, I strongly believe that the rate of CLABSIs could potentially decrease tremendously. Developing unit strategies and support systems for nurses is imperative in order to minimize the risk of an undesirable encounter. To see if CLABSIs are being decreased, recordings should be posted and/or announced for the work area/unit, listing the last day a CLABSI occurred followed by the implementation of ways CLABSIs can be prevented. As days, weeks, and/or months pass, if the correct procedures are being followed there should be no occurrences.

References:

Cantrell, S. (2013). Is science behind patient safety device selection?. Healthcare Purchasing News, 37(3), 40-46.

Chopra, Vineet. “Prevention of Central Line-Associated Bloodstream Infections: Brief Update Review.” Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. U.S. National Library of Medicine, n.d. Web. 06 June 2017

“Healthcare-associated Infections.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 01 Apr. 2010. Web. 01 June 2017.

Wilder, K. A., Wall, B., Haggard, D., & Epperson, T. (2016). CLABSI Reduction Strategy: A Systematic Central Line Quality Improvement Initiative Integrating Line-Rounding Principles and a Team Approach. Advances In Neonatal Care (Lippincott Williams & Wilkins), 16(3), 170-177. doi:10.1097/ANC.0000000000000259

 

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