What are main causes of CLABSI in Belgian home care setting?
Central Line-associated Bloodstream Infections.
Dr. Linda Johanson
Identification and description of the clinical issue.
The clinical issue or problem identified for my study is the central line bloodstream infections (CLABSI)
Central line bloodstream infections(CLABSI) is a health condition that affects many people.
It occurs when pathogens such as bacteria and other germs invade the patients central line after which they get into the bloodstream.
CLABSI related infections are often serious but they can be successfully managed through appropriate treatment approaches.
Femoral central venous catheters and internal jugular along with subclavian central lines have high risk of getting infected.
As per the survey conducted in 2019 about the central line bloodstream infections, it was found that the infection ratio for the said infections was 0.8 per 1000 central line days. This means that over 250000 people across the world bloodstream infections occur yearly and most of them are associated with the presence of intravascular devices.
Identification and description of the clinical issue. Cont.………
Risk factors for Central Line-associated Bloodstream Infections (CLABSI)
presence of gastrostomy tube.
ICU placement of central venous catheter.
Antibiotic therapy(Steffens et al., 2019,).
Multiple invasive procedures.
nonoperative cardiovascular disease.
Central line bloodstream infection is associated with numerous predisposing risk factors. From healthcare stats, it can be said that central line catheters are the common causes of health callings linked to CLABSI. However there are many other risk factors that predispose patients to contracting or developing central line bloodstream infections. Contamination may occur within the central line and this may cause central line related illness. Such contamination include; non interact dressing, contaminated infusion, central venous access devices as well as patient’s skin flora.
How to develop PICOT question for CLABSI
By analyzing the major components of PICOT, that is P-population, patients, or problem at hand, I-interventions required to solve the issue, C- control or alternative interventions to be compared, O-outcome or the objective to be achieved and T-time framework required to achieve desired outcome(Steffens et al., 2019).
This will help formulate questions such as;
Who and what is the issues that need to be addressed?
What is the proposed intervention and actions to remedy the issue?
What is desired outcome?
How much time is required to realized anticipated results?
To come up with PICOT statement of question on the clinical issues that I had chosen I had to analyze all the components of PICOT to identify their meanings so as to develop a questions that meets PICOT guidelines. The analysis of the PICOT components will help develop questions about the what are kind of population or patients affected with central line bloodstream infection in Belgian home care setting.
Research questions used to refine the search outcome.
Numerous questions may be developed which are associated with the issue of compliance with EBP healthcare guidelines that can be used to reduce incidences of patients contracting central line associated bloodstream infections.
What are main causes of CLABSI in Belgian home care setting?
From the result generated, it can be said that many patients are suffering from the CLABSI health challenges as a result of incorrect insertion of a central line by healthcare professionals.
Another questions for refining the EBP on the said issues was about the most applicable approaches or medical interventions that could be used to reduce increased chances of developing CLABSI
CLABSI has been identified as one of the health challenge that whose causes have been associated contaminated infusion, patient’s skin flora and contamination on insertion. Such risk may be reduce if nurses and other healthcare professional get extensive understanding on the major causes and risk factors leading to occurrence of CLABSI among patients.
PICOT Question on CLABSI
will treatment of adults patients with CLABSI (P) be effective when using intravenous antibiotics therapy (I) as opposed to use of supportive approaches such as oxygen therapy along with maintenance of hand hygiene (C) to reduce the incidence of CLABSI (O) among the adults within a period of eight months(T)?
antibiotics such as ampicillin should be used as the first line of antibiotic therapy to treat adult patients with CLABSI.
Also Vancomycin, Linezolid or daptomycin may be used in serious cases where the CLABSI pathogens seem to be resistant to ampicillin.
Antibiotics are type of medication that are used to treat infections caused by wide rage of pathogens. Normally the type of antibiotics given to patients largely depend on the kind of bacterial found in the blood stream of the patient. For serious infections, both antifungal and antibiotic medicine may be given via PICC line to reduce the rate of infection.
Four Research Databases Used To Conduct Search
I used wide range of research databases to conduct search for the clinical issues of my interest. These included;
Scopus: it’s the world’s largest abstract and citation database.
MedlinePlus: this contains chapters and whole articles that use @MCPHS option to locate whole test for incomplete chapters.
Cochrane Library (De Miranda Costa et al., 2020).
PubMed: provides medicine and science based publications.
By the help of the above mentioned research databases it was much easy to collected numerous articles have been enriched with content on the adult CLABSI along with its causes, predisposing factors, diagnosis and treatment measures to be used to effectively control such conditions. PubMed, Cochrane Library, Scopus and Scopus are all better equipped in terms of articles and chapters whose content provide more insights about medicine and other healthcare related problems together with possible remedies to such issues.
Levels Of Evidence In Each Of The Four Peer-reviewed Articles
Article #1: there was evidence acquired from a thorough examination and evaluation of how compliance are healthcare facilities based in the nursing practice that promote well-being of patients suffering from central line bloodstream infections. (level2)
Artcle#2: through various trails, the article determined the best EBP approaches that could be utilized for quality improvement to reduce CLABSI cases among children. (Level 3)
Levels Of Evidence In Each Of The Four Peer-reviewed Articles Cont.….
Article#3: via randomized trials and systematic review of the existing approaches, the article provided that EBP treatment approaches need to deployed within a comprehensive ambulatory cancer to promote better strategies that standardize neurology practices for central line infections(level 1).
Article #4. systematic review and evaluation of the impacts of existing national systems that promote patient health, well-being and safety. (Level 4)
Strengths of using systematic review for clinical research is that it provides scientists and other research with opportunity to identify and select research database whose content reduce the incidence of biased projection or results. This increases the accuracy of data collected and perhaps provide reliable content that is trusted, credible and therefore can be adopted for implementation in a clinical setup.
Conley, S. (2016). Central line–associated bloodstream infection prevention: Standardizing practice focused on evidence-based guidelines. Clinical Journal of Oncology Nursing, 20(1), 23-26. https://doi.org/10.1188/16.cjon.23-26
De Miranda Costa, M., Santana, H., Saturno Hernandez, P., Carvalho, A., & Da Silva Gama, Z. (2020). Results of a national system-wide quality improvement initiative for the implementation of evidence-based infection prevention practices in Brazilian hospitals. Journal of Hospital Infection, 105(1), 24-34. https://doi.org/10.1016/j.jhin.2020.03.005
Steffens, E., Spriet, I., Van Eldere, J., & Schuermans, A. (2019). Compliance with evidence-based guidelines for the prevention of central line–associated bloodstream infections in a Belgian home care setting: An observational study. American Journal of Infection Control, 47(6), 723-725. https://doi.org/10.1016/j.ajic.2018.10.019
Ting, J. Y., Goh, V. S., & Osiovich, H. (2013). Reduction of central line-associated bloodstream infection rates in a neonatal intensive care unit after implementation of a multidisciplinary evidence-based quality improvement collaborative: A four-year surveillance. Canadian Journal of Infectious Diseases and Medical Microbiology, 24(4), 185-190. https://doi.org/10.1155/2013/781690