Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)

The topic taken into consideration is the Central Line-Associated Bloodstream Infections (CLABSIs) and prevention. Comment by Kathryn Flynn: Delete; economy of expression per APA

1. Primary points basis four sections in the Literature Review: Comment by Kathryn Flynn: Kerry, this section needs to be organized and every sentence referring to a source has to be cited. It’s too difficult to follow. Use headings to help. Under model, list reference on the model you are using., etc.

a. Background of the problem/gap:

· There arises an urgency to intervene and develop effective measures to curtail the incidence of CLABSIs. Comment by Kathryn Flynn: All this needs to be cited and specific related to the resources you are using.

· The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections

· The nurses need to have the significant knowledge associated with evidence-based practices for the Central line-associated bloodstream infections (CLABSIs), their attitude towards the guidelines and the utilization of the hygienic measures for the Central Venous Catheter (CVC) patients. Comment by Kathryn Flynn: Clarify, cite resource to support what you mean. Comment by Kathryn Flynn: Newborns? Geriatrics? Home care? Clarify.

b. Theoretical foundations (models and theories to be the foundation for the project)

· The efficacy of training of nurses over the prevention of Central line-associated bloodstream infections (CLABSIs) in neonates and children, through the exploitation of a questionnaire defining their socio-demographic data and their practical skills (Elbilgahy, A. A. et al., 2015). Comment by Kathryn Flynn: This isn’t a model, belongs in lit review.; and needs clarification. Rephrase exploitation. Comment by Kathryn Flynn: APA format error.

· Knowledge about evidence practice reveals the discrepancies in the praxis, by the different nursing Pedagogics (Esposito, M. R. et al., 2017). Comment by Kathryn Flynn: Clarify; belongs in lit review.

· Prophylactic measures to eradicate the incidence of CRIs or Central line-associated bloodstream infections (CLABSIs), based on the opinions of the experts as well as the analysis of the research literature (Hentrich, M. et al., 2014) Comment by Kathryn Flynn: Use a full sentence.

c. Review of literature topics with a key theme for each one. Comment by Kathryn Flynn: Full sentence please.

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

· The efficacy of hygiene maintenance in the preponderance of CLABSIs rates in patients with CVCs, maintenance of patients with CVCs (Elbilgahy, A. A. et al., 2015); The key concepts in the study entail CLABSIs, ICU patients with CVCs, dressings, hygiene hub (Esposito, M. R. et al., 2017); The relevance of various interventions in reducing device-related infections. The key concepts are related to interventions (Hentrich, M. et al., 2014) Comment by Kathryn Flynn: clarify Comment by Kathryn Flynn: clarify Comment by Kathryn Flynn: we still need a model or theoretical framework. Refer to past lessons if you don’t have a clear understanding of this section.

Setting

· Adult ICU (Elbilgahy, A. A. et al., 2015). Comment by Kathryn Flynn: I thought you mentioned children avbove? Align all sections.

· The incidence of CRIs in cancer patients at the hospital (Hentrich, M. et al., 2014). Comment by Kathryn Flynn: Introduce acronym CRI first use.

Summary

· Gap/Problem: There is a need to implement evidence-based methods of improving health outcomes and CLABSIs prevention including the nursing education Comment by Kathryn Flynn: Improving infections? Clarify; rephrase.

· Quantitative application: the Quantitative project is to establish a relation between the occurrence of CLABSIs and staff training, reinforcement, and proper hygiene for Central Venous Catheters (CVCs) inserted in the hospital setting. Comment by Kathryn Flynn: You’ll need to say that a procedure already exists and needs to be changed or why it needs improvement. Is there a problem? Inconsistent care? Why is there a need for the project at your setting?

· Significance: The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections. Therefore the necessity to maintain insertion site hygiene consistently is determined to be the best practice in preventing infections that can lead to sepsis and septicemia Comment by Kathryn Flynn: cite

2.

a. Background of the problem/gap:

Challenges to a higher level of compliance with the randomized trials in prevention strategies. The decolonization which is being universal impacts the CLABSI amongst the larger community Comment by Kathryn Flynn: this isn’t clear. What are you trying to say?

a. Theoretical Foundations (models and theories to be the foundation for the project) Comment by Kathryn Flynn: Summarize model to be used; you’ll have to define one first.

