Neonatal Intensive Care Unit Analysis

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.

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.

My anticipated careee field after college is to work as a neonatal nurse practitioner. My plan is to go to Coloumbus state university and acquire my nursing degree. To eran a residereed nurse degree you must complete a 4 year degree. Due to taking dual enrollement classes in high school I should finish in less than 3. The I will transfer to Emory University or Berry College to get my nurse practitioner degree in approximately 2-4 years. Becoming a Neonatal Nurse Practitioner a person must have RN licensures and state authority for advanced practice. They must also have 2-4 years of experience in he feild or related area. The applicant must be familiar with advanced concepts, practices and proceedurs within the chosed field. Nurse practitioners

After earning his doctor of medicine from the Medical College of Georgia, Dr. Allen Cherer undertook an internship and a residency in pediatrics through the University of Louisville School of Medicine/Kosair Children's Hospital. He holds certification through the American Board of Pediatrics and the Sub-Board of Neonatal-Perinatal Medicine. Dr. Allen Cherer is also official educational provider through the Neonatal Resuscitation Program (NRP).

Healthcare-associated infections from invasive medical devices are linked to high morbidity, mortality, and costs worldwide. Especially in central line–associated bloodstream infection (CLABSI) or catheter-related bloodstream infection (CRBSI) and

Cross-contamination of newborns must be prevented because they are at risk for infection during their first couple months of life. Their immune system is immature. In the nursery, individual bassinets are provided that have a thermometer, diapers, t-shirts, and bathing supplies for that bassinet. All persons who care for the newborn should scrub first with a microbial soap prior to entering the

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.

Implementation of patient care practices for infection control is the role of the nursing staff. Nurses are responsible for maintaining hygiene, consistent with hospital policies and good nursing practice on the ward and monitoring aseptic techniques, including hand-washing and use of isolation. It is also in their scope of practice to promptly report to the attending physician any evidence of infection in patients under the nurse’s care and initiating patient isolation and ordering culture specimens from any patient showing signs of a communicable disease, when the physician is not immediately available. Limiting patient exposure to infections from visitors, hospital staff, other patients, or equipment used for diagnosis or treatment and maintaining

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

I am interested in pursuing a career in nursing. A career that really interests me is a neonatal intensive care nurse. This is a type of nurse that works in a neonatal intensive care unit. These nurses often work with infants who were born prematurely, born with birth defects, or infants who are having critical complications during the first month after birth. Infants in the neonatal intensive care unit require constant monitoring and are often being treated for life threatening diseases. According to The National Association of Neonatal Nurses (NANN) approximately 40,000 infants are born each year in the United States needing specialized NICU care. NICU nurses are always present when a baby is being delivered so they can provide immediate

National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is 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 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.

Catheter associated bloodstream infection (CRBSI) occurring in the neonatal intensive care unit (NICU) are frequent, complication related to it are potentially fatal and costly (Kim & Sandra, 2009). According to the center of disease control, an approximate of two hundred and fifty thousand cases of CRBSIs have been estimated to occur annually which cause health care to cost approximately twenty five thousand dollars per case, and between 500 to 4,000 patient die due to blood stream infection (CDC, 2002). Approximately 90 percent of blood stream infection occurs from central venous insertion (CVC). Even though CRBSI occurs from different ways, the most common source is contamination of the catheter by skin flora on insertion, skin flora

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.

Infants within the neonatal intensive care unit (NICU) are one of the most vulnerable patient population in the hospital. The quality and safety of these patients are at top priority because of their immune systems have not fully developed yet causing them to be at the highest risk for infections. According to the Institute of Medicine (IOM, 2001), quality is defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Masters, 2005). The Quality and Safety Education for Nurses (QSEN) defines safety as, “the minimization of risk of harm to patients and

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