...Preventing Central Line Associated Bloodstream Infections Angie Rees Grand Canyon University: NRS-433V March 28, 2015 Abstract Central line-associated bloodstream infection is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of, or within 48 hours, prior to the onset of symptoms and the infection is not related to an infection from another site. Central line-associated bloodstream infections (CLABSIs) occur when germs enter the bloodstream through a central line. A central line is a tube that is placed in a large vein to give fluids, blood, medications, or nutrition. CLABSI continues to be one of the most deadly and costly hospital-associated infections in the United States. Many lives have been saved in the past decade due to improvements. However, these infections continue to occur and more occur in other areas of the hospital outside of the ICU. One in four patients die with CLABSI complications. These serious infections usually cause a prolonged hospital stay with an increased cost. The average CLASBI cost an additional 0.6-2.7 billion every year. Some patients may be at higher risk for developing a CLABSI due to their length of hospitalization before catheterization, duration of catheterization, underlying medical conditions, location of catheter placement, or other factors. It is important that both the patient and the healthcare providers take the appropriate steps to help prevent an infection. Rutkoff, G. S. (2014)...
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...prevalence of catheter-related bloodstream infections in our hemodialysis clinic and to implement measures to reduce or prevent these infections. Catheter-related bloodstream infections create a cascade of potential serious health problems. These infections not only create a major challenge for the patient, but the health care professionals taking of the patient and subsequently the organization...
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...Prevention of Central Line Infections Kaitlin Kapple Walden University NURS 4000 Section 4, Evidence-Based Nursing Practice July 13, 2015 Prevention of Central Line Infections Central line catheters are widely used in healthcare to administer medications, fluids, blood products, and parental nutrition. There are over five million central line catheters placed in the United States a year (Bashir, 2012). With the large amount of central line catheters being placed, there is an increased risk of infection. Central line infections are a serious health condition and are the fourth most common type of hospital-acquired infection (Bashir, 2012). The purpose of this paper is to explain why central line infections occur and how nurses can prevent these infections. Practice Setting Problem Over ninety thousand central line infections occur each year in the United States. While many of these are treated, it is noted that twenty-five percent of these infections end in death (Bashir, 2012). Despite the noted decrease of central line infections in the United States, the Center of Disease Control states that the current rate of infection is approximately three infections per one thousand catheter days (Bashir, 2012). Central line catheters provide an entry point for bacteria to enter the body into a person’s bloodstream. This leaves patients at risk for local and systemic infections. Bloodstream infections from catheter infections one week after the central line was placed, has...
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...Catheter-Associated Bloodstream Infection Surveillance Variability Kochurani Thomas Grand Canyon University NRS-433V May 1, 2011 Bloodstream infections are the most common hospital-associated infection (HAI) in intensive care units (ICU) and a significant source of in-hospital deaths, increased length of stay and added medical costs. Both adult and pediatric patients who have catheters inserted into their blood vessels face increased risk of an infection developing along the invasive plastic devices which can become life-threatening as they spread into the bloodstream. According to Centers for Disease Control and Prevention (CDC), an estimated 248,000 blood stream infections are reported per year (CDC, June 2010), and mortality rate of 12%-25 %( CDC, 2011) .This dangerous lethal medical complication can be prevented by proper management of the catheter insertion and strict aseptic technique during care. Even though CDC has recommended standard catheter associated blood stream infections (CA-BSI) prevention strategies, the study shows areas of variability in the surveillance. A central line is an intravascular catheter that terminates at or close to the heart or in one of the great vessels which is used for infusion, withdrawal of blood, or hemodynamic monitoring. The Aorta, pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic veins, internal jugular veins, subclavian veins, external iliac veins, common iliac veins, common femoral veins...
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...Reducing Central Venous Line Infection Eileen D. Ibanez Medical Careers Institute Introduction Central venous access devices are used to administer chemotherapy, long-term antibiotics, parenteral nutrition, fluids and blood transfusion therapy. It is used for treatment of patients requiring long-term treatment for various health care disorders (WebMd, n.d.). Central venous catheters can also increase the risk of hospital-acquired bloodstream infections, which in turn will increase the length of hospital stay, total costs of care and risk of mortality (Hatler, Buckwald, Salas-Allison & Murphy-Taylor, 2009). The lack of use in consistent protocols for central venous access devices accrue an approximately 250,000 bloodstream infections in U.S hospitals yearly (Hatler et al., 2009). An estimated 90,000 deaths a year result from these bloodstream infections associated with intravascular catheters (Hatler et al., 2009). The health care system averages $25,000 to $40,000 per incidence (Mathers, 2011). The identification of proper and/or improper practice and application of evidence-based practice protocols is essential to keeping catheter patency and prevention of infections. Definition of Topic Stated by the authors of Evidence-based Practice to Reduce Central Line Infections, “a catheter related blood stream infection is defined as a positive blood culture with clinical or microbiologic evidence that strongly implicates the catheter as the source of infection” (Render et...