The theoretical model is associated with the strategies deployed and operational processes linked to the prevention of Central Line Association Bloodstream Infection (Hickok, J. et al., 2014).

b. Review of literature topic

Rapid Dissemination of Universal Decolonization in Adult Intensive Care Units (ICUs) Reduces Healthcare-Associated (HA) Central Line-Associated Bloodstream Infections (CLABSI) in over 100 Community Hospitals in a Single Healthcare System

c. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The study conducted a randomized trial concerning the 3 MRSA prevention strategies being deployed in 74 Intensive Care Units and a reduction in the risk of the infections. Comment by Kathryn Flynn: What study?? Every part of this needs clarifying. Say what you mean.

Setting

The 350 adults in Intensive Care unit formed part of the randomized trial, and it was spread over 160 hospitals (Hickok, J. et al., 2014). The deployment of planning and the central coordination of infection took place with the resources available. Comment by Kathryn Flynn: What was spread? Refrain from using it, they, those, etc. in scholarly writing. Use noun.

Summary

The universal decolonization amongst the ICU patients was closely linked to the decline in CLABSI, and the rapid implementation was a successful approach (Hickok, J. et al., 2014). Comment by Kathryn Flynn: Rapid impl. Of what? Clarify.

3.

a. Background of the problem/gap:

The complication linked to the urinary tract infection and the Central Line-Associated Bloodstream Infection and the costly diagnosis has led to the increase in morbidity Comment by Kathryn Flynn: When did we start with UTI? Align all parts with same content. Stay focused.

b. Theoretical foundations (models and theories to be the foundation for the project) Comment by Kathryn Flynn: Redo.

The model is associated with the evidenced-based guideline and elevation of infection rates. The systematic approach is significantly linked to the process and the reduction resulting as part of the intervention.

c. Review of literature topic

Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs.

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention is based on the narrative review forming part of the study. The conceptual model being deployed is categorized into various stages that form part of the awareness and proper care using catheters.

Setting

The setting is based on the 2015 systematic review conducted for the Intensive Care Unit and the elevation of infection rates (Patel, P. K. et al., 2018). The categorization of the intervention takes place basis the deployment of catheters, and the study evaluates the infections with the reduction in infections. Comment by Kathryn Flynn: This is not how you’ll define a setting. Review how to define a setting in past learning. Comment by Kathryn Flynn: Rephrase for grammar.

Summary Comment by Kathryn Flynn: You just did a summary. Why again?

The categorization of the intervention takes place and address of multiple stages as recognized by the enhanced preventive action.

4.

a. Background of the problem/gap:

The problem is linked to the hematologic malignancy that is prevalent amongst the patients having bone marrow transplants. The risk of CLABSI tends to be more amongst such patients, and the effect analyzed with the increased patient education tends to be significant.

b. Theoretical foundations (models and theories to be the foundation for the project)

The model pertains to the recognition of malignancy attributed as part of the core elements linked to the focus on hygiene amongst patients and the minimizing linked to the line access.

c. Review of literature topic

Implementation of a Central Line-associated Bloodstream Infection (CLABSI) Prevention Bundle for Adult Hematologic Malignancy and Bone Marrow Transplant Patients

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention with the adopted healthcare-associated infections tends to be crucial. The multidisciplinary model of control of infection and reducing the spread is a significant approach based on the study (Dombecki, C. et al., 2017). The observation with the 41% reduction in the non MBI CLABSI cases is crucial to note.

Setting

The setting involved the standardized process, and 240 patients were evaluated as part of the experiment.

Summary Comment by Kathryn Flynn: Ok third summary? Or is it fourth? Streamline the whole assignment after close review.

With the significant intervention, the identification of relevant strategies can bring about the increase in awareness of HH.

5.

a. Background of the problem/gap:

The challenges are associated to the infection control professionals while they are playing a crucial role in the management of infections linked to CLABSI. The challenges about prevention were significant.

b. Theoretical foundations (models and theories to be the foundation for the project)

Facilitating central line-associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff

c. Review of literature topic

Facilitating central line-associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The implementation of standardization as part of the procedure with the enhanced success rate is crucial to the study.

Setting Comment by Kathryn Flynn: You already did this?

A comprehensive study is deploying the eight hospitals that were part of the participation in the program led to the preventive initiative. The interview of informants was done and the 26 ICP’s too formed part of the study.

Summary

The interviews of more than 30 minutes with the participants led to a significant discovery with the informants well identifying the challenges about CLABSI prevention.

