Central Line-Associated Bloodstream Infections - Essay Example

? Nursing Nursing Research asserts that central line-associated bloodstream infections are still considered one of the most lethalinfections in the United States (Harnage, 2007). Most patients in the United States find it extremely costly to treat the disease. There are several strategies that have been employed in hospitals so as to minimize the mortality rate that is caused by this disease. One of the most common strategies that have been employed in hospitals to curb this predicament is the nursing competency assessment, especially in the ICU (Intensive Care Unit). This strategy is significantly striving to eliminate this deadly infection. This article will review literatures which analyze the ongoing versus annual nursing competency assessments that are aimed at decreasing the number of central line blood stream infections in the ICU. It is estimated that approximately 41,000 central line-associated bloodstream infections occur yearly in the United States alone. Research shows that these infections are liable for between 4 to 20% of the deaths that occur in the country annually. This shows that between 500 to 40,000 patients die yearly as a result of the bloodstream infections. In most health centers in the US, it is recommended that patients are grouped into the insertion bundle and the care bundle. Experts claim that combining nursing practices and technology can significantly reduce these infections. Most of the hospital teams in the United States have asserted that the nursing competency assessment has significantly reduced the number of patients with bloodstream infections in the Intensive Care Unit (Harnage, 2007). This assessment usually involves educating the nurses on the best approach to employ when handling the patients with these infections. For example, they are usually taught several methods of improving hand hygiene. This measure has empowered hand hygiene as part of the Central Line placement. According to Harnage (2007), most health centers have hand hygiene dispensers which are frequently checked. The assessment of nurses, physicians and other medical personnel is usually accompanied with an annual assessment of the personnel in order to decrease the bloodstream infections in the Intensive Care Unit. This assessment involves a periodical knowledge assessment of adherence to certain guidelines involved in the Intensive Care Unit. In most cases, nurses who are competent in the care of such patients are usually situated in the Intensive Care Unit. After the assessment, these nurses are known as intensive care nurses. This shows that intensive care nurses form an integral part in reducing the bloodstream infections. Most health centers, which aim for a high level of compliance, usually ensure that they prevent such infections. Therefore, nurses should be empowered to supervise the preparations during a line insertion by using a checklist that is aimed at preventing such infections (Harnage, 2007). Hatler, Zack, Hebden and Kaler (2010), noted that it is clear that clinical nurses form an integral part in optimizing the outcomes of a patient especially through monitoring and management of the patient. The bloodstream associated infections have a severe impact on mortality and cost of care. The intensive care nurses are responsible for providing the necessary care to such patients. There are several health centers that have devised other strategies beyond the common Central Line bundle to reduce the number of bloodstream infection in the Intensive Care Units (Richardson & Tjoelker, 2012). Some of the institutions have included a thorough nurse surveillance system. This is a valuable strategy that aims in ensuring optimal patient outcomes. According to a recent survey, this strategy has decreased the rate of deaths in the Intensive Care Unit and the Critical Care Unit significantly. In most instances, these infections usually prolong the hospitalization of a patient to an average of seven days and an approximate cost of between $3700 and $29500 (Richardson & Tjoelker, 2012). However, these rates vary from one health center to another. Therefore, the nursing surveillance system is one of the best strategies which ensure that the bloodstream infections are avoided or prevented. The Institute of Healthcare Improvement (IHI) is continually providing advice to the healthcare professionals based on some of the patient care practices. Furthermore, this institute also evaluates the care offered by the nurses in the hospital among other health care professionals. This is because these infections are mainly caused when the patient is exposed to contaminated objects in a hospital setup. In this case, the formation of a CNS-led (Clinical Nurse Specialist) team of nurses has successfully decreased the rate of the bloodstream infections. Most scholars highlight that the political, educational, psychological and economic contexts are critical in a health facility especially when talking about improving the performance