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...Approximately 2 million nosocomial infections occur annually in the United States. At least 90,000 deaths per year are a result, making nosocomial infections the fifth leading cause of death in acute-care hospitals. HAIs infections result in increasing morbidity, mortality, and cost as a result of increasing duration of stay , is estimated as estimated as 1 to 4 days for urinary tract infections, 7 to 8.2 days for surgical site infections, 7 to 21 days for bloodstream infections, and 6.8 to 30 days for pneumonia. The estimated mortalities associated with nosocomial bloodstream infections and pneumonia are 23.8% to 50% and 14.8% to 71% (overall), or 16.3% to 35% and 6.8% to 30% (attributable), respectively. The estimated average costs of...
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...This chapter presents the results of a Qualitative Analysis of Central and Midline care in Medical/Surgical setting. The key words for the study are central line bloodstream, infection, medical-surgical, phenomenology and qualitative. The study identified medical-surgical nurses having a limited understanding of the complexities involved in the prevention of central line-associated bloodstream infections (CLABSIs). The study was conducted to thoroughly look at the phenomenon of central line care to develop an understanding of the experience as relates to nursing care. The design that was applied for this particular study is a qualitative phenomenological framework. This design was preferred due to the amass of information, which was necessary if a diversified range of response was to be obtained. Through the use of this design, respondents would be free to express their experiences without being restricted to yes or no questions. According to Morrison, it was the best design to be applied for a study of this nature considering the sensitivity of the phenomenon under study. The setting takes place in a seasonally fluctuating 400-600 bed community hospital located in Southwest Florida. To increase reliability of results, the researchers in this study decided on this particular hospital with a purpose of obtaining information during times when there were many patients in the hospital and times when there were few patients in the hospital. A sample of 15 full-time, medical-surgical...
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...Bloodstream Infection Numbers Trouble Two Hospitals HCS/457 April 18, 2011 Bloodstream infections occur when catheters for delivering medicine and others fluids to patients, especially those in intensive-care units, become contaminated with bacteria. Up to one in four patients who acquire an infection die. Tennessee one of the state that begin releasing data on hospital infections in 2009 and the most recent report, shows that two known hospitals in Middle Tennessee scored less than 1.0. The SIR (standardized infection ratio) of 1.0 means the number of infections is equal to the expected number, guidelines of the National Healthcare Safety Network. A physician that heads infection disease prevention attributes the low scoring of these hospitals to the type of patients they treat. Both hospitals have large oncology units, treating patients with cancer therapies that can suppress their immune system, in addition to long periods of hospitalization put them at “high risk.” Whatever the reasons the community in which the hospitals service are putting patients at risk, because the data shows that the hospital are below the National Healthcare Safety Network in preventing bloodstream infections. Because rules have changed for reporting this sort of data from hospitals for reimbursement purposes, previous years could have yield more infections. There has not been strong reaction from the community that shows either of the two hospital admissions or patient seen, numbers...
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...Executive Summary - Infection Control and Prevention Current Compliance Status for Joint Commission Accreditation Nightingale Community Hospital is committed to providing healthcare excellence, a healing environment and to be the choice for patient care. In order to continue to provide quality healthcare services in accordance with our values of safety, community, teamwork, and accountability Joint Commission Accreditation provides guidelines and standards for the Priority Focus Areas (PFA) for the welfare and quality of patient care. Infection control and prevention extends beyond treating the patient. It encompasses all who work and visit the facility including medical staff, administrative staff, volunteers, vendors, and visitors. Implementing activities and programs to control, treat, prevent and identify sources of infection will help ensure the overall satisfaction and quality of patient care. Based on previous fiscal year data Joint Commission has identified Infection Control as one of the PFAs. In order to be in compliance with the standards and guidelines of Joint Commission Accreditation five areas of Infection Control and Prevention have been identified: 1. The hospital implements its infection prevention and control activities, including surveillance, to minimize, reduce, or eliminate the risk of infection. 2. Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization...
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...For example, although intensive care unit patients have central lines possibly if condition permits, collecting the blood sample for culture from a venipuncture may help decrease the incidences of blood culture contamination. Considering the reasons why is important to reduce this healthcare problem not only and most importantly protects patient but it allows for the reduction of healthcare costs and improvement of quality of care for the healthcare organization. Some of these techniques have already been applied in some hospitals and studies like in the Journal of Infection Control and Hospital Epidemiology, where attending physicians suggested to draw blood samples for culture by venipuncture instead of central lines unless patient has certain conditions that may not allow for intervention. The clinical microbiology department of the hospital created a monthly report hospital wide that included which samples were drawn from central lines and which were drawn by venipuncture. The results were drawn from January 2010 until December 2012. The data collected particularly for ICU showed a decrease in the catheter collected blood cultures from 75% in first 6 months of 2010, to 0-5 in early 2011 and 0-7 in first months of 2012 vs. the venipuncture...