6.

a. Background of the problem/gap:

The surgical site infection tends to be crucial. Concerning the surgery done for hip joint replacement or the knee joint replacement, the quality of life for the patients gets impacted to a greater extent.

b. Theoretical foundations (models and theories to be the foundation for the project)

The theoretical foundation rests upon the monitoring increase linked to the compliance based on the infection prevention taking place.

c. Review of literature topic

Infection Prevention and Quality Coordinators Collaborating to Decrease Central Line Associated Blood Stream Infections (CLABSI) by Monitoring Central Line Catheter Maintenance

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI).

The prevention with the compliance rates accounted for the six months before installation is significant. The retrospective analysis was critical to the study.

Setting

The setting involves the installation of handheld hygienic opportunities and the recording of the events over fourteen months (White, L. A. et al., 2016). There was a multicentre registry being collected as part of the study.

Summary

The subject being patients who had the hip replacement or the knee replacement based on the intervention had been encouraged to adapt to the measures (White, L. A. et al., 2016). There was a dramatic difference observed about HH

7.

a. Background of the Problem/Gap:

The services being provisioned for the outpatients needs to have changed. With the current setting, the infection control program and plan is challenged with the strategies that tend to be integrated with the outpatient treatment centers.

b. Theoretical foundations (models and theories to be the foundation for the project)

The models are associated with the delivery model and the analysis of the shift taking place concerning the treatment centers. The infection prevention being the prime focus stands to include the regulatory requirements too.

a. Review of Literature Topic

Decreasing CLABSI Incidence Associated with Decreasing MRSA Bacteremia LabID Incidence

b. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention concerning CLABSI is taking effect in the case of the inpatient and outpatients. Environmental safety rounds stand to be significant.

Setting

The setting in the study involved the consideration of 5 hospitals along with the 110 outpatient treatment centers. The infection control risk was crucial to the study.

Summary

The OTC integration taking place with the resolution of integration challenges led to the enhancement basis the inpatients and outpatients forming part of the study. The outpatient IP also visited the facility on a routine basis (Beverly, A. L. et al., 2018).

8.

a. Background of the problem/gap:

The rise in the number of incidents wherein the changes were made concerning CLABSI attribution brought about the negative impact.

b. Theoretical foundations (models and theories to be the foundation for the project)

The theoretical foundation is based on the prevention of infection cases amongst the patients having urinary tract infection.

c. Review of literature topic

The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention of CLABSI and the associated attribution confers to the prevention concerning the associated urinary tract infections that are crucial.

Setting

The setting involves the study of 502 patients at the hospital been taken into consideration.

Summary

The changes linked to the catheter-associated infections about the urinary tract can significantly enhance the central line association blood infection (Advani, S. D. et al., 2018).

9.

a. Background of the problem/gap:

With the revision in the definitions about CAUTI, the fungemia along with the lower bacteremia levels are impacted

b. Theoretical foundations (models and theories to be the foundation for the project)

The theoretical foundations which form part of the infection evaluation have had a significant impact.

c. Review of literature topic

Definitional change in NHSN CAUTI was associated with an increase in CLABSI events: evaluation of a large health system

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention involves taking into consideration the standardized infection rate and the evaluation of the same.

Setting

The setting involves the study taken into account concerning 137 adults about 65 hospitals (Fakih, M. G. et al., 2017). The CLABSI SIR has also evaluated the basis of the study.

Summary

The improved catheter-associated tract infections do lead to a greater reduction in the infections.

10.

a. Background of the problem/gap:

The background is linked to the review of potentially impacted cases wherein the identifier for the causes leading to CLABSI can be evaluated.

b. Theoretical foundations (models and theories to be the foundation for the project)

The study brings about the significant models as part of the evaluation done and the review considered in accordance.

c. Review of literature topic

Presentation Number 16 – Suspected Origins of Bacteremia in Center for Disease Control (CDC) National Healthcare Safety Network (NHSN) Defined Central Line-Associated Bloodstream Infections (CLABSI) at a Tertiary Care Academic Medical Center

d. Prevention of Central Line Associated Blood Stream Infection (CLABSI)

The prevention of CLABSI infections with the identification of root causes is crucial (Carpenter, A. D. et al., 2016).

Setting

The setting involves the 700-bed hospital associated with academic teaching.

Summary

The study involving the evaluation done in the arena of tertiary care segment is crucial. The infectious disease evaluation and the causes can be well traced.

