Milestone 2: Design for Change Proposal Guidelines

Preventing central venous catheter-related infections

Cases of central venous catheter-related infections have significantly increased over time. Catheters are used on critically ill patients who critical functions of the body have failed. The central venous catheter-related infections are as a result of nosocomial bacteremia. It is therefore important to come up with ways in which the catheter-related infections can be prevented

Lai, N. M., Lai A.O’Riordan, E., Chaiyakunapruk, N., Taylor, J. E., & Tan, K. (2016). Skin antisepsis for reducing central venous catheter-related infections. Cochrane Database of Systematic Reviews, (7), CD010140.: 10.1002/14651858.CD010140.pub2

Chamberlain college of nursing permalink:

http://onlinelibrary.wiley.com.proxy.chamberlain.edu:8080/doi/10.1002/14651858.CD010140.pub2/full

What is the Practice Issue?

The practice issue identified that is related to the central venous catheter-related infections is

Nursing education and quality improvement programs.

The nursing education and quality improvement programs will ensure that only those qualified to take care of catheter-related cases participate to reduce the rate of catheter-related infections.

Define the scope of the Practice Issue:

Nursing education and quality improvement programs are very important aspects of reducing catheter-related infections. In the prevention of catheter-related infections, better nursing education and quality improvement programs to healthcare providers are essential aspects of reducing the rate of CVCs. The practice will ensure the safety of the patients and also reduce the cost of healthcare to patients. The catheter-related infections lead to increased cost of healthcare, but with the training and quality improvement programs in health facilities, it will be possible to prevent cases of catheter-related infections. The medical staff will be required to have better skills and experience to attend to patients in need of catheters thereby reducing the risk of infections which relies on the expertise of the operators.

What is the practice area?

Education

How was the practice issue identified? (check all that apply)

The practice issue was identified through the determination of:

• Safety/ risk management concerns

• Unsatisfactory outcomes of the patients.

Significant financial concerns.

Describe the rationale for your checked selections:

Nurses training and quality improvement programs will assist in addressing the safety and risk management concerns. Patient outcomes and essential financial concerns will also be addressed using the quality improvement programs and training. Using less skilled operators in health facilities increases the risk of infectious complications that may result from poor skills which ultimately leads to negative patient outcome from the medical procedure. In case the preventive process adopted is not cost effective, few patients will be able to afford basing on the financial concerns of specific individual in need of medical services.

What evidence must be gathered? (check all that apply)

The evidence that must be gathered in this case must be in the form of

• Expert Opinion

• Patient Preferences

• Clinical Expertise

• Financial Analysis

Describe the rationale for your checked selections:

Nurses training and quality improvement programs will be based on expert opinion who have done a lot of research in the field and have enough experience to handle medical issues that could arise. Patients preference should also be highly recognized and considered crucial as it determines the outcome of the patient. If the patient preference is not considered the patient may be dissatisfied after catheter-related infections complications, have occurred. Financial analysis is also an important element since it determines the cost-effectiveness of the operation.

Describe the practice problem in your own words concerning the identified population, setting and magnitude of the problem in measurable terms:

Training and quality improvement programs are very crucial aspects of the medical profession. Most healthcare facilities in the country have the problem of partially skilled personnel. With partially skilled medical personnel combined with few number of operators, the patients face a high risk of catheter-related infections since there is a high chance of complications during the medical procedure. It is important to increase the number of skilled nurses and also increase the number of health facilities in populated areas. Catheter care requires well-trained staff who will prevent the infections caused by lack of proper skills and experience.

Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem. Write the complete APA reference for the systematic review article you selected:

In Bennett, J., Dolin, R., & In Blaser, J. (2015). Mandell, Douglas, and Bennett's principles & practice of infectious diseases. Philadelphia, PA: Elsevier.

Define the search terms for your systematic review:

Principles and practice of infectious diseases

Identify the objectives of the article.

The article has various objectives.

• To ensure that people have clinical and scientific knowledge relating to infectious diseases.

• To help people in identifying and responding to any infectious disease using the most effective medical procedures.

• To give the most comprehensive guidelines on diagnosis and treatment of infectious diseases.

Provide a statement of the questions being addressed in work and how they relate to your practice issue:

The authors of the article address various questions relating immunology and epidemiology. In the article, the authors discuss and give depth explanations of the issues being discussed. The article also explains the various agents of infection that lead to increased statistics of infectious diseases. It is clear that the article articulates issues that can be integrated to nursing education in the prevention of catheter-related infections.

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.

The authors of the article work with the intention of increasing the efficiency of healthcare providers. The intentions of the authors are clear through the various interventions seen from the article. The authors, for instance, show how important it is for the healthcare providers to have specialized skills that would help in dealing with specialized cases. The article is relevant to my proposal as it gives the reasons why nursing education and quality improvement programs should be taken seriously.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper.

The authors of the article use specific cases of infectious diseases to show how the specific cases should be handled. For instance, the authors of the article use the specific cases of anthrax and malaria to show how training and other quality improvement programs could prevent the diseases.

Outline evidence-based solutions that you will consider for your project.

There are various evidence-based solutions that I will use for my project. Some of which is will consider include therapeutic human immunodeficiency, bacterial drug resistance and also the emerging epidemics caused by viruses.

Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project

• Some of the notable limitations of the article include the fact that the investigations and research in the article are based on bacterial pathogens. The fact that there is no incorporation of fungal, viral and parasitic infections show that the research has not included all the agents of infectious diseases.

• Another limitation of the article is the fact that it does not have simplified formats making its information limited.

• Also, the fact that the investigations focus in distinguishing pathovars from non-pathovars does not provide good information that can be used in assessing CVCs related infections.