Clabsum Caps Essay

Catheter related bloodstream infections are not only responsible for prolonged hospital stays and increased hospital costs, it is also responsible for increased mortality of the hospitalized patients. According to Centers for Disease Control and Prevention (2017), an estimate of 30,100 central line-associated bloodstream infections (CLABSI) occur in intensive care units and wards of U.S. acute care facilities each year. CLABSI is a serious hospital-acquired infection that occurs when bacteria enters the bloodstream through central venous catheters. CLABSI is preventable as long as health-care personnel practice aseptic techniques when working with the catheter. A blood culture swabbed from the tip of the catheter is needed to confirm the

1) Summary of Article: Indwelling catheter use is common, but so are infections associated with them. About 80 percent of all urinary tract infections in hospitals are caused by catheters, and about 20 percent of all hospital infections total are UTIs. Evidence-based practice should be used for insertion, maintenance, and removal. Catheters should not be left in longer than they need to be. Unfortunately, this research shows poor administrative efforts are to blame for

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

Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end of the year, measured by the quality department on a monthly basis, and implemented through performance improvement factors including the interdisciplinary team through a strong focus on the nursing leadership team.

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.

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.

One of the ways to combat the incidence of Central Line Associated Bloodstream Infection (CLABSI) is by following the proper steps in Central Line Dressing changes. The topic you picked is an important one, both for patients and our overall health care system as well. If nurses will learn, and follow the proper manner in the way Central Venous Lines should be changed it can have a positive outcome for patients. CLABSI can be fatal to the patient, this can devastate the patient's family as well. “Although a 46% decrease in CLABSIs has occurred in hospitals across the U.S. from 2008-2013, an estimated 30,100 central line-associated bloodstream infections (CLABSI) still occur in intensive care units and wards of U.S. acute care facilities each

The purpose of this initiative is to decrease and/or eliminate central line-associated bloodstream infections (CLABSI) in the neonatal intensive care unit (NICU) at Aurora Bay Care Medical Center. Hospital acquired infections, including CLABSI, is a major cause of mortality, prolonged hospitalization, and extra costs for NICU patients (Stevens & Schulman, 2012). The goal of this initiative is to decrease CLABSI by 75% by reducing the number of days lines are in and standardizing the insertion process and line maintenance.

The IC department performs about 20 reviews a quarter utilizing the Bloodstream surveillance checklist tool to monitor for PICC/Central Line compliance. Hand sanitizer rewards are now being given to staff that has 100% in the process measure to increase CLABSI compliance. Our facility is engaged in the Hospital Improvement and Innovative Network (HIIN) formerly the Maryland-Virginia HAI Improvement Network is the hospital-wide collaborative to reduce CLABSIs. This 5-year initiative is an affiliation of the Medicare Quality Innovation Network Quality Improvement Organization for Maryland and Virginia, through Centers for Medicare & Medicaid Services (CMS). The initiative offers support efforts to improve health care quality and achieve

National Patient Safety Goals (NPSGs) were established in 2002 by the Joint Commission to help accredited organizations address specific areas of concern in regard to patient safety ("Catheter-Associated," 2015). NPSG.07.06.01 Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission," 2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing our CAUTIs can be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.

A two-year program called On the CUSP: Stop BSI was formulated in 2008 to prevent CLABSIs in hospitals nationwide and was organized as a state or region-level collaborative with centralized education, data collection, and program management functions (AHRQ, 2012). More than 1,000 hospitals and 1,800 hospital units, representing a total of 44 states, the District of Columbia, and Puerto Rico, participated in the program (AHRQ, 2012). The program structure included three main components: (1) a model to translate evidence into practice at the bedside to prevent CLABSIs; (2) the CUSP to improve the safety culture; and (3) a system to measure and report infection data (Sawyer et al., 2010). Results of the program revealed success in reducing CLABSIs nationwide by 41% from a baseline of 1.915 infections per 1,000 line days to a rate of 1.133 infections (AHRQ, 2012). With the nationwide success of the On the CUSP: Stop BSI program (AHRQ, 2012), the state of Hawaii embarked on their own study to determine if a national ICU collaborative to reduce CLABSIs would succeed in the state (Lin et al., 2012). The study, which began in January 2009 and ended in December 2010, included the CUSP, a multifaceted intervention approach to CLABSI prevention, and infection rate monitoring (Lin et al., 2012). Data was collected and reported from 20 ICUs representing 16 hospitals across the state (Lin et al., 2012). The results revealed the overall mean 9statewide CLABSI rates decreased 61% from 1.5 infections per 1,000 catheter days at baseline to 0.6 at 16 to 18 months post-implementation of the project, reinforcing the evidence that the On the CUSP: Stop BSI program can succeed in other states and substantially reduce CLABSI rates in hospitals (Lin et al., 2012). The success of the initial Hawaii study was the catalyst to conduct a second study in the state. This cohort study continued the national On the CUSP: Stop BSI program interventions, extended

Central line associated blood stream infection, better known as CLABSI, are on a continual rise in critical patients. CLABSI are implemented to help improve vascular access in patients where venous access is minimal or reduced. They help to maintain intraveneous access to deliver medications to the body and in case of emergency. Central lines are not given to every patient admitted into the hospital, only those who are critical. The purpose of this paper is to provide reasoning and evidence behind my research strategy for this particular topic. In the critical populations, how does not using chlorhexidine containing dressing compare to using the dressings influence the central line associated blood stream infection rates over two years.

UCDMC has dropped from an “A” grade to a “B” grade starting in the Fall of 2016 to present because infection prevention performance has fallen below average (LeapFrog Group, 2017). The infection report from LeapFrog corresponds with the SNI’s infection report for 2016 and 2017. Numerous CAUTI occur in the hospital nationwide each year and costs approximately $250 million (Agency for healthcare Research and Quality [AHRQ], 2016). CAUTIs are preventable and can

The Quality Improvement nursing process that I have chosen to research is patient safety. I have chosen to focus specifically on the topic of catheter associated urinary tract infections (CAUTI’s) during hospitalization and their preventions. It is estimated that 15-25% of hospitalized patients receive a urinary catheter throughout their stay, whether or not they need it. A large 80% of all patients diagnosed with a urinary tract infection (UTI) can be attributed to a catheter (Bernard, Hunter, and Moore, 2012). The bacteria may gain entry into the bladder during insertion of the catheter, during manipulation of the catheter or drainage system, around the catheter, and after removal.

Nurses should also have patients demonstrate hand washing technique. Teaching patients about infusion therapy and how to avoid the risk of intravenous infection will help calm their fears and decrease their risks of obtaining an infection. Technology today can help by having patients either record a video of the steps on their smart phone or by writing the steps down. This can decrease patient’s anxiety and stress while increasing confidence. While this topic has been around for many years, both medical professionals and patients need to be educated and strict compliance needs to be followed in order to avoid intravenous and central line infections. Further research is needed in order to discover additional ways of decreasing intravenous and central line infections in the home