Capstone Project Topic Selection and Approval

Capstone Project Topic Selection and Approval

Critical care is required for patients in the intensive care Unit (ICU). Infection risk in ICUs, medical wards, and surgical wards is associated with decreased immunity as a result of the patient’s health status, care practices, and the risk of infection transmission from one patient to another. Patients who used central lines were at a higher risk of infection. Central-line associated bloodstream infections (CLABSI) are the third most common cause of infection in healthcare facilities.

Problem

According to a Centers for Disease Control and Prevention report, the mortality rate associated with CLABSIs was between 12% and 25% in 2011. These infections also result in billions of dollars in additional costs in the United States, despite the fact that they are preventable. This condition may contribute to longer hospital stays, which may result in higher medical costs for the patient[Woo162]. Poor management of patients with central lines, which contribute to a bloodstream infection, is a problem in the cardiovascular ICU. This week, while conducting a literature review, I discovered that CLABSIs in the cardiovascular ICU are linked to the use of clinical protocols[Tra163].

This capstone project’s PICOT question will be:

Would the use of CLABSI bundles (proper hand sanitation, taking precautions with the use of barriers, using chlorohexidine, optimal site selection, avoidance of femoral spots, and daily reviewing of line protocols daily) by clinical practitioners (I) in adult patients in the cardiovascular ICU (P) reduce the incidence of CLABSIs (O) during the ICU hospitalization duration (T)?

Setting

This issue can be found in medical wards, surgical wards, intensive care units, and any other ward where patients use central lines. This issue was discovered in the cardiovascular ICU unit of the hospital. In Quebec, Canada, similar surveillance for these central line-associated bloodstream infections was implemented[Gon131].

Description of the Problem

There is widespread concern about how patients with central lines are managed, as well as the relationship between care practices and infection risks in these patients. Because nurses have the most contact with patients, educating them on CLABSI protocols will reduce the risk of CLABSI infections in the ICU and other wards. The primary issue affecting these patients is the increased risk of bloodstream infections associated with the use of central lines, as well as poor protocol adherence, including care for central catheters[Kra16].

In the cardiovascular ICU, the number of CLABSI infections could be reduced if clinical staff used the CLABSI bundle of care, which includes hand hygiene, barrier precautions, the use of chlorohexidine, optimal site selection, avoidance of femoral sites, and daily review of line necessity protocols, as opposed to managing these patients without protocols. CLABSIs are serious conditions, but they are easily avoided. This project also considered the use of peripherally inserted catheters to reduce the occurrence of bloodstream infections[Kra16].

The Problem’s Impact on the Workplace

The high rate of CLABSIs in the cardiovascular ICU contributes to a longer hospital stay, deterioration of the patient’s health, and increased mortality rates associated with hospital-acquired infections. Reducing CLABSI rates in the cardiovascular ICU would attract more patients due to improved metrics and hospital performance, influence accreditation boards, and possibly contribute to promotion and salary bonuses. To promote a positive work environment, hospitals are under both external and internal pressure to keep CLABSI rates in their units low or risk losing Medicare reimbursement[Woo162].

Solution Suggestion

Some proposed solutions for dealing with this issue include educating nurses on the proper use of CLABSI protocols and implementing these protocols in the ICU unit. To determine the most effective method of reducing these infections, various evidence-based studies will be conducted[Kau15]. According to the available evidence, using peripherally inserted central catheters may reduce the risk of CLABSIs. Proper central line care can help to reduce bloodstream infection in the cardiovascular ICU.

References

Australian Commission on Safety and Quality in Health Care. (2012, April). Preventing and Controlling Healthcare Associated Infections. Retrieved from Australian Commission on Safety and Quality in Health Care: https://www.safetyandquality.gov.au/wp- content/uploads/2012/10/Standard3_Oct_2012_WEB.pdf

Centers for Disease Control and Prevention. (2016). National and State Healthcare-Associated Infections Progress Report. Centers for Disease Control and Prevention.

Gonzales, M., Rocher, I., Fortin, E., Fontela, P., Kaouache, M., Tremblay, C., . . . Quach, C. (2013). A survey of Preventive Measures Used and their Impact on Central Line- Associated Bloodstream Infections (CLABSI) in Intensive Care Units (SPIN-BACC). BMC Infectious Diseases, 13:562. Retrieved from https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-562.

Kaur, G. (2015). An Interdisciplinary Approach to Reduce Intensive Care Unit (ICU) Central line Associated Bloodstream Infections (CLABSIs) using LEAN Six Sigma. American Journal of Infection Control, 43(6), S64. Retrieved from https://www.ajicjournal.org/article/S0196-6553(15)00400-9/fulltext.

Kramer, R. D., Rogers, M. A., Conte, M., Mann, J., Saint, S., & Chopra, V. (2016). Are Antimicrobial Peripherally Inserted Central Catheters Associated with Reduction in Central Line-Associated Bloodstream Infection? A Systematic Review and Meta-Analysis. American Journal of Infection Control, Retrieved from http://www.ajicjournal.org/article/S0196-6553(16)30799-4/fulltext.

Patel, P. A., Boehm, S., Zhou, Y., Zhu, C., Peterson, K. E., Grayes, A., & Peterson, L. R. (2017). Prospective Observational Study on Central Line-Associated Bloodstream Infections and Central Venous Catheter Occlusions Using a Negative Displacment Connector with an Alcohol Disinfecting Cap. American Journal of Infection Control, 115-120.

Trotter, T. (2016). Development of an Evidence-Based Maintenance Bundle for Preventing Central Line Associated Blood Stream Infections (CLABSIs) to Standardize Processes and Reduce CLABSI Rates. The Journal of the Association for Vascular Access, 21(4), Retrieved from https://www.avajournal.com/article/S1552-8855(16)30226- 4/abstract.

Woodward, B., & Umberger, R. (2016). Review of Best Practices for CLABSI Prevention and the Impact of Recent Legislation on CLABSI Reporting. SAGE, 1-7. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/2158244016677747.

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In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a   clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and EBP can be found on the   “Educational and Community-Based Programs” page of the Healthy     People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

The problem, issue, suggestion, initiative, or educational     need that will be the focus of the project
The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
A description providing a  high level of detail regarding the problem, issue, suggestion,     initiative, or educational need.
Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
Significance of the problem, issue, suggestion,     initiative, or educational need and its implications to nursing.
A proposed solution to the identified project   topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA   Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to LopesWrite.