“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?” Comment by Kathryn Flynn: Clarify. Comment by Kathryn Flynn: So you’ll reinforce standard care? Why is that needed? Comment by Kathryn Flynn: define

P: Patients > 65 years of age with a central line

I: Staff training and reinforcement of central catheter, hub hygiene Comment by Kathryn Flynn: you’ll need to compare same to same. Here, you are comparing trained individuals to standard care. Are you just training with standard care? Why is important, and why do you think that will change anything, if they ae already doing it that way?

C: Compared to standard care

O:  Reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) Comment by Kathryn Flynn: How will you measure pre and post intervention?

T: A period of one-month

a. Location: ICU Clear Lake Regional Medical Center, Webster, Texas

b. Population: The population being sampled in the study is 120 adult ICU nurses (Elbilgahy, A. A. et al., 2015); 335 nurses were intrigued (Esposito, M. R. et al., 2017) Comment by Kathryn Flynn: Is this someone elses’ study? In this section, you need to state what you want to do, not refer to a past study.

· Independent Variables: crystalloid fluids, hub hygiene and line changes Comment by Kathryn Flynn: What are you referring to? This wasn’t in the lit review, problem statement or anything.

· Dependent Variables: pedagogy Comment by Kathryn Flynn: This will need to be modified.

· The data sources will be interviewers who are the healthcare professionals who have allied staff as information will be collected through the interview process. Comment by Kathryn Flynn: Use a full clear sentence. I have no idea what this means.

· For evidence-based practice in a healthcare setting, it is proper to have the nurses asked questions about the particular practices in relation with the staff training, reinforcement of the Central line catheter hub hygiene once it has been inserted, the cleansing of the site and cases of Central Line-Associated Blood-stream Infections. Comment by Kathryn Flynn: Why is this important? It doesn’t seem significant.

· While the reading of existent articles will offer a source of information through which questions can be asked of the participants, the questionnaire will serve as the instrument for validating the study. Comment by Kathryn Flynn: Redo this part please.

· The process will assist in acquiring the observational, additional, and basic data that is targeted. Comment by Kathryn Flynn: Vague; clarify.

· The questionnaires will focus on Adult ICU practices (Rodrigues, Correia, & Kozak, 2016).

· The data tools were exploiting the practices of nurses in Adult ICU, questionnaire responses, and a review of the other related articles.

· The collection of data will be through an interview questionnaire which will be derived from previous literature exploring the related issues. Comment by Kathryn Flynn: Vague; clarify.

The sources of data will be the healthcare professionals with allied staff as data will be gathered from them via interviews.

The purpose of this quantitative project is to establish a relation between the occurrence of CLABSIs, and staff re-education of hub hygiene for Central Venous Catheters (CVCs) inserted patients at the hospital and to explore the preventive measures being taken by the healthcare staff at hospitals in Webster, Texas for the prevention of CLABSIs. Comment by Kathryn Flynn: If you are interviewing with open ended questions, it would be qualitative. If you are codifying data then, it would be mixed method. I can’t say until you clarify this submission.

a. Location: ICU Clear Lake Regional Medical Center, Webster, Texas

b. Population: The population being sampled in the study is 120 adult ICU nurses (Elbilgahy, A. A. et al., 2015); 335 nurses were intrigued (Esposito, M. R. et al., 2017). Comment by Kathryn Flynn: Are you replicating a study? Why are you taking a sample size from past research? You have to justify your own sample size. There is a formula for this.

7. Determining the Sample Size

· A sample population is often selected based on the PICOT question the evidence-based study is being held on people who are 65 years and more. The patients are with a Central line catheter hub hygiene.

· The sample population is targeted from ICU Clear Lake Regional Medical Center, Webster, Texas.

· After a focused consideration of the required population, a random sampling of nurses from the target group will be picked, and that will help in acquiring comfortable to deal with in terms of the study expenses and data acquisition, the researcher used focused group (Nayak & Singh, 2015). Comment by Kathryn Flynn: Rephrase; grammar errors; unclear.

· The selection of a sample population should not be haphazard for it will lead to biased results. Furthermore, a large sample size helps in having precise results.

· It is necessary to calculate the sample size for validity and reliability of results. The study will, therefore, allow an error of plus-minus 5 (Patino & Ferreira, 2016). Comment by Kathryn Flynn: There is no context for this; explain.

· To avoid oversampling to have a minimal sample size that we are targeting are the 120 adult nurses out of the 335 (Andersomn, Kelley, & Maxwell, 2017).