improvement. The nurse surveillance system aims at building a criterion that aims at nursing excellence. The nurse surveillance program ensures that the healthcare organizations meet the required performance measures that are set by various programs. The main purpose of the Clinical Nurse Specialist team is to ensure that patients positively respond to treatment through proper monitoring of both patients and nurses. The CNSs have a strategic procedure that involves data analysis, critical examination and implementation of certain changes in a health care institution with an aim of decreasing the number of Central Line blood stream infections (Richardson & Tjoelker, 2012). The CNS has also reinforced education through monitored data and modified data collection. The CNS-led team mostly comprises of nurses who work at the care units of a hospital. Their main task is evaluating the data related to the increase in infections. The educational strategies employed encompass certain learning sessions and simulation scenarios which ensure that the nurses’ knowledge is properly assessed. After the implementation of these strategies by the CNS team, there was a radical decrease in the number of Central Line blood stream infections. Moreover, the Central Line infection data is continually monitored in the intensive and critical care units (Richardson & Tjoelker, 2012). According to Kallen and Patel (2009), an inserted central catheter is also considered as a Central Line. The Central Lines are used both in the outpatient and inpatient setting for various purposes. The prevention of blood stream infections usually involves the Central Line Bundle which consists of five main components. These components usually involve hygiene before line insertion. Together with this, the CNS learning strategy, which measures the competence of the nurses, can substantially decrease these infections (Kallen & Patel, 2009). As stated above, Central Line is one of the major risks for bloodstream infections. The rate of Central Line Blood Stream Infections varies by the type of catheter (Kallen & Patel, 2009). Therefore, to avoid these infections, the nurses should be educated concerning some of the crucial guidelines that are entailed in the prevention of these infections. They are also supposed to implement a catheter insertion checklist that usually takes note of the procedures undertaken by the health care professionals. This strategy also educates the nurses who are involved in the catheter insertion on how to use the checklist. Furthermore, they are also taught about the insertion and proper maintenance of the insertion. In this case, the nurses must undergo a complete educational program which is normally viewed as an assessment test. They also complete a post education test which is set to ensure their competence in the insertion procedure. There are several recommendations for the prevention and monitoring the infection. These prevention efforts are normally recommended before the insertion, during the insertion and after the insertion. The recommended strategies should not be overlooked since; there are numerous risk factors that are closely associated with the Central Line blood stream infections. In fact, the nurses are supposed to be encouraged to notify the health physicians of Central Lines, which are redundant. According to research, approximately 9% of the insertions are inappropriate in most of the hospitals. As a matter of fact, the nurses are responsible for these cases, since; they are authorized to perform a daily assessment of the need for the Central Lines (Hatler, Zack, Hebden, & Kaler, 2010). In addition, the nurses are also supposed to be encouraged to frequently ask and answer questions which are related to patient care outcome. In fact, the clinical nurse specialists are paramount in any health institution. This is because they assist the health personnel in identifying the problems in the Intensive Care Unit. They also conduct performance improvement activities. In this case, they mostly strive to establish a caring environment for nurses and patients. The caring culture enhances the care provided by the nurses hence, sustaining patient satisfaction. According to various studies, the nurses are closely associated with job satisfaction. In fact, relationship-based care is one of the strong foundations to achieve cultural transformation (Hatler, Zack, Hebden, & Kaler, 2010). Additionally, the culture of asking and answering questions by the nurses can be regarded as a nursing competency assessment which empowers the nursing department. Through this empowerment, the nurses are able to strategize on the importance of an effective intervention for avoiding infections in the ICU. This innovative approach usually involves three specialty tracks which include adult health, psychiatric-mental health and gerontology. The educational approach is guided by the CNS faculty in order to create an innovative learning environment to manage human and economic resources. Nurses should have prior