Assignment: Bloodstream Infections

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Assignment: Bloodstream Infections

Assignment: Bloodstream Infections

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Central Line-Associated Bloodstream Infections Literature Review

Kerry S. Murphy

Grand Canyon University

Translational Research and Evidence-Based Practice

DNP-820-O501

Dr. Kari Lane

September 26, 2018

Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS 2

Central Line-Associated Bloodstream Infections Literature Review Comment by Microsoft Office User: The heading of introduction is inferred in APA format

I. Introduction

Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.

II. Questions Posed in the Studies

a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.

b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the

evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?

c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?

d. Srinivasan, Wise, Bell, Cardo, Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.

e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.

f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva, Zong, Jeong, & Lee, (2015 (2011) the inquiry is into what level of knowledge, attitudes, and behavior the nurses in the cancer setting in the Italian hospitals have about CVC procedures.

g. O’Grady, Alexander, Burns, Delilnger, Garland, Heard, Lipsett, Masur, Mermel, Pearson, Raad, Randolph, Rupp, & Saint (2011), the inquiry focused into how Positive blood culture shows the relationship between CLABSI and CDC surveillance.

h. Perin, Erdmann, Higashi, Sasso, Bianco et al. (2016) the research question is; What are the CLABSI-related preventive measures implemented among adult patients hospitalized in an ICU?

i. Esposito, Guillari & Angelillo (2017) inquiries into what level of knowledge, attitudes, and behavior the nurses in the cancer setting in the Italian hospitals have about CVC procedures. It also questions the predisposing factors for the knowledge, attitudes, and behavior.

j. Oliveira, Stipp, Silva, Frederico, & Duarte (2016) questions into the standard procedure in the ICU, the catheterization of a central venous access good care practices from insertion and handling to the moment of withdrawal.

k. In a research by Basinger, M. A. (2014), the research question questions into the causal effects of the CUSP on the reduction of CLABSIs within the relationship CUSP team member webinar attendance has with the reduction of CLASBIs.

l. Xu & Wu (2017) inquire about how a Comprehensive Unit-Based Safety Program which involves the improvement of communication, teamwork, and safety in the ICUs.

m. Bianco, Coscarelli, Nobile, Pileggi, & Pavia (2013) find it interesting to establish the role of knowledge, evidence-based practices, the insertion and maintenance of CVC with the protection of CLABSIs.

n. The Final research is by Han, Liang, & Marschall, (2010), who question how the involvement of education to the family and the patient can help prevent CLABSIs attacks among patients on CVC care. Another study by questions the relationships between Positive blood culture and CLABSI with CDC. Comment by Microsoft Office User: Synthesize each section by describing articles with commonalities and differences. But you need to write in paper format in paragraph form.

III. Identified Subthemes Comment by Microsoft Office User: No longer use an outline, use headings (according to APA format) for your main concepts, and place your subthemes underneath, as described in your 10 Strategic Points document

With the picot question In Patients > 65 years of age with central line catheters, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) compared to standard care over a one-month period at ICU Regional Medical Center, Texas? From this, there are various subthemes that emerge in this study. These include; the issue of hygiene and its effect on CLABSI, knowledge and how it impacts on infection, policies or experience and how it affects perception and prevention of infections, evidence-based practice, non-evidence-based practice, disinfection and sterilization, Insertion bundle, Maintenance bundle, and Quality Improvement. Comment by Microsoft Office User: First this isn’t a PICOT questionSecond you need to synthesize this information describe multiple articles at once So discuss CLABSI the subthemes under CLABSI would include Hygiene and impactKnowledgePoliciesNurse experienceEvidence Based Practices/InterventionsDescribe in full

The reviewed literature has shown that the nurse, patients, family, and evidence versus non-evidence-based practice are important in the analysis of the situation. Besides, the setting, type of catheter, and conditions affect the entire discussion.

IV. Risk Factors Associated with CLABSIs

a. Contamination on Insertion

The catheter may gain entry into the bloodstream during the insertion of the line into the body of the patient. The rate of infections during insertion is substantially dependent on the hygiene levels that are put in place by the health care providers (Dick et al., 2015). The rates of infection during insertion happen to be high showing ignorance or lack of professionalism among the health caregivers. Contamination during insertion may also result from the instruments used and how sterilized they are.

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