...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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...CLABSI accounts for 3.64 CLABSIs per 1000 line days in ICUs equivalent to 43,000 CLABSIs Cite. This translates to over 6000 lives lost and millions of dollars spent in hospital costs that could have been saved from an avoided and preventable infection. ICUs can greatly benefit from VBP as they contribute to the hospitals mortality rates and ICU length of stay. Working collectively with hospital ICUs to create and establish effective ICU CLABSI protocols and guidelines that must be adhere to can tremendously effect the broader spectrum of the CMS initiative. Implement this plan can directly address care outcomes and resource use in ICUs to improve quality of care. It will address ICU length of stay and drastically reduce hospital costs and reduce the hospital’s mortality and morbidity...
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...Research Critique Part 1 1 Research Critique Part 1 CLABSI in the Pediatric Oncology Population Cathy Frederick Grand Canyon University NRS-433V Introduction to Nursing Research October 11, 2015 Research Critique Part 1 2 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...
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...Running head: BEING ACCOUNTABLE: UTILIZING EVIDENCE-BASED Being Accountable: Utilizing Evidence-Based Research Grand Canyon University NRS 430V Professional Dynamics August 27, 2011 Being Accountable: Utilizing Evidence-Based Research Merriam-Webster defines accountability as “an obligation or willingness to accept responsibility or to account for one’s actions” (Merriam-Webster, n.d.) What does this term mean from the global healthcare perspective? In the healthcare arena, it is a legal, moral, and ethical term used to describe healthcare providers’ obligation to themselves, their patients, and to society as a whole. The nurse is an integral part of the healthcare team that contributes to accountability realm. How does this concept translate into everyday professional nursing practice? According to the American Nurses Association, “accountability means to be answerable to oneself and others for one’s own actions. The nurse acts under a code of ethical conduct that is grounded in moral fidelity and respect for the dignity, worth and self-determination of patients.” (p. 9). The ANA developed the Code of Ethics for Nurses as a tool or guideline for the nurse to “carry out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession” (ANA, n.d.). Nurses have a responsibility for the care they provide during their nursing practice. To whom is the professional nurse responsible and accountable? Nurses are...
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...Nursing Quality Committee Inter-professional team leadership plays an important part when creating strategies to solve issues and obtain a positive outcome (DeNisco and Barker, 2016). Central Line Associated Bloodstream infection (CLABSI) is one of the main issues that hospitals have in common. However, nurses and leaders can work together to establish a committee which focus on CLABSI. The committee will help nurses to transform their frustrations into accomplishments and the collaborative team of healthcare professionals will assist to find the solutions of the problems (DeNisco and Barker, 2016). A team of nurses should participate in the committee to obtain knowledge and share their experiences with previous cases of CLABSI. The team will discuss...
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...in order to receive full annual payment update. Good Samaritan Medical Center (GSM) had a total report of 3 months with no national benchmarking available for CAUTI/CLABSI. GSM reports 0.0 for year to date even though there have been 2-reported CLABSIs report in ICU and Med/Tele units for March. Due to the complexity of the patient in the ICU with multiple lines and surgeries, the patient met surveillance criteria for CLABSI with 1 of 2 blood cultures was positive of S. aureus (Good Samaritan Medical Center, 2016). The other incident was on med/telemetry with no information on the incident. The last documented CAUTI was 11/14/2015. The Ministry Excellent Goals (MEG) target for 2016 for CAUTI is 0.451-0.500 and for CLABSI the target is 0.370-0.414. CAUTI or catheter-associated urinary tract infections is a urinary tract infection that can include the bladder and the kidneys. If a patient has a catheter and it causes an infection in the bladder or kidney it is a CAUTI and was caused by a healthcare-associated infection and could have been prevented. CLABSI or central line-associated bloodstream infection is a serious infection that occurs when bacteria or viruses enter the bloodstream through the central line (CDC, 2010). Please review the following chart with the information regarding CAUTI and CLABSI data from GSM. (Good Samaritan Medical Center, 2016) The HCAHPS for GSM are nurse communication and pain management. The MEG year to date goal is 75.1, the 2016...
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...lasts longer. It is difficult to insert these lines in newborn and premature infants and takes several attempts, thus making them more prone to infections, especially nosocomial infections which are very common in neonatal intensive care units. The most common infection is the central line associated blood stream infection (CLABSI). The risk is greater when the central intravenous line is in place for a longer duration, prolonged use of antibiotics, parental nutrition, low birth weight infants, low immune system, and lack of staff education. Inserting a central intravenous line is a sterile procedure so it is a nurse’s responsibility to minimize the risk of infections. Health care-associated infections increase the length of hospitalization, hospital cost, patient discomfort, and morbidity and mortality rates (O'Grady & Pearson, 2002). Thus, it is important for health care professionals to be responsible for knowing their roles and using maximum sterile barriers while placing and caring for central venous catheters. According to the Agency for Healthcare and Research Quality (AHRQ), there are many practices healthcare professionals should follow to prevent CLABSI (Marschall, 2008). The use of maximum sterile barriers are one of the essential practices observed in a patient care scenario that occurred in the neonatal intensive care unit. Jenkins is a former 30 weeks-premature male infant born with respiratory distress and placed on a ventilator. He later developed bowel distention...
