Prevention of Central Line-Associated Bloodstream Infections 3

Introduction

The Purpose of this study is to explore the problem of CLABSIs and examine available measures to prevent, control and reduce incidences. In particular, this project proposes teaching proper CVC maintenance as the intervention to prevent CLABSI. With this in mind, this literature review section will sample various studies which have been done with regard to prevention of CLABSI. Past studies which have been done in this area will be analyzed with more attention being paid to the methodology used, the results, and the solutions they proposed. This section of the project will analyze the theoretical foundations of the approach used, the review of literature, and the key themes which will guide the study. After choosing the topic, the databases from which the searches will be conducted were identified. The searches were then conducted with the key words being “management and prevention of CLABSIs.” The references and bibliographies of research studies found were used to locate others. Comment by Kathryn Flynn: Use ‘project’ throughout, not study or research. Go through paper parts and modify. Comment by Kathryn Flynn: Educational sessions are not enough for a DNP project, per AQR. EBP interventions should be used to support project.

A total of 200 articles were established to talk about the CVCs, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles were left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related journal articles. Other search tools include The National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted studies. Comment by Kathryn Flynn: clarify

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Background

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 (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). CLABSIs are among the leading causes of deaths each year in different countries across the globe. These types of infections have 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. This section of the research is an analysis of articles related to CLABSIs with the significant 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. A quick survey of the literature indicates that many scholars have investigated various prevention measures but none has explored training on CLABSIs maintenance bundle as a preventive measure. This is the gap that this project seeks to fill. Comment by Kathryn Flynn: sp Comment by Kathryn Flynn: delete; don’t incriminate yourself Comment by Kathryn Flynn: are you sure? Doesn’t seem accurate..Prevention of Central Line-Associated Bloodstream Infections 3

Criterion	Learner Score (0, 1, 2, or 3)	Chairperson Score (0, 1, 2, or 3)	Comments or Feedback
Introduction (to the Chapter) and Background (to the Problem) This section describes the overall topic to be investigated, outlines the approach taken for the literature review, and defines the evolution of the problem based on the gap or need defined in the literature from its origination to its current form.		1	You’ll develop this section according to feedback in Chapter one when you submit it. Keep lit review focused on project specifics, not just infection in general.
Introduction states the overall purpose of the project.		1
Introduction provides an orienting paragraph so the reader knows what the literature review will address.		1
Introduction describes how the chapter will be organized (including the specific sections and subsections).
Introduction describes how the literature was surveyed so the reader can evaluate the thoroughness of the review.		1
Background provides the historical overview of the problem based on the gap or need defined in the literature and how it originated.		1	Develop specifics according to Ch 1 modifications
Background discusses how the problem has evolved historically into its current form.		1	develop
This section is written in a way that is well structured, has a logical flow, and uses correct paragraph structure, sentence structure, punctuation, and APA format.		2
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for AQR review, please remove all of these assessment tables from this document. Score 0 (not present); 1 (unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).

Theoretical Foundations

The Quality Health Outcomes Model (QHOM) is used to study healthcare quality and outlines relationships existing betweeen interventions, characteristics and outcomes of patients, and the characteristics of the healthcare system. This model/framework has been used by various researchers to test the effectiveness of infection prevention measures, for instance by Gilmartin and Sousa (2016). The QHOM theoretical framework has been increasingly forming the conceptual framework for researches which assess quality and system interventions for care improvement. Providing high quality healthcare services is the interest of every health care provider. Even ancient renowned philosophers such as Plato and Aristotle identified quality as one of the “great ideas.” The question of how quantity can be quantified has been under discussion for a long time. The QHOM is one of the models proposed to quantify the quality of healthcare (Mitchell & Lang, 2004). The model can be used to show the relationship between adherence to CLABSI prevention interventions as demonstrated by Gilmartin and Sousa (2016). This model will effectively answer the fundamental question asked in this study: How does staff training of proper CVC maintenance reduce the incidence of CLABSIs? Comment by Kathryn Flynn: sp. Align next verb to proper tense according to remediation of this word; don’t know what you’re trying to say. Comment by Kathryn Flynn: Be used by the researcher to.. Comment by Kathryn Flynn: EB best practice Comment by Kathryn Flynn: Delete; subjectivePrevention of Central Line-Associated Bloodstream Infections 3

Criterion	Learner Score (0, 1, 2, or 3)	Chairperson Score (0, 1, 2, or 3)	Comments or Feedback
theoretical Foundations This section identifies the theories or models that provide the foundation for the project. This section should present the theories or models(s) and explain how the problem under investigation relates to the theory or model. The theories or models(s) guide the clinical questions and justify what is being measured (variables) as well as how those variables are related.		2
This section identifies and describes the theories or models to be used as the foundation for the project.		1	Develop how/ why you’ll use it
This section identifies and describes the seminal source for each theory or model.		1	develop
This section discusses how the clinical question(s) align with the respective theories or models.		1	develop
This section illustrates how the project fits within other evidence-based on the theory or model.		1	develop
This section reflects understanding of the theory or model and its relevance to the project.		1	clarify
This section cites references reflecting the foundational, historical, and current literature in the field.		1
This section is written in a way that is well structured, has a logical flow, and uses correct paragraph structure, sentence structure, punctuation, and APA format.		1
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for AQR review, please remove all of these assessment tables from this document. Score 0 (not present); 1 (unacceptable; needs substantial edits); 2 (present, but needs some

Prevention of Central Line-Associated Bloodstream Infections 3