Central-line infections are common in intensive care units and due to their increased risk an exposure, they are life threatening and costly. Processes, for example, changing occlusive dressings, cleaning the site of insertion, as well as scrubbing the end caps before a nurse can access the line are some of the ways in which practitioners expose themselves to these infections. Since nurses working in the intensive care units are constantly exposed to the risk of central line infections, it is crucial to compare their practice of central line care to the best evidence-based practices available to ensure that patients and staff are protected from the infections. Central-line infections have resulted in thousands of deaths each year and have increased the cost of healthcare by billions of dollars. As such, …show more content…
this paper addresses the PICOT statement: Would newborn infants admitted to the Neonatal Intensive Care Unit have a decreased incidence of central-line infections if nurses utilized the central-line bundle protocols, which involve, hand hygiene, maximal barrier precautions, and chlorhexidine skin antisepsis, optimal catheter site selection, with subclavian vein as the preferred site for non-tunneled catheters in adults, daily review of line necessity with prompt removal of unnecessary lines, and line secure and dressing clean and intact as opposed to if the nurses deal with central lines without a protocol, during the stay at the Neonatal Intensive Care Unit? P- Newborn infants admitted to the Neonatal Intensive Care Unit I-Use of central-line bundle protocol C- No protocol, individual basis O- Decreased incidence of central-line infections T- The stay at the Neonatal Intensive Care Unit? Due to the prevalence of central-line infections, many people question the nursing practice regarding the way nurses handle, maintain, and monitor patients with central lines.
Therefore, implementing evidence-based knowledge focused on arriving at positive goals for better patient outcomes should be a priority. Additionally, if nurses are to decrease the incidences of central-line infections, then hospitals need to be focused on prevention through clinical reasoning and preventive action. It is the responsibility of nursing care to provide the best care possible and to follow infection control standards. To prevent central-line infections, nursing practitioners should implement the central-line bundle. The bundle involves five elements, which are; hand hygiene, proper cleaning prep, site selection, sterile barriers, and continuous monitoring, which have been recommended and supported by various federal agencies, for example, the Society for Healthcare Epidemiology of America, SHEA and the Centers for Diseases Control and Prevention, CDC. The bundle has been implemented in nationwide hospital intensive care units with commendable success from 38 percent to 71
percent. Preventing the introduction of bacteria that cause central-line infections in neonatal intensive care units through proper care and implementation of the bundle should be the goal of every health care practitioner. Therefore, thorough monitoring and maintenance recommended with the central-line bundle for neonatal intensive care units must be implemented outside the units as well. Studies have indicated that nearly all hospital-acquired infections are preventable when nursing staff strictly apply the recommended preventive measures. Preventive intervention practices exceed the central-line bundle by using a committed multi-disciplinary team for the neonatal intensive care units. As such, establishing a dedicated team to perform stringent surveillance throughout the entire hospital would be essential in providing data collection of maintenance compliance. This maintenance compliance would involve proper dressing changes and daily review of line necessity.
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
A study conducted by the Centers for Disease Control and Prevention shows that “annually approximately 1.7 million hospitalized patients acquire infections while being treated for other medical conditions, and more than 98,000 of these patients will die as a result of their acquired infection” (Cimiotti et al., 2012, p. 486). It was suggested that nursing burnout has been linked to suboptimal patient care and patient dissatisfaction. Also, the study shows that if the percentage of nurses with high burnout could be reduced to 10% from an average of 30%, approximately five thousand infections would be prevented (Cimiotti et al., 2012). In summary, increasing nursing staffing and reduction burnout in RNs is a promising strategy to help control urinary and surgical infections in acute care facilities (Cimiotti et al.,
The focus of health care is and has always been, practicing good hygiene, living a healthy lifestyle, and having a positive attitude reduces the chance of getting ill. Although there is not much prevention we can take for some of the diseases but we can certainly practice good hand hygiene to prevent infection and its ill effects. Research proves that hand washing is surely the most easy and effective way to prevent infection in health care. The question for this research: Is Hand washing an effective way to prevent infection in health care? It led to the conclusion that due to the high acuity, high patient: staff ratio, and lack of re evaluation certain units in the health care facilities cannot adhere to correct hand washing guidelines. Hand
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
The role of nurses in the prevention of MRSA in the hospitals cannot be overemphasized. The prevalence of MRSA in hospitals calls for awareness and sensitization of all party involved in patient caregiving in the hospital. According to Wilkinson and Treas (2011), nurses take on many roles in the hospital: a caregiver, advocate, communicator, leader, manager counsellor, change agent and an educator. (Wilkinson &Treas. (2011) p.13.) The target of healthy people 2020 is to reduce MRSA and all other hospital acquired infection by 75% in the year 2020. (Healthy people 2020) This cannot be achieved without the maximum support of nurses because nurses have regular one on one contact with patients on daily basis.This paper will take a closer look at the role of a nurse as an educator in the prevention of MRSA in the hospital. One of the nurse’s roles in the prevention of MRSA in hospitals is patient/visitor/staff education.
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20 Haugen, N., Galura, S., & Ulrich, S. P. (2011). Ulrich & Canale's nursing care planning guides: Prioritization, delegation, and critical thinking. Maryland Heights, Mo. : Saunders/Elsevier.
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare
The IC Model will be designed to prepare nurse faculty to teach clinical staff the fundamental principles of IPC focusing on the chain of infection (COI), transmission routes, standard precautions, transmission-based precautions, donning/doffing of personal protective equipment (PPE), and post-exposure management (PEM) procedures. The purpose of the IC Model is to provide faculty a comprehensive overview of IPC strategies based upon scientific evidence, which can be incorporate...
In addition, healthcare workers’ handwashing technique differs from the one you use at home. It is “important that all surfaces of the hands are cleaned thoroughly to dislodge and wash away pathogens” (Burton & Ludwig, 2015, pg. 261). The spread of pathogens in a healthcare setting happens with high likelihood. Therefore, it is imperative to wash one’s hands in the following situations. First, upon entering the patient’s room, secondly, anytime your hands are visibly dirty, third, between caring for two patients in the same room, forth, immediately after removing your gloves, and finally after touching body fluids, secretions, excretions, or contaminated