Chg Dressings

In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were followed by the staff in the effort to reduce CAUTI. The six interventions included: “communication of CAUTI data to interdisciplinary teams, a nurse-driven, physician approved protocol, problem analysis using Lean principles, daily unit-based surveillance rounds, silver alloy urinary catheters, and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling urinary catheter” (Roser, Piercy & Altpeter, 2014). The nurse-physician protocol allowed for nurses to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014). An education session was implemented by nurses using principles from the Lean system that checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that no single intervention alone could reduce the occurrence of CAUTI development. Nurses must integrate several interventions to have an effective result at lowering the rates. However, this particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline. Roser et al. (2014) emphasized that education and awareness of

Getting an infection from improper care during or after insertion of a central line is the last thing you want to get while in the hospital. This paper will discuss Kaiser Permanente’s policy on central venous catheter, also known as a central line, care and dressing change, and whether it follows the current evidence-based practice on preventing bloodstream infection in patients who have them inserted. I will explain about what a central line is, why evidence-based practice is important in the clinical setting, what Kaiser Permanente’s policy about central line care and dressing change is, if Kaiser is currently following evidence-based practice based on current articles about preventing central line associated bloodstream infections (CLABSIs), and what my role in using evidence-based practice is as a future registered nurse.

Braden scale (Braden & Makelburts, 2005) use in hospitals allows nurses to identify patients at risk for pressure ulcer based on their sensory perception, mobility, activity, moisture and nutrition. Although the Braden scale is a useful tool but healthcare administrations has yet found the best method to eliminate pressure ulcers or bedsore in intensive care units. The use of foam dressing will be introduced to the intensive

Article by Clancy (2009) explained central lines were a result of an estimated 250,000 blood stream infections and accounted for 30,000 to 62,000 patient deaths, then adding that each infection cost upwards of $36,000 and cumulatively add up to at least $9 billion in preventable costs annually. The article also explains how the mindset has changed from the cost of having a central line in place and expecting complications to lowering infection rates by an intentional interventional process/s. The article speaks of 5 basic steps to reduce CLABSI, hand washing, insertion techniques, skin cleansing, avoidance of certain sites and earlier removal of the CVC. Studies showed that these guidelines were only followed 62% of the time. The system was changed to ascertain that all the clinicians were in compliance. This prompted 5 interventions, education, a CVC insertion cart with all necessary equipment, physicians having to validate central line necessity, a concise checklist for bedside clinicians and the empower of nurses to stop procedures if guidelines were not followed. These low cost interventions from 11.3/1000 in catheter days in 1998 to zero in the fourth quarter of 2002.

Franks, P. J., & Moody, M. (2007). Randomized trial of two foam dressings in the management

The perception then coming from that patient is that, they are at peace that they will not have to worry about “catching” another infection. Additionally, the nurse manager, supervisors and educators on the unit stress the use of these caps. These formal leaders on our floor are content to have seen the rates of CLABSI decline, and the last time they floor has seen as CLASBI was this past March. Subsequently, the nurses on the unit are all compliant with the use of the Curos™ cap. As they do not want to see their patients suffer any more than they already are, and the use of this intervention is fast and the results are great.

Critically ill neonates are at high risk for CRBSIs. Blood stream infections can occur from different point of entry, the most common source is contamination of the catheter by skin flora on insertion, skin flora contaminating the external catheter, hub or both. Implementing evidence based

Choosing a change model can be difficult for an organization. The company must ensure that the model it chooses will help them make the smoothest transition possible for everyone involved. The chosen change model must also help the company reach its goal within the time frame the company needs to have changes made.

The INTACT trial showed a significant reduction in pressure ulcers (PU) incidence in the intervention group at the hospital (cluster) level, but this difference was not significant at the

The first phase of this model is the preparation phase. In this phase, it is important to delineate the purpose and potential outcomes of the study. The research is searched, sorted and selected. It is important during this phase

In 2015, a review was conducted by Urological Nursing, regarding the bathing techniques implemented within the hospital to prevent CAUTIs. The study revealed that while using chlorohexidine wipes were fast, they actually did nothing to prevent CAUTI’s. Whereas, using soap and water resulted in lower incidence of infection. They even discovered that using the soap and water technique required less money, and is available in ready to use wipes. This can create the same timely effect that the chlorohexidine wipes did, minus the stinging

The National Pressure Ulcer Advisory Panel suggests emerging pressure ulcer prevention therapies which include prophylactic sacral dressing (PSD) application as an adjunct to nursing care (“Prevention and treatment of pressure ulcers”, 2014). Multiple studies have been completed on PSD use and have shown positive results. In a study by Byrne et al (2016), multiple factors place patients at risk for developing a pressure ulcer including low Braden scores indicating high risk and multi system involvement. The application of a PSD, resulted in a slightly greater than 50% decrease in pressure ulcer development (Byrne et al, 2016). In an article by Swafford, Culpepper, & Dunn, (2016), they completed a review of literature that showed

(2011) compared the effectiveness of the solicitation of CHG using a mouth swab to not swabbing the oral cavity and its relationship with VAP. In the study, 145 trauma patients were assigned randomly to either the 5 ml CHG group or the no care group. The results of the study were that only 33.3% of the patients in the CHG group developed VAP versus 55.6% of the no care group (Grap et al., 2011). The study concluded that in patients who are intubated for more than 48 hours, the early use of CHG was found to prevent VAP in the trauma patients (Grap et al., 2011). In another RCT, Munro et al. (2009) performed a study analyzing the use of CHG and usual care to perform oral care. The patients were randomly assigned and some received 5 ml of 0.12% CHG swabbing two times a day, and the other group received usual care. The groups were also compared to tooth brushing and tooth brushing with

The models of change that I have chosen to describe are the ADKAR model and Kotter’s 8 step change model. The ADKAR model is mainly used to help identify and drive change as well as a tool to understand any gaps that are needed to strengthen along the change process. It is also a useful framework for planning change within an organization, before implementation, and in the execution phase of the change management process. This process begins with five key goals that are the basis of the model; awareness of the need to change, desire to participate and support the change, knowledge of how to change, ability to implement the change on a daily basis, and reinforcement to keep the change in place. Each step in the ADKAR model

The independent variable for this proposed experiment is daily bathing with CHG impregnated washcloths and the dependent variable is the incidence of hospital-acquired bloodstream infections. Extraneous variables that may affect the dependent and independent variables include demographics, patient health history, healthcare personnel compliance of hand hygiene and contact precautions, incoming visitors, microorganism susceptibility to CHG, and patient’s length of stay.