CLABSI in the ICU Comprehensive Nursing Essay Example

Defining the Scope: CLABSI in the ICU Comprehensive Nursing Essay Example

The purpose of this research is to prevent and reduce CLABSIs in intensive care units by providing a sixth-month tailored training of nurses and offering patient education of evidence-based quality improvement strategies. The target population for this study is patients in the ICUs recommended for central lines, including indications for blood transfusion, IV nutrition, fluid resuscitation, blood tests, pressure monitoring, and catheterization. The purpose of the study is grounded on the quality caring model, which highlights the significance of evidence-based practice nursing in modern healthcare. Therefore, the study’s goals will be to identify nurses’ perceptions of CLABSI mitigation guidelines, train nurses in exiting EBP CLABSI mitigation practices and reduce the number of CLABSIs in a hospital’s ICU.(CLABSI in the ICU Comprehensive Nursing Essay Example)

Various studies and quality improvement initiatives have established certain practices crucial in reducing CLABSIs in ICUs. For instance, Esposito, Guillari, & Angelillo (2017) used self-administered questionnaires to determine nurses’ knowledge, perspective, and behavior on risk factors and prevention of CLABSI in oncology and outpatient chemotherapy units. The study found that using sterile gauze to cover the catheter site, disinfecting needleless connectors, hydrogen peroxide to disinfect the catheter site, and anticoagulant solutions are the main recommendations for preventing CLABSIs.(CLABSI in the ICU Comprehensive Nursing Essay Example)

Moreover, Esposito et al. (2017) argue that the lack of education of CLABSIs prevention recommendations contributes to higher incidences. Equally, higher education and a positive attitude towards antiseptic utility, hand washing, and aseptic dressing techniques are crucial in preventing CLABSIs. Therefore, education interventions are vital in addressing the knowledge gap and practice incompetency regarding evidence-based CLABSI prevention interventions.(CLABSI in the ICU Comprehensive Nursing Essay Example)

The AHRQ Safety Program for Intensive Care Units (ICUs) is designed to prevent CLABSI by facilitating ICU participation (AHRQ, 2019). In addition, the program aims to eliminate or reduce CLABSIs by nurturing the adoption and implementation of the AHRQ’s EBP and the Comprehensive Unit-based Safety Program (CUSP). The CUSP was designed to guide clinical teams in improving healthcare safety by fostering teamwork and collaboration, implementing best clinical practices and patient safety measures. The CUSP includes checklists, conducting morning briefings to encourage appropriate nurse roles and interventions, benchmarking other professional tools, having routine nurse care rounds, and offering teamed patient checkups.(CLABSI in the ICU Comprehensive Nursing Essay Example)

Furthermore, Ling et al. (2016) reviewed and summarized the Asia Pacific Society of Infection Control (APSIC) guide on central line insertion, maintenance, and implementation for CLABSI prevention and found the following. The APSIC recommends optimal catheter site selection, optimal barrier precautions, hand hygiene, and skin preparation using alcohol-based chlorhexidine. For maintenance, the APSIC recommends hub disinfection, aseptic dressing techniques, changing access devices/lumens, daily assessment of central line necessities and replacement, hand hygiene, and following standardized sets changes.(CLABSI in the ICU Comprehensive Nursing Essay Example)

Despite the achievement of existing prevention and reduction interventions and guidelines, CLABSIS remains a challenge in the ICUs for most hospitals. As highlighted in this paper, a lack of knowledge of the established practices and guidelines contributes to limited practices and challenges in reducing CLABSIs. This lays the framework for the proposed quality intervention, i.e., nurse training and patient education. In this regard, the proposal will make use of the guidelines established by the center for disease prevention and control (CDC) and the department of health and human services (DHHS) to train the nurses and patients on CLABSI risk factors and appropriate guidelines for insertion and maintenance of central lines for ICU patients. In addition, the CDC provides resources for patients and healthcare provides on crucial issues regarding prevention, reduction, and monitoring of CLABSI in ICUs.(CLABSI in the ICU Comprehensive Nursing Essay Example)

In sum, intervention measures for appropriate central line insertion and management techniques, adoption of closed infusion systems, appropriate site selections, and central line removal (Reyes, Bloomer & Morphet, 2017). Moreover, continuing nurse education on EBP interventions, regular nurse reports, aseptic techniques for central line maintenance, appropriate interprofessional communication, chlorhexidine dressings of catheter sites, and open infusion containers contribute to reduced incidences of CLABSI ICUs.(CLABSI in the ICU Comprehensive Nursing Essay Example)

According to Reyes, Bloomer & Morphet (2017), the following EBP interventions reduce CLABSI cases. Quality interventions include appropriate nurses’ healthcare collaboration, compliance checklists, hygiene education training, implementation, and incidence surveillance. Moreover, patient and nurses’ feedback mechanisms, appropriate tools, guidelines or protocols, and care campaigns promote central venous lines. Education interventions take many forms, including conference calls, online coaching, emailing central line management practices, and web seminars. Other quality interventions include regular supervision and nurse rounds, and extra ICU intensivists.(CLABSI in the ICU Comprehensive Nursing Essay Example)

The intensive care units present complex healthcare requirements, which necessitate the use of central lines. Although central line catheters offer patients various life benefits, they predispose them to multiple risks of bloodstream infections when not inserted or maintained appropriately. This makes CLABSI a significant public health issue that requires evidence-based intervention. Moreover, studies have shown that ICU patients require specialized treatments, further predisposing them to blood infections risks.(CLABSI in the ICU Comprehensive Nursing Essay Example)

CLABSIs lead to prolonged hospital stays, high morbidity and mortality, and increased medical costs. According to the Agency for Healthcare Research and Quality (AHRQ), about 250,000 CLABSI cases occur annually (cite in Haddadin, Annamaraju, & Regunath, 2020). Moreover, about 80 central line infections in every 1000 central line – days. The International Nosocomial Infection Control Consortium (INICC) surveillance data revealed a 4.1% CLABSI rate in every 1000 central line – days. The incomplete adherence and lack of knowledge of the central line catheter insertion and management guidelines and insufficient nurse-staff rations increase the rates of CLABSIs.(CLABSI in the ICU Comprehensive Nursing Essay Example)

References

Agency for Healthcare Research and Quality. (August 2019). AHRQ Safety Program for ICUs. Retrieved 18 August 2021,(CLABSI in the ICU Comprehensive Nursing Essay Example) from https://www.aha.org/center/hret/ahrq-safety-program-icus-preventing-clabsi-cauti

Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PloS One, 12(6), e0180473(CLABSI in the ICU Comprehensive Nursing Essay Example) 10.1371/journal.pone.0180473

Haddadin, Y., Annamaraju, P., & Regunath, H. (2020). Central-line associated bloodstream infections (CLABSI). StatPearls [Internet].(CLABSI in the ICU Comprehensive Nursing Essay Example) https://www.ncbi.nlm.nih.gov/books/NBK430891/

Ling, M. L., Apisarnthanarak, A., Jaggi, N., Harrington, G., Morikane, K., Ching, P., … & Lee, C. M. (2016). APSIC guide for the prevention of central-line associated bloodstream infections (CLABSI). Antimicrobial Resistance & Infection Control, 5(1), 1-9. 10.1186/s13756-016-0116-5

Reyes, D. C. V., Bloomer, M., & Morphet, J. (2017). Prevention of central venous line-associated bloodstream infections in adult intensive care units: a systematic review. Intensive and Critical Care Nursing, 43, 12-22. https://doi.org/10.1016/j.iccn.2017.05.006