NR 451 W3 Milestone 1 Evidence Worksheet Susan Russell Capstone Project
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NR 451
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NR 451
What is the Practice Issue? Preventing central venous catheter-related infections
Central line associate bloodstream infections (CLABSI) are highly preventable but thousands of
patients develop them each year. Central line associated blood stream infections can be catastrophic for
patients but c...
nr 451 w3 milestone 1 evidence worksheet susan russell capstone project
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Chamberlain College of Nursing
NR451 RN Capstone Course
Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
Student Name: Susan Russell Date: 7/22/17
DIRECTIONS
1. Refer to the guidelines for specific details on how to complete this assignment.
2. Type your answers directly into the worksheets below.
3. Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
4. Post questions about this assignment to the Q & A Forum. You may also email questions
to the instructor for a private response.
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Practice Issue Worksheet
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What is the Practice Issue? Preventing central venous catheter-related infections
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Central line associate bloodstream infections (CLABSI) are highly preventable but thousands of
patients develop them each year. Central line associated blood stream infections can be catastrophic for
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patients but can also be an extreme financial burden for hospitals. One of the major problems
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associated with the use of central venous catheters is colonization by micro-organisms that can result in
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local and systemic infections. Over the last several years at the facility I work for, we have seen an
increase each year in the amount of central line associated infections. It is estimated that 5 million
central venous catheters are inserted every year in the United States (Worthington 2005). Research has
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shown that infectious complications associated with central venous catheters cause significant morbidity
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and mortality, with considerable costs to the healthcare system (CDC 2011). It is necessary that we
standardize our insertion practices, provide central line care bundles, educate staff on the importance of
making physicians aware of the length of time central lines are in place, provide education on a
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standard catheter care, education of effective use of alcohol for scrubbing injection hubs for fifteen
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seconds before using, education for effective hand washing and sterile techniques for procedures.
Finally we need to implement a nurse driven protocol for line removal based on criteria that is approved
by physicians so that central lines can be removed without a specific order but based on pre-approved
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criteria.
This study source was downloaded by 100000822096590 from CourseHero.com on 04-07-2021 16:58:34 GMT -05:00
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 1
https://www.coursehero.com/file/26761938/NR451-W3-Milestone1-Evidence-Worksheet-Susan-Russell-capstone-projectdocx2docx/
, Chamberlain College of Nursing
NR451 RN Capstone Course
Define the scope of the Practice Issue:
In the USA, approximately 80,000 reported cases of CLABSI occur in intensive care units
(ICUs) every year. Although the exact mortality attributable to these CLABSIs remains
unclear, reports have cited figures up to 35% (CDC 2011). “Hospital acquired infections
kill nearly 100,000 Americans a year, according to the Centers for Disease Control and
Prevention (CDC, 2011), with 2 million patients needing treatment that costs over 25
billion dollars a year" for infections acquired in the hospital. Hospitals are now liable
when patients acquired infections and for the cost of treatment of the infections.
Hospitals need to provide best practice and best infection control measures. Hospitals
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need to take a proactive approach in preventing CLABSI. Unfortunately every hospital
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and long-term care facility is impacted by CLABSI. It is difficult to know the exact extent
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of how many CLABSI infections there are since some patients die of other causes or are
transferred to long term care facilities or are treated for an infection with antibiotics and
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are not thought of as of having a CLABSI. There have been few guidelines and
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standardization of practice in maintaining central lines.
We need to start at looking at the process and how we insert these lines and the person
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inserting them and their ability to maintain sterile technique. We need to look at how we
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care for these lines. If the hospital has a special post insertion care bundle with necessary
supplies to care for a line. If line inspection is being done and documented. If central line
dressings are being changed when they are wet or soiled and that dressings are being
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changed every seven days. We need to look at the products we are using, chlorohexidine
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gluconate is the desirable cleansing solution for catheter’s insertion sites. We need to look
at the hand hygiene practices of staff working with line. Insertion line hubs for medication
or piggy backing lines need to be scrubbed for a minimal of 15 seconds before using. The
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implementing of alcohol insertion hubs to help maintain sterility is a great addition to the
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care bundle but expensive. Bathing patients with chlorohexidine bathing cloths on
admission of patients at high risk for CLABSI has shown to reduce CLABSI infections.
Hospitals need a coordinated effort between teams to combat non-compliance and to
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evaluate processes and data related to infections. We can also look at a nurse driven
protocol for line removal when criteria is met for discontinuation that does not require a
physician order.
This study source was downloaded by 100000822096590 from CourseHero.com on 04-07-2021 16:58:34 GMT -05:00
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 2/16/17 GH 2
https://www.coursehero.com/file/26761938/NR451-W3-Milestone1-Evidence-Worksheet-Susan-Russell-capstone-projectdocx2docx/
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