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...Strategies (Vol. 6: Prevention of Healthcare–Associated Infections)" under the head Quality Improvement and Patient Safety What is Accountability? In Fundamentals of Nursing it says “The ability and willingness to assume responsibility for ones’ actions and accepting the consequences of one's behavior.” Accountability of nursing professional is a legal obligation; for a professional nurse it is relating to ethics and moral responsibility. Within the kingdom of professional accountability, there are many factors. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for nursing judgment and actions. A professional nurse has the responsibility to take decisions and practice within the scope of care, calling upon his/her information and skills to make judgments in favor of the patient. A professional nurse is accountable to their profession, their patients, employer, and other health care team members and to themselves. Nurses are accountable to provide safest care for their patient based on evidence based practice and safe nursing interventions. Nursing profession as a whole is build up on accountability, unselfishness, integrity and social justice. A professional nurse who take decisions and practice on the basis of those ethical values will always be in favor of the patient, no matter what is his/her professional level. Methods The Healthcare-associated infections. In a patient care situation as a nursing professional...
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...Purpose of the Research This paper will perform a research critique on a qualitative research study published in the Infection Control and Hospital Epidemiology, March 2013, Vol. 34, No.3. The study was presented with contributions from multiple individuals, Dr. A. Gaur, Dr. D, Bundy, C. Gao, PhD, Dr. E. Werner, Dr. A. Billett, Dr. J. Hord, Dr. J. Siegel, Dr. D. Dickens, C. Winkle, RN., and Dr. M. Miller. The research was to identify the host and organism characteristics of the hospital-acquired condition, central line-associated bloodstream infections (CLABSIs) in pediatric hematology/oncology patients. Problem Statement CLABSIs increase the risk for increased mortality and morbidity, extended hospital stays, and raises the overall cost of healthcare. Children’s Hospital Association Hematology-Oncology Quality Transformation Collaborative Project (CHAHQTCP), was a qualitative research project that began on November 1, 2009 and ended July 31, 2011. This project was initiated to identify the contributing factors to blood stream infections (BSI) in pediatric hematology patients. The goal of this research was to reduce CLABSIs by 50%. To be included, the CLABSI needed occur 48 hours after being hospitalized or within 48 hours of discharge. By identifying the organism and the time surrounding the reported symptoms, and by incorporating standardized central venous catheter (CVC) maintenance care bundles with an adherence rate of 90%, the decrease in CLABSIs would be achieved...
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...patients acquire infections while being treated for other medical conditions. In 2011, there were an estimated 722,000 hospital acquired infections (HAIs) in United States Acute Care Hospitals. Additionally, about 75,000 patients with hospital acquired infections died during their hospitalization (CDC, 2018). (Note: To ensure consistency, we will use HAIs when referring to nosocomial infections, please refer to the definition section for further understanding of the terms) More than half of all the incidents occurred within the intensive care unit. HAIs can be associated with the devices used in medical procedures, such as central line-associated...
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...The Quality Transformation Network (QTN) of Children's Hospital Association has brought some major transformations at the hematology/oncology unit of Akron Children’s Hospital since it joined the network in 2009. “We built a team of nurses, doctors and the infection control staff to focus on central line care,” says Jeffrey Hord, M.D., director, Showers Family Center for Childhood Cancer and Blood Disorders. “This was new for our institution. We built a relationship with the infection control officer that did not exist before. And we have line care on our mind much more.” He credits nurses with doing most of the work, including training new unit staff and also the float nurses. “Doctors can be most involved in reducing line entries,” he says, “following the standard work orders to ask every day with every patient, what can we do to reduce line entries?” Before QTN: Limited Data, No Analysis As for data collection, a rigorous requirement of QTN, Hord admits, “Before joining, we did not have good ongoing data collection about line days in our inpatient unit, much less elsewhere. Now, we have built a system to track line days of our entire patient population anywhere.” When a central line-associated bloodstream infection (CLABSI) occurred, the unit did not have any particular follow-up, much less the root cause analysis required by QTN. “Now, when a positive culture comes back, the team receives an email notification, and nurses involved in the care of the patient are quickly...
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...education and certification levels of nursing staff (The Sentinel Watch, 2016). Process indicators are measurement methods of patient assessment and nursing interventions (The Sentinel Watch, 2016). Nursing job approval is also considered a practice indicator. The outcome indicators reflect patient outcomes that are determined to be nursing-sensitive because they depend on the quantity or quality of nursing care (The Sentinel Watch, 2016). The ANA identified several critical nursing sensitive indicators that apply to hospital-bases nursing. Patient satisfaction with pain management, patient satisfaction with nursing care, patient satisfaction with overall care, pressure ulcers, patient falls, nurse job satisfaction, rates of nosocomial infections, total hours of nursing care per patient, per day and staffing mix are original indicators that apply to hospital-based nursing (The Sentinel Watch,...
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