Literature Review Corrections Essay 4

Central Line-Associated Bloodstream Infections Literature Review Comment by Microsoft Office User: The heading of introduction is inferred in APA format

I. Introduction

Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.

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II. Questions Posed in the Studies

a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.

b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the

evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?

c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?

d. Srinivasan, Wise, Bell, Cardo, Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.

e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.

f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva, Zong, Jeong, & Lee, (2015 (2011) the inquiry is into what level of knowledge, attitudes, and behavior the nurses in the cancer setting in the Italian hospitals have about CVC procedures.

g. O’Grady, Alexander, Burns, Delilnger, Garland, Heard, Lipsett, Masur, Mermel, Pearson, Raad, Randolph, Rupp, & Saint (2011), the inquiry focused into how Positive blood culture shows the relationship between CLABSI and CDC surveillance. Literature Review Corrections Essay 4

h. Perin, Erdmann, Higashi, Sasso, Bianco et al. (2016) the research question is; What are the CLABSI-related preventive measures implemented among adult patients hospitalized in an ICU?

i. Esposito, Guillari & Angelillo (2017) inquiries into what level of knowledge, attitudes, and behavior the nurses in the cancer setting in the Italian hospitals have about CVC procedures. It also questions the predisposing factors for the knowledge, attitudes, and behavior.

j. Oliveira, Stipp, Silva, Frederico, & Duarte (2016) questions into the standard procedure in the ICU, the catheterization of a central venous access good care practices from insertion and handling to the moment of withdrawal.

k. In a research by Basinger, M. A. (2014), the research question questions into the causal effects of the CUSP on the reduction of CLABSIs within the relationship CUSP team member webinar attendance has with the reduction of CLASBIs.

l. Xu & Wu (2017) inquire about how a Comprehensive Unit-Based Safety Program which involves the improvement of communication, teamwork, and safety in the ICUs.

m. Bianco, Coscarelli, Nobile, Pileggi, & Pavia (2013) find it interesting to establish the role of knowledge, evidence-based practices, the insertion and maintenance of CVC with the protection of CLABSIs.

n. The Final research is by Han, Liang, & Marschall, (2010), who question how the involvement of education to the family and the patient can help prevent CLABSIs attacks among patients on CVC care. Another study by questions the relationships between Positive blood culture and CLABSI with CDC. Comment by Microsoft Office User: Synthesize each section by describing articles with commonalities and differences. But you need to write in paper format in paragraph form.

III. Identified Subthemes Comment by Microsoft Office User: No longer use an outline, use headings (according to APA format) for your main concepts, and place your subthemes underneath, as described in your 10 Strategic Points document

With the picot question 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 at ICU Regional Medical Center, Texas? From this, there are various subthemes that emerge in this study. These include; the issue of hygiene and its effect on CLABSI, knowledge and how it impacts on infection, policies or experience and how it affects perception and prevention of infections, evidence-based practice, non-evidence-based practice, disinfection and sterilization, Insertion bundle, Maintenance bundle, and Quality Improvement. Comment by Microsoft Office User: First this isn’t a PICOT question Second you need to synthesize this information describe multiple articles at once So discuss CLABSI the subthemes under CLABSI would include Hygiene and impact Knowledge Policies Nurse experience Evidence Based Practices/Interventions Describe in full

The reviewed literature has shown that the nurse, patients, family, and evidence versus non-evidence-based practice are important in the analysis of the situation. Besides, the setting, type of catheter, and conditions affect the entire discussion.

IV. Risk Factors Associated with CLABSIs

a. Contamination on Insertion

The catheter may gain entry into the bloodstream during the insertion of the line into the body of the patient. The rate of infections during insertion is substantially dependent on the hygiene levels that are put in place by the health care providers (Dick et al., 2015). The rates of infection during insertion happen to be high showing ignorance or lack of professionalism among the health caregivers. Contamination during insertion may also result from the instruments used and how sterilized they are.

b. Contaminated Skin of the Patient

The insertion is done on the body of the patient. A contaminated skin of the patient may contain germs which may enter the body during the insertion (Dombecki et al., 2017). The fact that patients have negligible knowledge concerning the different ways the infection may occur means that there is so much responsibility placed on the health caregivers. The infection rates due to unsanitary practices of the patients seem to have drawn the attention of the authors of the different articles analyzed. With the rates of CLABSIs rising each year, mortality rates have also increased. Researchers have made CLABSIs prevention a priority to address such risk factors to avoid or reduce infection rates.

c. Non-Compliance with the Central Line Maintenance

There are guidelines for healthcare professionals meant to reduce the chances of CLABSIs infection. Such guidelines include not using antiseptics and ensuring complete dressing changes (Orwoll et al., 2018). As much as these guidelines and policies are in place does not mean that compliance is definite. Cases of caregivers who do not comply with the stipulated guidelines are common and such levels of unprofessionalism have cost patients their lives.

