Central line associated Bloodstream infections

Literature Review Your name October 3, 2016 Your Institution of Affiliation Synthesis The correlation between the risk of CAUTIs and its tendency to occur in EDs is still ambiguous. Some findings report that patients admitted in EDs have a higher tendency to develop CAUTIs because of inappropriate use, improper documentation and unneeded ICUs insertion (Gokula, Smith, & Hickner, 2007). However, there are also findings which offer a contradicting result saying that it is weak to no direct relationship between the being a staff in the ED and the tendency of having CAUTIs (Hazelett, Tsai, Gareri, & Allen, 2006). Despite this, as it is already established in the medical field, inappropriate and prolonged usage on ICUs can easily cause CAUTIs aside from other complications. Bhatia, et al’s (2010) research, found out that in the ED department about 50% of IUCs are still being used despite the lack of order by the physician with most of these orders being inappropriate and "not necessary." In order to circumvent this, multiple studies have already been done about the correlation of educating these physicians and providers and the reduction of inappropriate ICU usage, proper documentation, and reduction in the duration of its use (Fakih et al., 2010). Based on these data collected, it is apparent that the issue in ICU misuse is prevalent and that it serves as one of the leading cause of CAUTIs and other bacterial infection in patients. However, the correlation between the risks of a patient to develop these complications when admitted in the ED is also ambiguous because of these different results. Despite this, almost all fo the research show that there is. Inconsistencies and Contradictions As said earlier, there is an inconsistency between the results of these different authors. Some point out that the ED has a greater tendency to misuse ICUs as compared to other departments. However, these differences might be because of the different populations that they employed and the different aim that their studies have. As an example, the greater tendency of having an infection in the ED might be because of the fact that most of these Indwelling IUCs are inserted in this department. Furthermore, the difference in research designs and type of the study itself can also affect the result of the data. For example, Gokula, et al’s (2007) work is a quantitative correlational type of study, while its design type is prospective interventional. This is much different from Hazelett, et al’s (2006) quantitative study which used a retrospective design type. As said, these inconsistencies can also be affected by the sampling population that they worked on. Hazelett, et al’s study worked on by reviewing the charts of the 1633 individuals who were admitted by the ED, while others, such as Gokula, et al’s only employed as few as a hundred individual. Preliminary Conclusions So far, using the five types of research that I used, the date shows that, despite the ambiguity of the results, patients admitted in the ED are more likely to get CAUTIs due to inappropriate catheterization, improper and long duration of use. However, because of the lack of data and the differences between the results of these studies (which have different goals and methods), it is still unclear if the practices of those in the ED poses a higher risk of infection as compared to those in other departments. In spite of this, we can still see that this research serves as a wake-up call or a message to any health care provider that this issue should be addressed soon. Many types of research are devoted towards finding a solution to solve the problem of misuse, improper documentation, and extended duration of catheter use. Most of these, research shown that there’s significant decrease in the risk and cases of CAUTI when the staff is well trained and educated about this particular usage. In general, however, I still believe that in order to serve as an avenue of change. More research should be devoted not only towards the ED but also to other departments. Many studies only report to ED since most of the Catheterization are done in this part. Furthermore, I also believe that further research should be done with the efforts of determining how to encourage the staffs to properly document even the part of inserting the IUC. I think that, since this is one of the most taken-for-granted parts of the Emergency Department, proper catheterization is already being neglected. Also, I do think that there’s still a need to do further research to develop less risky ways to use in-dwelling IUCs such as bacteria resistant catheters, biofilm remover, etc. Finally, I do think that by doing more research on this field, not only the technological but also the social and political sphere can and should change. Furthering the pool of knowledge an...