knowledge concerning most of the activities that are carried out in a hospital setup. This may increase the satisfaction of patients basing on the effort of the nurse in providing better health care. Additionally, the educational strategy also decreases the anxiety of the nurse. The estimates provided by various disease management organizations claim that there are over 1.6 million cases of hospital acquired infections that are majorly attributed by nurses who lack a proper educational approach to various cases in the hospital setting. The educational approach can be described as a physical assessment in different diagnosis, disease management and decision making (Moody & Patton, 2011). The ongoing annual nursing competency assessment has lowered the infections in the Intensive Care Unit. The significant decline in the blood stream infections in the Intensive Care Unit is attributed by several interventions in the medical field. As described above, the healthcare related infections form a large economic and social burden to a nation. Nurses should practice to the full extent of their training and education. Most health care systems occasionally conduct a competency assessment of the nurses through various strategies. According to the Affordable Care of Act of 2010, the assessment of nurses is one of the new health care structures that are being enacted in health care centers all over the world. This asserts that nurses have a fundamental role in changing the health care system (Moody & Patton, 2011). When the nurses are able to achieve these health care strategies, then, they will be able to provide high-quality care by increasing some of the most prominent measures and reducing errors. Further analysis in the Intensive Care Unit points out that the patients in this unit are more vulnerable to the blood stream infections. This is because there treatment involves the use of invasive devices, antibiotics and steroids. For example, they may undergo dialysis, surgery, transplants and medical therapies. The care bundle is considered as the best approach in this case. There are other supplementary nursing practices which can also be applied to ensure that the blood stream infections are avoided. Some of the most common practices include the use of the catheter kit, ensuring proper hand hygiene, site care, line access and appropriate staffing in the Intensive Care Unit. The information provided is a clear indication that annual nursing competency assessment is one of the main factors that can significantly reduce the rate of Central Line blood stream infections (Moody & Patton, 2011). In conclusion, the central line management program is one of the most effective programs that have been employed in the United States among other countries with the aim of reducing these infections. Moreover, the strategic assessment of nurses through learning procedures and other problem solving tactics has proven to be resourceful in reducing the cases of infections even without supervision. Health centers can also employ other steps to diminish the rate of infections. Some of the most prominent procedures include establishing a multidisciplinary approach in problem solving. The health centers can also conduct an annual mandatory education approach which is closely related to the competency assessment through a formal program. After successfully completing this program, they are provided with a certificate of proficiency. In addition, the ICU nurses should also be allowed to apply their skills through supervising the ICU personnel. Through these procedures, the blood stream infection can be reduced by a substantial percentage. References Harnage, S. (2007). Achieving zero catheter related blood stream infections: 15 months success in a community based medical center. The Journal of the Association for Vascular Access, 12(4), 218-225. Retrieved from http://www.rymedtech.com/assets/files/press/Harnage-Reprint-%20Low%20Res%20-%20Secure.pdf Hatler, C., Zack, J., Hebden, J., & Kaler, W. (2010). Walk the walk to reduce catheter-related bloodstream infections. American Nurse Today, 5(1), 26-31. Retrieved from http://www.americannursetoday.com/assets/0/434/436/440/6116/6118/6122/6174/5bf3862f-a647-4391-b3f1-27532fe3f158.pdf Kallen, A., & Patel, P. (2009). Central line-associated bloodstream infections (CLABSI) in non-intensive care unit (non-ICU) settings toolkit. Retrieved from http://www.cdc.gov/HAI/pdfs/toolkits/CLABSItoolkit_white020910_final.pdf Moody, R., & Patton, S. (2011). 2011 National Association of Clinical Nurse Specialists National Conference Abstracts. The Journal for Advanced Nursing Practice, 25(2), 75-95. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1123716&Journal_ID=54033&Issue_ID=1123586 Richardson, J., & Tjoelker, R. (2012). Beyond the central line–associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes. Journal of Advanced Nursing Practice, 26(4), 205-211. Retrieved from http://www.nursingcenter.com/evidencebasedpracticenetwork/JournalArticle.aspx?Article_ID=1361126 Read More