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¶ … Catheter-Related Infections
Central Catheter-related ICU Infections
Central Catheter-Related Infections in ICUs
Reducing Central Catheter-Related ICU Infections in Michigan
Reducing Central Catheter-Related ICU Infections in Michigan
Teams of clinicians at five hospitals across Michigan reported their efforts to reduce the frequency of catheter-related bloodstream infections in intensive care units (ICUs) through the implementation of five patient safety measures: (1) hand washing, (2) full barrier precautions during insertion of central venous catheters, (3) use of chlorhexidine to clean the insertion site, (4) avoid using a femoral site for catheter insertion, and (5) never leaving unnecessary catheters in the patient (Pronovost et al., 2006). The intervention was based on the published research findings from five research groups: Berenholtz et al., 2004; Cohran et al., 1996; Eggimann et al., 2000; Warren et al., 2004; and Warren et al., 2006. Three of these studies investigated the efficacy of interventions on catheter-related bloodstream infections in an ICU setting, while the other two evaluated the effect of interventions more generally. All emphasized clinician education in the prevention of these infections and together this group of studies represented the evidence base upon which Pronovost and colleagues (2006) designed the intervention they tested.
The study design involved designating ICU team leaders, consisting of a physician and nurse, who...
Through a partnership with hospital-based infection-control professionals, the team leaders implemented the intervention and collected infection data. In addition to the five patient safety measures, a number of other measures were implemented, which included checklists, the creation of a central-line cart with all necessary supplies, best practice procedures preventing clinicians not adhering to guidelines from continuing, and reminders and feedback at daily rounds and meetings. The independent variable in this study was the intervention and the dependent variable (outcome) the incidence of central catheter-related ICU infections occurring over time. The study period was between March 2004 and September 2005, a full 18 months, and took place in 103 ICUs in 67 Michigan hospitals. About half of the ICUs, however, did not contribute to baseline data.
Central catheter-related infections were defined according to National Nosocomial Infections Surveillance (NNIS) guidelines (Pronovost et al., 2006). Infections were determined by culture and validated by hospital infection-control officers. The data was collected by these officers and submitted to researchers once a month. One catheter day was based on the use of one or more central lines per patient per day. For the purpose of data analysis, three months of sequential data was grouped to form quarterly data. Statistical analysis was based on calculations of median values and interquartile ranges, because…
Reference
Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S. et al. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-2732.
As contributive to further research, researchers may be interested in singling out the various CR-BSI-reductive variables used in the multi-faceted programs and seeing the effect of CHG in contrast to the others. Note too, that a teaching / training program was the constituent of the two multi-faceted programs, whilst the study of the independent training program, in reality, also incorporated the other 2 programs in that participants were induced
Nosocomial Infections Synthesis The evidence-based approach utilized and advocated by all the authors cited in this essay can be viewed through the lens of a PDSA process as described by Hadaway (2006). For example, Pronovost and colleagues were interested in reducing the incidence of preventable CR-BSIs in the ICU setting in Michigan. They first identified an evidence base supporting an intervention and then planned how to implement the intervention to cause a
Reducing The Risk of CVC Related Infections Post InsertionMultiple lumen central venous catheters (CVCs) are used to administer large amounts of intravenous fluids, blood products, and medications. In the past, they were only used in the intensive care unit. However, they are now used in all areas of health care. CVCs are inserted through a large central vein like the subclavian vein, and they terminate at the junction of the
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process Overview Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include
Catheter-Associated Urinary Tract Infection (CAUTI) Decreasing the health care-associated urinary tract infection (UTI) is a goal that most hospitals and doctors are trying to do. The purpose of this project was to create a gathering count starting point to forecast clinically major UTIs that develop in hospitalized patients that are women. There were a lot of cases looked into but 20 women were chosen for this investigation. These women were interviewed
Quality Improvement Program Needs Assessment and Quality Improvement Plan Paula Stechschulte, PhD, RN Quarter This paper discusses the process of drafting a quality improvement plan at a community level medical facility, a plan that is aimed at reducing days under urinary catheter and also reducing the rates of infections associated with the said catheters. As a high rate of incidence of infection related to catheter usage is costly for the hospital, this implementation