Central Line-Associated Bloodstream Infections - Report Sample

Introduction

Central Line-Associated Bloodstream Infections (CLABSI) is a type of blood infection that develops and is diagnosed within 48 hours of central line placement. The infection develops whereby bacteria or other pathogens enter a patient's bloodstream through the central line. CLABSI is one of many other hospitals acquired infections (HAIS) that are serious but can be prevented or successfully treated. The following documentation purports to outline the preventive actions against CLABSI and other hospital-acquired infections.

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Criterion Long Description

CLABSI prevention is an essential aspect in the nursing profession as it the duty of bedside or attending nurses to ensure a central line is placed, cleaned, or removed correctly. Suffice it to say that CLABSI prevention is solely the duty of nurses. Appropriate training of bedside nurses can ensure CLABSI prevention across the health spectrum (Lakhanigam, 2016). For hospitals to effectively prevent CLABSI and consequently substantial medical bills, they should postulate a process, structure, and measures to prevent the blood infection. In the US, there are close to 250,000 annual cases of CLABSI, with 80,000 arising in patients on intensive care units (Lakhanigam, 2016).

The most significant measure that nurses can take involves the correct placing of central lines. According to Thom et al. (2015), best practices include ensuring patients observe proper hand hygiene, using chlorhexidine as antisepsis, using maximal sterile precautions before inserting catheters and avoiding the femoral vein as an access point. Nurses can also be trained to use antimicrobial-coated catheters.

Pyrek Kelly (2017) proposes that nurses should observe the five critical components for preventing incidences of HAIS. These include ensuring proper patient hygiene, observing maximum barrier precautions such as using sterile barriers, using chlorhexidine for skin antisepsis, observing optimal catheter site selection, and regularly assessing central lines. According to Kirtil and Akyuz (2018), 8.2 percent of intensive care unit nurses are better placed to prevent CLABSI. The researchers also asserted that nurses' education level was correlated with the error incidences in patients.

Position Statement

Owing to better management practices, well-managed hospital settings perform better than the less properly managed hospitals. The purpose of CLABSI prevention is to identify factors which describe the level differences of hospitals in efforts to prevent central line infections. The recommendation for identifying how different hospitals perform include conducting extensive qualitative case studies that compare high and low performing hospitals. The guideline for comparing high and low performing hospitals was developed by Mcalearney, Hefner, Robbins, and Harrison (2015). The researchers conducted qualitative research on management strategies in eight US hospitals. The research participants were 194 interviewees, such as administrative leaders, clinical leaders, and other professional staff.

The information retrieved from the researchers is credible as it was published by infection control and hospital epidemiology. The research has also been published on PubMed. The levels of evidence included research results that affirmed higher-performing hospitals outperformed other hospitals in CLABSI prevention owing to high level commitment, recognition, doctors and nurse alignment, systemic education, and quality use of data (McAlearney et al., 2015). The researchers cited 28 sources from medical backgrounds, which asserts that they did comprehensive research. The researchers adopted a qualitative study of management practices. A qualitative approach identifies the standards of services offered to patients.

The quality of evidence provided by the research is enough to suggest that hospitals that are well managed to prevent CLABSI and HAIS cases. The recommendation is being adopted by many hospitals seeing as nurses have to ensure correct placement, cleaning, and removal of central lines. Implementation of the proposal is, therefore, still ongoing.

Quality Improvement

The proposed recommendation to improve patients' nursing management addresses the ethical principle of beneficence, which entails refraining from maltreatment and minimizing harm (Husson University, 2017). When nurses take proper care of patients, CLABSI and other HAIS are reduced, reducing hospital costs and staying for patients. Better nursing management also meets the ethical principle of non-maleficence, which entails inflicting patients' least harm and avoiding unnecessary risks (McDermott-Levy et al., 2018). When nurses take extra precautions to avoid risks, patients are protected from CLABSI and other HAIS.

Conclusion

This paper documented how CLABSI, as one of HAIS, can be prevented by better nurses' management. CLABSI results from improper insertion, removal, or management of central lines. This has the potential to incur patients more medical costs and prolong their stay in hospital. Nurses can be trained to conduct routine checks on patients to ensure their catheters are functioning correctly and are clean.

References

Considine, J., Shaban, R. Z., Fry, M., & Curtis, K. (2017). Evidence based emergency nursing: Designing a research question and searching the literature. International Emergency Nursing, 32, 78–82. https://doi.org/10.1016/j.ienj.2017.02.001

Kirtil, I., & Akyuz, N. (2018). Precautions are taken by nurses about the prevention of Hospital-Acquired Infections in Intensive Care Units. Pakistan journal of medical sciences, 34(2), 399.
https://dx.doi.org/10.12669%2Fpjms.342.14610

Lakhanigam, S. (2016, November 26). Preventing Central Line Infections: A Nursing Priority. Minority Nurse https://minoritynurse.com/preventing-central-line-infections-a-nursing-priority/

McAlearney, A. S., Hefner, J. L., Robbins, J., Harrison, M. I., & Garman, A. (2015). Preventing Central Line-Associated Bloodstream Infections: A Qualitative Study of Management Practices. infection control & hospital epidemiology, 36(5), 557-563.
https://doi.org/10.1017/ice.2015.27

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), 473-481.
https://doi.org/10.1016/j.outlook.2018.06.013

Pengine, W. (2019, August 26). Beneficence Nursing and Ethics. Husson University. https://online.husson.edu/beneficence-nursing-ethics

Pyrek, K. (2017, August 21). Bundled Interventions, Ongoing Education, Can Address the Threat of device-related Infections. Infection Control Today.
https://www.infectioncontroltoday.com/view/bundled-interventions-ongoing-education-can-address-threat-device-related-infections

Thom, K. A., Li, S., Custer, M., Preas, M. A., Rew, C. D., Cafeo, C., ... & Lissauer, M. E. (2015). Successful implementation of a unit-based quality nurse to reduce central line-associated bloodstream infections. American journal of infection control, 42(2), 139-143.
https://doi.org/10.1016/j.ajic.2013.08.006.