Reducing Central Line-Associated Blood Stream Infections Discussion
Reducing Central Line-Associated Blood Stream Infections Discussion
Strategic Plan Summary
Reducing Central Line-Associated Blood Stream Infections (CLABSI) rates is a focus of many hospitals as a way of improving safety when delivering healthcare services. In this project change proposal, the nursing practice intervention that will be implemented to address the identified problems is education about the central line prevention bundle. Evidence-based studies showed that CLABSI rates significantly decreased in hospitals with the integration of the bundle. The components of the CL insertion bundle include “hand hygiene prior to insertion, maximal barrier precautions, chlorhexidine skin antiseptics, optimal site selection (avoidance of femoral vein in adults), and daily review of line necessity” (Furuya et al, 2016)Reducing Central Line-Associated Blood Stream Infections Discussion.
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The strategic plan I will use to implement the intervention include slide-show presentation, or interactive videos about proper central line maintenance, and hands-on practice on a mannequin. I will also involve nursing leadership or nurse education management to help me assess nurses’ compliance with simulation of central line catheter maintenance. I will also educate nurses on how to re-locate the available evidence-based resources and the organization’s policy on central line management.
Another strategic plan that will help to increase nurses’ compliance with CLABSI prevention bundle is implementing a formalized nursing-led rounding process. In other words, the nurse manager will pull a nurse from the unit to act as a peer influencer by observing the central line care and stops the procedure if any protocol breaks occur and offers real-time education to the nurse who performs the CL care (Hugo et al, 2022)Reducing Central Line-Associated Blood Stream Infections Discussion. However, nurses who are filling the roles of the influencers are required to have a designated time outside of patient care which can be a potential problem in a staff-limited settings. Therefore, nursing shortage may influence the implementation process.
References
Furuya, E. Y., Dick, A. W., Herzig, C. T., Pogorzelska-Maziarz, M., Larson, E. L., & Stone, P. W. (2016). Central Line-Associated Bloodstream Infection Reduction and Bundle Compliance in Intensive Care Units: A National Study. Infection control and hospital epidemiology, 37(7), 805–810. https://doi.org/10.1017/ice.2016.67
Hugo, M. C., Rzucidlo, R. R., Weisert, L. M., Parakati, I., & Schroeder, S. K. (2022). A Quality Improvement Initiative to Increase Central Line Maintenance Bundle Compliance through Nursing-led Rounds. Pediatric quality & safety, 7(1), e515. https://doi.org/10.1097/pq9.0000000000000515 Reducing Central Line-Associated Blood Stream Infections Discussion
Capstone Change Project Resources
Successful implementation of the strategic plan will require identifiable resources, including supplies and equipment, training, education and assessment of competency, infection prevention professionals, and automated surveillance systems. The four will contribute directly to the effective utilization of the central line bloodstream infection (CLABSI) bundle.
Supplies and equipment: The use of the CLABSI bundle will require the hospital to purchase diverse strategic supplies and equipment. The bundle demands high levels of hygiene which justifies the need for handwashing stations, sanitizers, and other related supplies (Karapanou et al., 2020). Also, the hospital will require charts and kits to help train and remind caregivers of the key provisions of the bundle.
Training, education, and assessment of competency: The hospital will need to carryout comprehensive training of all its caregivers on the use of the new tool and related policies. The hospital will need to collaborate with local learning institutions to get professionals who understand the use of the tool to train, educate and assess the competency levels of the nurses (Dombecki et al., 2020)Reducing Central Line-Associated Blood Stream Infections Discussion. The teachers thus come out as critical resources to the success of the bundle.
Infection prevention professionals: Epidemiologists and infection prevention professionals come out as yet another category of important resources. The healthcare professionals will help create infection control policies and manage related programs. They will ensure compliance with the new policies and thus contribute directly to the success of the strategic plan. Their input will ensure the timely identification of problems with the strategic plan and efficient implementation of corrective measures.
Automated surveillance systems: Finally, a system to monitor the new policies is an equally important resource. The surveillance system will capture data on the rates of infections to help show the successes or failures of the new system (Goldman et al., 2021)Reducing Central Line-Associated Blood Stream Infections Discussion. Doing so is important since it gives the project managers opportunity to review the new policies effectively to ensure the successful use of the tool in eliminating central line infections.
Per professor: add auditors. Staff designated to audit will evaluate performance and compliance.
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References
Dombecki, C., Sweeney, J., White, J., Valyko, A., Stillwell, T., Mills, J., & Washer, L. (2020). CHG Skin Application in Non-ICU Patients with Central Venous Catheters: Impact on CLABSI, MRSA Bacteremia, and Lab ID Rates. Infection control/ hospital epidemiology, 41(1), S164-S165.
Goldman, J., Rotteau, L., Shojania, K.G., Baker, r., Rowland, p., Christianson, m., Vogus, t., Cameron, c., & Coffey, M. (2021). Implementation of a central-line bundle: a qualitative study of three clinical units. Implementation Science Communications, 2(105), 1-09.
Karapanou, A., Vieru, A.-M., Sampanis, M. A., Pantazatou, A., Deliolanis, I., Daikos, G. L., & Samarkos, M. (2020). Failure of central venous catheter insertion and care bundles in a high central line–associated bloodstream infection rate, high bed occupancy hospital. Am J Infect Control, 48(7), 770-776. Reducing Central Line-Associated Blood Stream Infections Discussion