Evidence Based Practice Project Reflective Report

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

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.

Rheumatoid Arthritis has been subject of numerous studies and researches in the look for a better understanding of how it effects the individuals diagnosed with it. There is a higher incident of females diagnosed with RA than male as well as a relationship with genetic and environmental factors involved. Around one percent of the world population is affected by RA; therefore, diverse studies have been performed to understand how the lives of the diagnosed patients can be impacted by the disease. For example, how RA affects the mobility, safety and activities of daily living in general as well as the development of interventions to better approach RA. On

Central line bundle is a group of evidence-based practice strategy for patient with central catheters, when implemented together, produce better outcomes than implemented individually (Institute of health care improvement, 2010.). The main elements of central line bundle are hand hygiene, maximal barrier precaution upon insertion, Chlorhexidine skin antisepsis, optimal catheter selection, and daily review of line necessity with prompt removal of unnecessary lines Aseptic technique when using and caring for a central line catheter can decrease the chance of contamination in this critically ill infants. Staff education on adherence to aseptic technique and strict central line care guidelines are essential to decreasing bloodstream infections.

This essay aims to explore the importance of utilising evidence based care while working with clients and other health care providers to form a professional and reliable nursing team. This essay also aims to focus and evaluate a qualitative article entitled “Patient experiences of bladder problems following stroke” selected from the Nursing Standard. The assignment will adopt a systematic approach to expose the strengths and weaknesses of the chosen qualitative research article. I found this topic quite intriguing after undertaking a clinical placement in a stroke unit and learnt that many people suffered in silence as they found urinary incontinence embarrassing to live with as

I work in ICU unit as a registered nurse, where we provide care for patients with life threatening medical conditions. Working in ICU require a careful assessment and monitoring of patient progress in order to dictate sudden changes in the patients’ medical condition that might require emergency intervention. Evidence base practice is very important for our daily patient care. According the article published for the April issue of the journal critical care nurse, it encourages nurses to critically evaluate and apply evidence to daily practice to improve patient outcomes and to stop using practice intervention that are based solely on tradition. “It is well established that evidence-based practice (EBP) is associated with higher quality care

This article is about transplant nurse role in research evidence based practice in nursing care. Transplant nurses should practice transplant nursing that is based on evidence. Institute of medicine reported that by 2020, 90% of clinical decisions should be based on evidence, but today 12% to 14% clinical decisions are only based on evidence. Pravikoff and colleagues surveyed 3000 nurses in United States with a 37% response rate .Fifty-eight percent of responding nurses had never used research to support their practice and 46% had never heard of evidence-based practice.77% of those nurses did not know how to search computer for research literature and 82% had never used hospital library.

Evidence based practice (EBP) models evolved as a result of the need for nurses to have guidance on diffusing the use of research knowledge into practice.

Berenholtz, S. M., Lubomski, L. H., Weeks, K., Goeschel, C. A., Marsteller, J. A., Pham, J. C., . . . Hines, S. C. (2014). Eliminating central line-associated bloodstream infections: A national patient safety imperative. Infection Control & Hospital Epidemiology, 35(1), 56-62. doi:10.1086/674384

The prevention and elimination of CLABSI in hospitals, specially in critical care units, have being a problem for many years. New research and strategies have been performed, however, CLABSI rates have remained at unacceptable levels. The purpose of this research is to demonstrate that the use of an antimicrobial PICC will decrease the incidence of PICC-associated CLABSI rate for the acute and critical care environments of hospitals. On 2014, “The Influence of an Antimicrobial Peripherally Inserted Central Catheter on Central Line-Associated Bloodstream Infections in a Hospital Environment” by Glenell S. Rutkoff, MSN, RN, CGRN, was published on JAVA on 2014.

PICO Question: How does the elimination of soda beverages in diet influence children 's BMI with diagnosed obesity?

I reflected upon which experience to use in meeting my learning objectives while engaging with patients. Therefore, I identified supporting Margaret with her personal care as one of my learning objectives. I then discussed this with my mentor who agreed to support me with this.

Each clinical day, I am constantly thinking about what is evidence based; what have I learned for lecture. To be honest, I never thought I would be thinking so much about evidence based practice, but I feel it’s essential that each and every single one of my patients gets the best possible care that they deserve. Some ways that I’ve incorporated EVP into my clinical is having discussions with employees about the correct needle length size, observing employees do certain procedure and reflect back, as well as, if I see something that doesn’t seem right, I’ll ask the nurse a question. For example, the nurse and I were doing a postpartum assessment and I noticed when the nurse was assessing the patient’s lochia, that she didn’t have the patient turn to see if any blood was pooled under her.

The author of this paper is asked to offer reflective evidence on a number subjects covered during the class for which this assignment is being completed. The subjects of the reflective evidence include the consultancy pitch assessment and at least two of formative assessment opportunities done throughout the year including CV development, mock interviews, mock presentations and peer review of pitches.