Central Line Acquired Bloodstream Infection and Quality Improvement Process and Plan
Please can you update the previous Capstone paper, and take these instructions into consideration please. thank you.
his submission is missing several required elements on your selected quality improvement model and tool. Your Literature review is well organized, I would prefer to see studies conducted in the U.S. on this topic as our practices may be quite different from The Asian nations and Middle East hospitals.
For this Assignment, write a 4-5 page paper that addresses the following:
Introduction (Approximately 1-2 paragraphs)
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.
Provide the rationale for selecting the practice problem.
Literature Review (Approximately 4-5 paragraphs).
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.
Include an explanation of the quality management measurement and data that were presented.
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)
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.
Explain why the specific process was selected and document your explanation with references.
Quality Improvement Plan (6 – 10 paragraphs)
Using the Quality Improvement Process described in Week 3, provide a detailed explanation of the quality improvement plan that you will use to address the practice problem.
Use the scholarly references identified during the literature review to support the plan.
Resources (Completed in Week 5) (2 to 3 paragraphs)
Describe the resources needed to support the change in practice such as personnel time, supplies for staff education, cost of new equipment, or cost of software.
Explain why each resource is necessary.
Summary (1 to 2 paragraphs)
Summarize the key points discussed in the paper.
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. 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
The intensive care units (ICUs) have received the most attention regarding central line-associated bloodstream infections. However, Banach and Calfee (2013) note that most central line-associated bloodstream infections in US hospitals happen outside of the ICU shifting the awareness regarding the infections to non-ICU settings. The infection occurs following contamination of the central-catheter by pathogens (fungal or bacterial contamination). The infection may occur during catheter insertion with the microorganisms present at the insertion site and seldom through contaminated intravenous fluids (Banach and Calfee, 2013). Diagnosis and management catheter-related bloodstream infections and subsequent catheter removal should be initiated whenever a patient with an intravenous catheter has a fever and other symptoms of systemic infection. Such symptoms include the presence of any positive blood culture and any inflammatory signs (Banach and Calfee, 2013). Early detection and management of central-catheter infections increase the survival rates of the patients.
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.
Central line infections are a major concern for hospitals in the United States. An estimate by the Centers for Disease Control and Prevention indicate that 41,000 central line infections are recorded in US hospitals every year (Wallace & Macy, 2016). Consequently, there has been a multidisciplinary effort to reduce these infections using appropriate insertion methods and management of central venous access devices. Prevention methods used include; educating and training the healthcare professionals regarding proper insertion and management of catheters, implementation of the central-line bundle to enhance performance, increased monitoring and surveillance for central-line infections, and documenting and reporting compliance and comparison rates of data between healthcare institutions both locally and nationally (Wallace & Macy, 2016; p.47). Implementation of the above measures in the suburban Baltimore hospital resulted in a decreased infection rate from 2.9/1000 central-line days in 2010 to 0.8 by 2011, 0 by 2012, and 0.91 in 2013 (Wallace & Macy, 2016; p.52). Implementation of specific prevention measures and team willingness increases the success of central-line prevention measures.
The cost of central line infections is not only lives lost but also includes monetary cost and additional time spent at the hospital. For instance, according to Medina et al. (2014), in the United States, it is reported that about 250,000 central line-related infections occur every year. In the intensive care unit, 0.8 out of every 1000 central line days there is registered a central line acquired bloodstream infection. Globally, the rate is much higher with 4 out of every 1000 central line days a diagnosis of central line infection is recorded (Medina et al., 2014). However, it noteworthy that most of the central lines placed occur outside of the intensive care unit.
Another study by Goudie, Dynan, Brady & Rettiganti (2014) did not look at the rate of infection but rather at the costs associated with central line infections. Goudie, Dynan, Brady & Rettiganti (2014) set out to see how much time is spent on hospitals and how much it cost them. The study group was children under the age of 18 years, and the observations were drawn between 2008 and 2011. Goudie, Dynan, Brady & Rettiganti (2014) relied on a propensity score-matched case-control study. The investigation revealed that children with discharge sheets that had central line infections stayed longer and paid more than those who did not. However, during the study period, it was noted that the centra...