Preventing Central Venous Catheter-Related Infections (CVCs)
Today, care providers use central venous catheters (CVCs) to treat patients who are critically ill, as the device allows the patients to access fluids, blood products, medications, and paternal nutrition important for the body of a sick person( Lai et al., 2012). Although the use of CVCs has been remarkable in responding to different clinical situations, the devices are known for causing infections that may complicate the health of the individuals receiving care services through CVCs insertion (Öncü et al. 2003). The most common form of infection that is associated with CVCs is central venous catheter-related blood stream infection (BSI), and physicians recognize the infection as a serious condition leading to the increase of morbidity and mortality rate, in particular for patients who their illness is extreme and critical. Therefore, as blood stream infection has become a prevailing issue in relation to the use of CVCs, this paper suggests the use of skin antiseptic as the ultimate solution that clinician can use to prevent the prevalence of the infections related to central venous catheters.
Change Model Overview
As the use of skin antiseptics to prevent CVCs blood stream infection means that the nurses will be changing the way of carrying out their work, it will be relevant for the nurses to consider understanding the implication of ACE Star Model Evidence-Based Practice Process in their work. According to Nelson and Staggers (2014), as an EBP model, Ace Star Model presents different forms of knowledge that are research evidence, and nurses can use the knowledge from this model to make clinical decisions and articulate processes necessary to reduce complexity within their tasks.
The Scope of EBP
In the U.S., it is estimated that clinicians use at about 5 million CVCs to facilitate care services every year. Likewise, in the UK, 200,000 CVCs are used each year, which is an indication of the fact that infections related to the use of CVCs are increasing on daily basis (Lai et al., 2012). More than 80,000 cases of blood stream infection are reported in the US every year due to the use of CVCs, especially in intensive care units (ICUs) (Lai et al., 2012). Consequently, this has made the use of CVCs to lead to the causes of many deaths, morbidity, and increasing the cost of healthcare services (Patil et al., 2011).
Stakeholders
- Health care leaders
- Nurses working in the ICU
- Hospital pharmacists
- Doctors attending to patient through CVCs
- Surgical technicians
- Medical lab technologist
- Therapists
- Medical Assistants
Responsibilities of the Team Members
Involving the above team members in the implementation of the proposed plan will be critical to the healthcare organization and the entire workforce. As such, through the change or plan suggested in this paper, the above members will be assigned to responsibilities such as providing patient care through skin antiseptic, supporting patients receiving the care services through CVCs, diagnose, and treating the patient by incorporating CVCs and skin disinfectant.
Evidence
In this section, some of the interventions measures that clinicians can use to slow down the occurrence of catheter-related bloodstream infections will be identified by reviewing literature findings on the similar subject. The use of secondary sources to gather evidence about the prevention of CVCs will be essential, as the investigator will collect opinionated information in the most convenient time.
Summary of the Evidence
Kallen, Patel, and O’grady (2010) argue that in the management of CVCs blood stream infection, educating and training the medical staffs who insert and check on the CVCs is an important method for preventing diseases related to CVCs, as through training doctors get a better experience regarding CVCs complications and infections. Frasca, Dahyot-Fizelier, and Mimoz (2010) express that in the U.S. staffs education is applied as a long-term model for reducing catheter-related infections in the U.S. hospitals. Gahlot et al. (2014) have also found out that the new technologies utilized in the healthcare system can as also be applied to reduce CVCs infections. For example, to reduce CRBSI, it is suggested clinicians need to consider using antibiotic lock solutions and new hub models (Gahlot et al., 2014).
Recommendation
Based on the literature used to gather evidence about the prevention of CVCs, it can be recommended that before the introduction of using skin antiseptic to control the prevalence of CRBSI, educating the staffs about the method will be relevant. As such, the training will make the clinicians involved in the change project have enough experience in the use of skin antiseptic every time they are using CVCs.
Translation
Action Plan
This project is set to take 90 days in which, throughout this period, the team will arrange every task in a sequence for efficiency after project completion. Therefore, to implement the advocated change, several steps will be followed.
