Analysis of existing evidence, and Quality improvement process
QUALITY IMPROVEMENT PROCESS ` 1
QUALITY IMPROVEMENT PROCESS. 2
Analysis of existing evidence, and Quality improvement process.
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Over the past years, advancement in health care has been steady. However, one area that have shown tremendous success is in fighting the central line-associated bloodstream infections. Information from the centers for control and prevention show that the total number of sick individuals in the United States intensive care units airing from the disease declined by sixty percent. It is through the collaboration of various stakeholders, clinicians, government agencies, and hospital associations that the infections have reduced. This collaboration has spread across states and have shown sustained outcomes in minimizing such infections and death rates, and accounts for an essential quantifiable national prosperity story in quality improvement and model for boosting medical and well-being of Americans.
Central line-associated bloodstream infection.
A central line-associated bloodstream infection(CLABSI) is a laboratory-confirmed bloodstream germ that grows within 48 hours of central line positioning. It occurs when bacteria, viruses, or fungi pass through the central line and enter into the bloodstream (GALURA NANCY, 2019). Research shows that the infection affects between two hundred thousand and five hundred thousand patients annually, causing a thirty percent mortality rate. The most affected patients are those with existing chronic illnesses such as diabetes and respiratory disease, the elderly and those in immune suppress states.
CLABSI is a patient safety issue that can be prevented by the healthcare system; however, the infection dramatically impacts the health system and patient safety. In this case, the disease leads to extended hospital stays, accumulated mortality rates, and healthcare costs. For instance, in the United States, the central line-associated bloodstream rate in the intensive care unit accounts for 0.8 per nine hundred central line days. The increased healthcare cost poses a very high burden accounting for about forty-five thousand dollars per patient. However, most instances are stoppable if there are proper aseptic procedures, inspections, and leadership plans. As such, the primary purpose for performing quality improvement is to address some issues such as the increased death rates, extended stays at hospitals, and the high costs. With the help of the quality improvement model, such problems will significantly reduce.
Findings and guidelines.
Research shows that central line-associated bloodstream infections have affected many people due to several malpractices within the intensive care unit. Hence, making the practice problem a significant threat. Based on the findings, most health care workers do not have enough education or proper training to handle or prevent such infections. Most central lines are not in a sterile environment whereby they are being inserted at the bedside alongside ultrasound in the general medical wards and the intensive care unit. Also, hospitals are using the non-catheters that tend to be at high risk of CLABSI. Therefore, hospitals should provide training to its staff, find standardized treatment procedures, and reduce the incidence of the infections occurring.
Since CLABSI is a threat to the practice problems, healthcare providers need to put specific and intensive measures to prevent the infection from occurring. Several leaders aired out their views and pointed out that there are practical measures that help in preventing infections. These measures include, first, ensuring proper adherence to the recommended insertion procedure and practices when it comes to central line application to avoid the disease. These procedures involve observing good hygiene, monitoring the checklist, removing unrequired central lines, using subclavian vein, applying appropriate skin antiseptic, and ensuring that the nurse uses sterile gloves, caps, masks, and sterile drape (Salim Ali, Brown Carlos, & Kenji, 2018). The second is to ensure that healthcare providers in intensive care units have enough experience. The third is to ensure that daily disinfecting of the catheters before assessing the lines (O’ & Samir, 2017). Lastly, ensure the removal of the central lines once they are no longer required to reduce the rate of reinfections (Chase, R, & D, 2019).
Quality improvement process and models.
Quality improvement processes and models try to solve the malpractices found in any intensive care unit when dealing with bloodstream infections. One of the critical model is plan do study act (Ling, 2016). It is a four-step problem-solving model that aims at improving a situation. The model is a structured trial and error process. The models have four steps that help develop a plan for the CLABSI in an intensive care unit. The improvement is incremental and requires evaluations and refinement of the process.
In this quality improvement model, several tools are useful. These tools include audit tools, line charts, and a processing map (Arrieta, 2019). An audit is essential and needs to be a requirement for all physicians who insert the central lines and clinicians who control the lines to ensure compliance of the set guidelines without fail. Line charts will help control the growth and success of the project. Processing maps will assist in gathering data. The model is useful since it gives a flow of all steps. In this case, the health care providers start by defining, finding the cause of the infections. Next, they educate staff about the quality improvement project, and they ask them to perform a literature review and understand the surveillance audits. Lastly, they find why the patient had CLABSI and do all monthly inspections to determine whether to act, leave, or adapt the project.
In conclusion, quality improvement is essential because it helps reduce any infections within the intensive care units. Therefore, hospitals should implement models that help minimize or eradicate such diseases.
References
Arrieta, J. O. (2019). Adiós Bacteriemias’: a multi-country quality improvement collaborative project to reduce the incidence of CLABSI in Latin American ICUs. International Journal for Quality in Health Care. Chase, M. J., R, C. J., & D, C. J. (2019). Healthcare-associated infections in children : a guide to prevention and management. Cham, Switzerland : Springer. GALURA NANCY, H. S. (2019). ULRICH & CANALE’S NURSING CARE PLANNING GUIDES : prioritization, delegation, and critical thinking. [S.l.]: SAUNDERS. Ling, M. L. (2016). APSIC guide for prevention of central line associated bloodstream infections (CLABSI). Antimicrobial Resistance & Infection Control, 5(1) 16. O’, G. N., & Samir, K. (2017). Complex Infectious Disease Issues in the Intensive Care Unit, An Issue of Infectious Disease Clinics of North America, E-Book. Elsevier. Salim Ali, (. B., Brown Carlos, (. D., & Kenji, I. (2018). Surgical critical care therapy : a clinically oriented practical approach. Cham, Switzerland: Springer.
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