NURS 4220. Capstone paper. Central Line Acquired Bloodstream Infection
NURS 4220
Capstone Paper Guide
The Capstone Paper is the culminating Assignment of your BSN program at Walden University. In this Assignment you will identify a quality improvement practice problem, review related peer-reviewed, evidence-based practice articles, and propose an evidence-based practice plan that you will use to address the practice problem.
Capstone Paper Overview
The Capstone Paper is 4-5 pages in length. Drafts of the first three sections of the paper (Practice Problem; Purpose, Methods, and Findings; and Quality Improvement Process) are submitted in Week 3. Your Instructor will provide you feedback on these sections that you will address and incorporate into your subsequent Capstone Paper submissions in Week 5 and Week 6.
The last three sections (Evidence-Based Practice Performance Improvement Plan Explanation, Resources, and Summary) are submitted in Week 5. You will again receive feedback from your Instructor on your paper.
You will submit the final version of your paper in Week 6. The final version should address all of your Instructor’s questions and should incorporate all of their feedback.
Assignment Template
You will use the Walden University APA Course Template to complete this Assignment.
o Walden University. Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved from http://academicguides(dot)waldenu(dot)edu/writingcenter/templates/general#s-lg-box-2774360
Delete the abstract page in the template. This is not required for this course.
The template includes the correct font and formatting: 12 pt. Times New Roman font, double spacing, and 1 inch margins on all sides.
Writing Standards
• Review the Academic Writing Expectations Checklist Capstone Level found in your Week 1 Learning Resources
o Note the new expectations for Use of evidence and Credit to Source
o Use a Scholarly Voice
http://academicguides(dot)waldenu(dot)edu/writingcenter/scholarlyvoice
http://academicguides(dot)waldenu(dot)edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859
o Review the Walden University Writing Center webpage: Using Evidence: Synthesis - http://academicguides(dot)waldenu(dot)edu/writingcenter/evidence/synthesis
This is the practicum problem I chose. (CLABSI) Central line acquired blood stream infection.
Capstone Paper Outline
• Introduction (Approximately 1-2 paragraphs)
o State the practice problem in measurable terms and that reflect quality indicators.
This is the same problem described in the week 1 practicum discussion.
Keep in mind that this section may need to be revised after you complete all of the other sections.
o Provide the rationale for selecting the practice problem.
• Literature Review (Approximately 4-5 paragraphs).
o Synthesize the purpose, methods, and findings from at least five peer-reviewed, evidence-based practice articles that support your practice problem.
Two main components of successful synthesis include evidence of the student's own ideas and a well-organized presentation of evidence.
o Include an explanation of the quality management measurement and data that were presented.
o Include a minimum of at least 5 peer-reviewed evidence-based practice articles that support your practice problem.
• Quality Improvement Process (Approximately 2-3 paragraphs)
o Describe the quality improvement process (posted in the practicum discussion) and the tool that will be used as a basis for the practice problem.
This process will be used to support the proposed quality improvement plan.
o Explain why the specific process was selected and document your explanation with references.
Central Line Acquired Bloodstream Infection
Student Name Here
Walden University
Central Line Acquired Bloodstream Infection
Whenever a central line is placed in a patient, there is the possibility of that patient developing an infection. A central line acquired bloodstream infection is a lab tested and confirmed infection that is not attributable to any other outside sources and is established within 48 hours of the central line being placed. Central line infections are among one of the costliest infections and amount to about $46000 per patient (Medina, Serratt, Pelter & Brancamp, 2014). Moreover, patients who get infections from central lines experience prolonged hospital stays and have a high chance of mortality. In fact, patients in the intensive care unit record infections in about 0.8 out of 1000 central line days. Investigating this problem is essential as central line blood infections are a major factor towards increased mortality and morbidity.
Literature Review
Lin et al. (2017) investigated how central line acquired bloodstream infections were affecting patients admitted to the intensive care unit in Asian nations. Their study was based on the surveillance of patients admitted to the Taiwan hospital intensive care unit for one year, between 2012 and 2013 (Lin et al., 2017). It was their observation that the patients in intensive care units were more susceptible to infections from central-catheters and a delay in their removal resulted in increased mortality. Their observation discovered that central line infections occurred every 4 out of 1000 central-catheter days (Lin et al., 2017). They looked at 186 episodes of central line infections in 156 intensive care patients and it was discovered that the biggest culprit of the infections was the Gram-negative bacteria.
Rosenthal (2009) focused on the rate of central line infections in developing nations and the results revealed that the infection rate was higher than that of the United States. The biggest cases of central-catheter infections were attributed to children and adult patients in intensive care units which ranged between 1.6 and 45 instances per every 1000 catheter days (Rosenthal, 2009). Rosenthal (2009) data was gathered from peer-reviewed articles published between 1998 and 2008 and that touched on central-line infections in developing nations as defined by the World Bank. However, these classifications may have changed over the years due to the evolving economic conditions. Nonetheless, the study aids developing nations to understand the effects of central-line infections and how to reduce the mortality rates.
King Abdulaziz Medical Center is one of the largest hospitals in the middle east with a capacity of over 600 beds. Yaseen et al. (2016) sought to understand how best to reduce the central-catheter infections to zero. The rate of central line infections was 2 out of 1000 central-catheter hours and the study wanted to see if the implementation of bundle care will reduce the rate of infections (Yaseen et al., 2016). The biggest challenge to achieving the desired rate of zero was the low compliance rate (Yaseen et al., 2016). However, after the creation of a multi-disciplinary team, the compliance rate shot up to 98 percent and the recorded central-line infections dropped to about 0.7 per 1000 central-line days (Yaseen et al., 2016). It was projected that at 100 percent compliance to the central line care bundle the ...