- Explaining the issue of focus or problem that needs improvement
- Defining the objective of the plan
- Selecting the team that will be involved in the intervention program
- Design the implementation plan
- Create a plan for sustainability and continuous improvement
Process, Outcome Evaluation, and Reporting
In this project, the desired result is to enhance that hospitals’ and clinicians use skin antiseptic to regulate the increasing cases of BSI due to the utilization of CVCs. Conversely, to evaluate the outcomes of the plan, the researcher will test the effectiveness of using antiseptics to inhibit the growth of blood stream infection when CVCs are being employed in the ICUs or any other hospitals department. Finally, to deliver the results of the project, the team leader will describe the outcomes systematically by outlining the most relevant point that should be noted with regard to the prevention of CVCs blood stream infection.
Identify the Next Step
In the context of implementing the plan, the project planner will use the project members to close the gap through their knowledge on the use of skin antiseptic to reduce the escalation of blood stream infections. In other words, to implement the plan, healthcare personnel will be linked with the program, as the project will be successful when care providers understand the benefits of using skin antiseptic to curb CVCs infections.
Disseminate the Findings
This will be the final step for this project, whereby the results will be communicated to internal stakeholders and other groups that will benefit from the project. Meeting the hospital staffs as a group or even individually is the method that will be used to share the findings, as the method enhances clarity and gives people an opportunity to come up with ideas that can be used to project new plans. Lastly, to disseminate the findings to external stakeholders such as the people receiving care services or the relative of the patients, family members of the patients offered care through CVCs would be given a copy of the executive summary highlighting the findings of the project in the form of the report supported by evidence and data.
Conclusion
This paper proposes a change that will help doctors and nurses minimize the growth of CVCs related infections. Throughout the content of the paper, it is suggested that before clinicians use the new technique to reduce central venous catheters blood stream infection, it will be fundamental to understand the ACE Star Model Evidence-Based Practice Process, as the model will ensure that physicians and nurses will transfer their knowledge into outstanding actions. As such, this means that for the care providers set to use antiseptics to reduce the spreading of CVCs infections, it will be necessary to reflect the knowledge transformed from the Ace Star Model, which will help them deal with a number of hurdles that may happen in the process of controlling CVCs infections. When the nurses and doctors who are linked to the change plan uses ACE Star Model five points, which includes knowledge discovery, evidence summary, translation of the knowledge into practice, integration, and evaluation, they will convert the findings that will be presented in this project into plans for effectiveness.
References
Frasca, D., Dahyot-Fizelier, C., & Mimoz, O. (2010). Prevention of central venous catheter-related infection in the intensive care unit. Critical care, 14(2), 212. doi: 10.1186/cc8853.
Gahlot, R., Nigam, C., Kumar, V., Yadav, G., & Anupurba, S. (2014). Catheter-related bloodstream infections. International Journal of Critical Illness and Injury Science, 4(2), 162-167.
Kallen, A. J., Patel, P. R., & O’grady, N. P. (2010). Preventing catheter-related bloodstream infections outside the intensive care unit: expanding prevention to new settings. Clinical Infectious Diseases, 51(3), 335-341.
Lai, N. A., Lai, N. M., O’Riordan, E., Chaiyakunapruk, N., Taylor, J. E., & Tan, K. (2012). Skin antisepsis during catheter insertion for reducing central venous catheter related infections. Cochrane Database of Systematic Reviews, (7). CD010140. doi:10.1002/14651858.CD010140.pub2.
Nelson, R., & Staggers, N. (2014). Health informatics: An interprofessional approach. St. Louis, Mo.: Elsevier Mosby.
Öncü, S., Özsüt, H., Yildirim, A., Ay, P., Çakar, N., Eraksoy, H., & Çalangu, S. (2003). Central venous catheter related infections: risk factors and the effect of glycopeptide antibiotics. Annals of clinical microbiology and antimicrobials, 2(1), 1-6.
Patil, H. V., Patil, V. C., Ramteerthkar, M. N., & Kulkarni, R. D. (2011). Central venous catheter-related bloodstream infections in the intensive care unit. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 15(4), 213-223.