· With the confidence level of 95 calls upon the usage of 180 nurses to have an error of 5 percent only. This population will be equally divided between the treatment group and the control group. The particular ratios of gender are not necessary, yet the ration of re-trained and those left without that are of significance. Comment by Kathryn Flynn: Clarify this after you tell clearly what you’ll be doing as an intervention.

· The study will select diverse participants in terms of gender while ensuring that they are 65 years and above and attending adult CVC patients. Comment by Kathryn Flynn: This is not clear. Write clear sentences.

· It will be important to calculate sample size for validity and reliability of results (Patino & Ferreira, 2016).

· The study will allow an error of plus-minus 5 to avoid oversampling to have a minimal sample size that we are targeting are the 120 adult nurses out of the 335 (Anderson, Kelley, & Maxwell, 2017).

· This population will be equally divided between the treatment group and the control group.

The formula below will help determine the population to be sampled. Comment by Kathryn Flynn: Ok, so tell sample size here.

8. Inclusion/exclusion criteria of the subjects

· People who are 65 or above and are from ICU Lake Regional Medical Centre, the central line catheter hub clinic section.

· The nurses who are not from the Central line of ICU Clear Lake Regional Medical Center will be excluded (Patino & Ferreira, 2018). Comment by Kathryn Flynn: Are your participants patients or nurses? Align this section.

· Those who will have signed consent will be included in the study because of having fulfilled the research ethics standards.

· When the interviews and questionnaires have been conducted, the incomplete questionnaire forms will be excluded while the interview subjects who have not attended the interview will not be considered.

· Questionnaires that are entirely filled and interview subjects who will turn for the interview and response will be included in the findings.

· The instruments utilized in the research are the interview questions and a questionnaire. The creation was founded on the PICOT question and the statement of the problem, to acquire the desired information. Comment by Kathryn Flynn: What tool? Specify. Is it a valid tool? Has it been tested? Comment by Kathryn Flynn: I need to know specifics in order to consider approving this. Did you make the questions? Attach in appendix.

· While the questionnaire had most questions as closed, the interview questions will be open to allow attainment of supplementary data from the participants.

· Direct questions are expected to occur at the end of the interview (Nayak & Singh, 2015), Nevertheless, in this interview process, there will be utilization of indirect question with more direct questions for the target information from the nurses who have been retrained on hygiene of the hub at Clear Lake Regional Medical Centre and them are handling adult patients with CVC versus others who might not have had a similar training from two other hospitals and not every other nurse anywhere. Comment by Kathryn Flynn: Did these researchers say this? Or is that what they did in their research? Unclear.

· The questions will be simplified as much as possible, and they will allow one response at a time.

· The questionnaires will contain demographic questions on the gender, the CLABSI prominence among the adult patients with CVC, how regular the cleansing process is conducted by the trained nurses, and any other hygiene process that are carried out by the re-educated nurses.

The dietary practice, interview guidelines, and demographic questionnaire were as clear as possible to allow the response of the clients.

· Since crisis management as a subject matter is very sensitive to the organization, compliance with confidentiality agreements is paramount (Mkunga, 2017).

· In this research study, any details that the respondent will not want it disclosed will be removed and deleted from any written or oral records, while others are candidly presented.

· Before the recruitment process, the participants will be contacted and be informed of the research and its significance (Castillo-Montoya, 2016).

· They will then be asked to declare their readiness to partake in the study and the free times they have for the interview process or questionnaire filling process.

· The form will have the clinical question, the usability of results, assurance of anonymity and confidentiality in which the researcher will indicate how the results will be exposed, to whom they will be exposed and how the subjects will be prevented from harm.

· The only harm could be labeling the nurses as unhygienic, hygienic, effective or ineffective, and mentioning their particular names.

· Since the study is checking on evidence-based care and its impact, the subjects will not be mentioned, and the results will be written in a manner that they do not openly show which health care has a particular condition (Kamat, 2018).

· It is necessary that health care centers be informed of the study.

Before the study, the researcher will acquire their permission through formal e-mails, which will be sent to the administration for approval. Comment by Kathryn Flynn: Define who ‘their’ is Comment by Kathryn Flynn: Kerry, I think I can deduce what you would like to do. However, the assignment needs clarification, organization, citations, and organization. Please review comments and review every component of the assignment to amend, and resubmit. Feel free to make a conference call appointment. Thanks.