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...identify one example of descriptive statistics, identify one example of inferential statistics, explain data at each of the four levels of measurement and describe the advantages of accurate interpretation of statistical information to improve decision making. The purpose of infection prevention and control is to put into place policies and procedures that minimize the spread of infections, especially in the hospital setting. The primary function of infection prevention and control surveillance is to reduce the occurrence of infections by using risk factors and implementation of risk-risk reduction measures and the effectiveness of interventions (Centers for Disease Control, 2012). Central line associated blood stream infections, (CLABSI) and catheter related urinary tract...
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...Initiating Smart Goals Jennifer Clay Chamberlain School of Nursing Mary Thomas NR 447 Collaborative Health Care Introduction Smart goal #1; nursing will assess for appropriate use of indwelling catheters every shift in order to prevent CAUTI, nursing will obtain an order for discontinuation if no longer needed, this will be audited weekly in order to reach the goal of zero UTI’s on a monthly basis. This smart goal was developed to insure nursing is doing everything possible to prevent CAUTI. The goal steers toward patient safety and because Medicare and Medicaid do not reimburse for UTI’s acquired while hospitalized any longer. Smart goal #2; there will be 100% compliance in doing CVAD assessments, dressing changes, and the use of 70% isopropyl alcohol caps (CURO’s) in order to decrease the rate of CLABSI’s in the Medical-Surgical unit. This goal is to insure nursing is doing proper assessments, dressing changes, proper hand hygiene, using CURO’s caps and handling techniques in order to prevent contaminating the line. Goal 1: Preventing CAUTI Prevention of Hospital-acquired UTI’s should be a goal for every acute care setting to prevent the high cost of treatment, each episode of symptomatic CAUTI cost at least $600. It is not surprisingly the most common of health care associated infections accounting for about 40% of HAI’s. (Saint Et.al) This goal is to develop a way for nursing to assess the use of indwelling catheters and discontinue them if not needed to...
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...Introduction This paper explain the Accountability of a nursing professional based on an evidence report from Agency for Healthcare Research and Quality Assessment(AHRQ) , the report is " Closing the Quality Gap: A Critical Analysis of Quality Improvement 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...
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...of the following paper is to discuss the use of statistics within Mercy Medical Center located in Des Moines, Iowa by using examples and explanations of terms used in statistics such as descriptive and inferential statistics and the four levels of measurement. Within Mercy Medical Center, nursing care is centered around the use of evidence based research thus making it important to understand the basic use of statistics in evaluating research. Hospitals must monitor for the amount of infections which occur in various units continuously since an infection can adversly afffect a patients treatment and may possibly lead to death. One of the infections which can occur is central line acquired blood stream infections (CLABSI). The raw data that is gathered from CLABSI is an example of descriptive statistics. The term descriptive statistics is given to the analysis of data which helps to describe, show, or summarize data in a meaningful way so that patterns may emerge from the data making it easier to visualize the information (Lund Research, 2013). There are two types of statistics which are used to describe data, measures of central tendency and measures of spread. With measures of central tendency, this is a way of describing the central position of a frequency distribution for a collection of...
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...How Are Statistics Used in Your Workplace There are many uses for statistical application in the field of infection prevention and control. The purpose of infection prevention and control is to put into place policies and procedures that minimize the spread of infections, especially in the hospital setting. The primary function of infection prevention and control surveillance is to reduce the occurrence of infections by using risk factors and implementation of risk-risk reduction measures and the effectiveness of interventions (“Center for Disease Control”, 2012). Two examples of how statistics are utilized are the hospital-wide surveillance of central line associated blood stream infections (CLABSI) and catheter related urinary tract infections (CAUTI). Infection rates of CLABSI and CAUTI are reported to senior leadership on a monthly basis; if an increase in infection rates is noted...
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...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 interviewed,” says Hord. “Two or three days later, the team convenes for the root cause analysis, and we go through a checklist of questions.” He cites a case of a positive culture for a bone marrow transplant patient. These patients need to be bathed to get the chemo off their skin, so the infection could have been from a waterborne pathogen. During the root cause analysis, the question...
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...discussed at length, along with ways to improve the nurse’s role in support of the organization’s agenda. The first question asked was how important is the nurse’s role in clinical outcomes. Jennifer stated that the impact that a nurse has on clinical outcomes is “huge,” due to the fact that nurses are responsible for all patient outcomes. Care of the patient in the hospital usually begins and ends with the nurse. With public hospital reporting, the fact that nurses play an instrumental part in a hospital organization’s strategic agenda is very evident. Hospital boards are also looking into how nurses support the organization and how they can improve frontline nursing care in respect to core measures such as never events, falls, CLABSI (Central Line Blood Stream Infections) and all other nursing indicators. The next...
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...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 dropping significantly. One hospital has changed its surveillance methodology and has become more aggressive in the hospital surveillance and investigative approach to central line bloodstream infections. The other hospital that is one of the first research institutions to show CLABSI could be prevented has implemented a 30-step grid for its medical staff and nurses to follow. Dr. Peter...
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