Prevention of Central Line-Associated Bloodstream Infections (CLABSIs) 2

Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)

Submitted by

Kerry Sean Murphy

DPI Project Proposal Chapter 3 – Methodology

Doctor of Nursing Practice

Grand Canyon University

Phoenix, Arizona

July 20, 2019

CHAPTER THREE: Methodology

Introduction

This project will be exploring the prevention of Central Line-Associated Bloodstream Infections (CLABSIs). In this chapter, the discussion will focus on examining the variables that would help in preventing, controlling, and reducing the incidences of bloodstream infections. The methodology section will describe the objectives and describe the activities the project will entail to meet the objective of lowering infection rates. Further, the chapter will look into the methods of data collection and ways of analyzing the data as well as the ethical considerations the project will need to take into account.

Statement of the Problem

There is a need to have the CLABSI maintenance bundles due to cases of infection that have been recorded involves the adults that have been admitted to the intensive care units. According to Mishra et al., (2016), there are still several cases reported in India on such infections and in spite of the existence of guidelines for maintenance Central Line-Associated Bloodstream Infections (CLABSIs) continue to remain a problem. Clear Lake Regional Medical Center in Webster Texas reported a total of 18 hospital-acquired infections (HAI) in 2018. In 2019 in two quarters the facility has already reported 20 HAI (“SIR Report | HAI | CDC,” 2019). There is a need to develop procedures and expand education that would improve and reduce the number of HAI like CLABSI. Comment by Kathryn Flynn: Please describe what this is to the non nurse before terminology is used. Comment by Kathryn Flynn: It would be a lot more credible for the justification to be in research from US. Comment by Kathryn Flynn: Use APA format (author, year)

Clinical Questions

The clinical questions are how to develop different ways in which the CLABSI can be minimized, specifically among patients greater than 65 years of age. Objectives of the project will look to answer the following questions

(i) What is the influence of the staff training on maintenance of a higher level of hygiene after insertion and cleanliness of insertion sites? Comment by Kathryn Flynn: This is subjective. Use evidence based, etc. and nte why it’s better than existing care.

(ii) How is consistency in the application of the evidence-based practices likely to impact infections rates after insertion using improved site maintenance? Comment by Kathryn Flynn: How will this be measured? Has this question been approved? Comment by Kathryn Flynn: Subjective. State what intervention you are implementing and use the same name for the intervention at every location in your writing. This will give the reader clarity.

(iii) How CLABSI maintenance bundles (specifically the using of chlorhexidine gluconate bathing (CHG)) lower the number of HAI infections.

There is a need to have a higher level of training among the staff regarding proper CHG bathing to maintain a higher level of cleanliness that would consequently reduce the number of infections. The cleaner the sites of insertion, the better the possibility of reducing the infections related to CLABSIs (Guerin, Wagner, Rains, & Bessesen, 2010). CHG bathing is a part of the CLABSI maintenance bundle and performed adequately with other aspects of the bundle can prevent post-insertion infections. The measuring outcomes will consist of a periodical survey among the nurses that have CLABSIs patients before and after the maintenance bundle use. A consistent survey of one month is effectively going to determine if the intervention has achieved the objectives of the lowering CLABSI rates. Comment by Kathryn Flynn: Justify why Comment by Kathryn Flynn: Like what? Comment by Kathryn Flynn: What’s the validated tool? Name it here and refer to it in index. Comment by Kathryn Flynn: No, it will give you the data to apply statistical significance to, so you can see if a correlation exists.