V. Interventions

a. Removal of Unnecessary Lines

The authors agree that there are times patients will have lines which are no longer being used for any medical purpose. These are mainly patients who have spent so much time in the hospitals, and the chances of being discharged seem minimal (Sodek, 2016). The caregivers are meant to remove lines once they have served the purpose. The more these lines remain on the body of the patients the more the chances of infection. Bacteria and all other associated germs will easily enter the body.

b. Health Care Providers to Follow RecommendationsLiterature Review Corrections Essay 4

Healthcare professionals are trained on the best practices that are meant to ensure that the chances of patient infections are minimized or even eliminated entirely. Unfamiliarity creeps in at times, and the well-being of the patients is jeopardized (Stone et al., 2014). Just like any other profession, health care ties the professionals around practices which ensure ethical undertakings to safeguard the lives of the patients. The authors are for the idea that health care professionals should be just to patients and do what their work ethics dictates them to do. Such will ensure improved health and safety of the patients.

c. Encouraging Teamwork

In any health care setting, there are two main participants. These are the health caregivers and the patients. One of the authors suggests that teamwork between these two parties will go a long way in reducing the rates of these infections (Stone et al., 2014). Teamwork will ensure that there is knowledge sharing, that key concerns and risks that may be known to one of the parties are made known to the other. The impact teamwork will have towards preventing the cases of CLABSIs in hospitals is immeasurable. The same should be embraced and upheld.

VI. CLABSIs associated infections/Transmissions

a. Hematogenous Transmission

This is an infection that is characterized by a primary tumor penetrating into blood vessels. They then get transported in the blood vessels and eventually into the distant parts of the body of the patient (Stone et al., 2014). Once at the distant sites, the cells will penetrate the walls of the vessels again and build a basis for another, a new tumor on the new site. Such are the same cases that happen with CLABSIs. Examples include catheter-associated Urinary Tract Infections (CAUTI) that can lead to CLABSI’s. Literature Review Corrections Essay 4

b. Catheter-associated Urinary Tract Infections (CAUTI)

A urinary tract infection (UTI) refers to an infection in any part of the urinary system. UTIs are also common healthcare-associated infections reported by both patients and healthcare givers. These infections are associated with urinary catheters, a tube which is used by doctors through the urethra to drain urine (Douglas, 2015). Most of the hospitalized patients end up with urinary catheters inserted in their bladder. Prolonged use of the catheters increases the risks of the infections. Health caregivers should ensure that these catheters are removed when not being used to reduce the risk of patients contracting the CLABSIs.

c. Contaminated Infusates

The term refers to the introduction of pathogens into the body of patients. The introduction of these pathogens occurs through the sterile used by the health care providers. During surgery or during other procedures which may require line insertion, bacteria may be introduced into the body of the patient (Stone et al., 2014). Contaminated infusates happen to be one of the ways CLABSIs bacteria is introduced into the bloodstream. Patients and the health care providers need to be educated on such risks.

VII. Necessity for Interventions

a. Reduced incidences of CLABSIs

The preventive measures mentioned above by the authors of the different articles will go a long way into reducing the incidents that are reported by patients and caregivers concerning CLABSIs (Klintworth et al., 2014). Encouraging adherence to the hygiene standards, the policies and the recommendations as they relate to CLABSIs infections will enable the creation of an environment that will enhance the well-being of the patients and also minimize the chances of contraction of the infections. The infection is deadly and is already costing patients and nations dearly.

b. Reduced morbidity

Morbidity has been defined as how often a disease occurs or is reported in a population. The morbidity rate is determined by examining the number of patients with a certain disease at a given period (Kim & Biorn, 2017). Reduced cases of a disease mean that preventive and treatment measures are effectively implemented by all stakeholders involved. CLABSIs infections are no exceptions here. The literature work of the previous authors appreciates that the health care institutions that have adopted the interventions measures above report few and reduced cases of the infection.

VIII. CLABSIs Symptoms

a. Site Discharge

The area where the catheter is placed should remain dry, and no discharge should be coming from the area. Some patients, however, may notice yellow or green discharge (Conley et al., 2018). The drainage should be a cause for alarm, and the authors have identified the discharges as some of the top indicators that something has gone wrong and healthcare providers should act up. Discharges show that the area is not fresh and has been exposed to bacteria and germs, something that should be of great concern.

Literature Review Corrections Essay 4