Central Line–Associated Bloodstream Infection

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While the implementation plan prepares students to apply their research to the problem or issue, they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000-word review that includes the following sections Central Line–Associated Bloodstream Infection:

Title page

Introduction section

A comparison of research questions

A comparison of sample populations

A comparison of the limitations of the study

A conclusion section, incorporating recommendations for further research

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

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Introduction

Although nursing practice (like any other medical profession) is intended to improve healthcare outcomes, errors that place the patient at risk are not uncommon. Some of these errors are avoidable through the application of evidence-based practice that relies on proof from reviewed research outcomes. That is true for central line infection where it is noted that although the use of central line is intended to improve care outcomes, the occurrence of an infection defeats that purpose by adding to the patient’s already complicated health situation. As such, the proposal is that nursing practice in the management of central lines should be matched with evidence that intentionally targets reduced incidence of infection (Aloush & Alsaraireh, 2018). To acquire a better awareness of how best to address the incidence of central line infection, a PICOT question was presented. The PICOT question is framed as: “Among patients using central line (P), does matching nursing practice for central line nursing management with evidence drawn from nursing research (I) versus central line management without considering evidence from research (C) have an effect on the incidence of bloodstream infections associated with central line use (O) measured over a two-month trial period (T)?” The question was framed after reviewing eight research questions as discussed.

A comparison of research questions

The eight research articles addressed different questions with the intention of addressing the issue of central line infection. Aloush and Alsaraireh (2018) asked the question: Do nurses comply with central line infection guidelines? Page et al. (2016) asked the question: Can incidence of central line-associated bloodstream infection be reduced for oncology inpatients through educational intervention? Marschall et al. (2014) asked the question: What are the strategies for preventing central line-associated bloodstream infections? Esposito, Guillari and Angelillo (2017) asked the question: What are the knowledge, attitudes, and behavior among nurses regarding the prevention of central line-associated bloodstream infections? Conley (2016) asked the question: What are the best practice guidelines for nurse administration of central lines? Perin et al. (2016) asked the question: What are the best strategies for preventing central line infection in the ICU? Hina and McDowell (2017) asked the question: What procedural features can be applied to minimize the risk of central line infection? Al Qadire, Tawalbeh and Suliman (2017) asked the question: What are nursing students’ knowledge levels concerning preventions of central line infection? The eight presented research questions all show that central line infection is an issue of concern. In fact, they all concur that a solution is required and they even go on to present comparable solutions. Given that the present research is also concerned with central line infection as a nursing concern, the eight reviewed articles are relevant since they provide insight into the present problem Central Line–Associated Bloodstream Infection.

A comparison of sample populations

Aloush and Alsaraireh (2018) is an observational study that relied on descriptive cross-sectional design. Page et al. (2016) applied a simulated care model that included a pre-test and post-test analysis. Marschall et al. (2014) relied on a literature review that made use of secondary information. Esposito, Guillari, and Angelillo (2017) applied a cross-sectional study design. Conley (2016) applied a literature review approach that made use of secondary information to collect relevant material. Perin et al. (2016) applied a systematic review to analyze secondary sources of information. Hina and McDowell (2017) applied a systematic review approach to evaluate secondary sources of information. Al Qadire, Tawalbeh and Suliman (2017) applied a descriptive cross-sectional design to collect primary information. The eight studies applied elements of either qualitative or quantitative research to collect the required information. This implies that any reliable research method can be applied to collect the required information. The present study intends to identify a mixed-method research approach that would collect adequate amounts of the required information.

A comparison of the limitations of the study

Reviewing the information presented in the eight articles (particularly their questions and methodologies) identified one inherent limitation that reduced the value of their results. The studies either applied a quantitative approach. None of them applied a mixed-methodology approach or a qualitative approach. This implies that in collecting the required information, some important elements were overlooked. For instance, the studies had robust estimates since they used large samples. Still, this approach missed important information that would have collecting by spending more time with a small number of participants whereby the participants’ reactions would be evaluated and follow up questions asked where appropriate. The identified concern will be addressed by applying a mixed-method approach.

Conclusion and recommendations

One must accept that central line infection is of concern to medical practitioners since they are an important medical device that cannot be overlooked. In addition, one must acknowledge that relying on evidence from the medical research could address the issue by identifying the best practices. To address the issue, the present research frames a PICOT question as: “Among patients using central line (P), does matching nursing practice for central line nursing management with evidence drawn from nursing research (I) versus central line management without considering evidence from research (C) have an effect on the incidence of blood stream infections associated with central line use (O) measured over a two-month trial period (T)?” The question is informed by eight research articles whose research questions are concerned with how best to address central line infection as a practice problem. The eight articles are intended to inform the present research by offering comparative and contrasting background information to explore the PICOT question. The eight articles are noted to present one methodological limitation that will be addressed by applying a mixed method approach that includes elements of both quantitative and qualitative approaches Central Line–Associated Bloodstream Infection.

References

Al Qadire, M., Tawalbeh, L. & Suliman, M. (2017). Student nurses’ knowledge of guidelines for preventing central venous catheter-associated infections. International Journal of Advanced Nursing Studies, 6(1), doi: 10.14419/ijans.v6i1.7295. Retrieved from https://www.sciencepubco.com/index.php/IJANS/article/download/7295/2635

Aloush, S. & Alsaraireh, F. (2018). Nurses’ compliance with central line associated blood stream infection prevention guidelines. Saudi Medical Journal, 39(3), 273-279. doi: 10.15537/smj.2018.3.21497. Retrieved from https://europepmc.org/articles/PMC5893917;jsessionid=2BDDD0B7C9C65AD5DE7B19F56C07CB73

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. doi: 10.1188/16.CJON.23-26. Retrieved from https://cjon.ons.org/file/24791/download

Esposito, M., Guillari, A. & Angelillo, I. (2017) Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLoS ONE, 12(6), e0180473. doi: 10.1371/journal.pone.0180473. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180473

Hina, H. & McDowell, J. (2017). Minimising central line‐associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units. Journal of Clinical Nursing, 26(23-24), 3962-3973. doi: 10.1111/jocn.13824

Marschall, J., Mermel, L., Fakih, M., Hadaway, L., Kallen, A., O’Grady, N. … & Yokoe, D. (2014). Strategies to prevent central line–associated bloodstream infections in acute care hospitals: 2014 update. Infection Control and Hospital Epidemiology, 3(7), 753-771. doi: 10.1086/676533. Retrieved from https://www.jstor.org/stable/10.1086/676533

Page, J., Tremblay, M., Nicholas, C. & James, T. (2015). Reducing oncology unit central line–associated bloodstream infections: initial results of a simulation-based educational intervention. Journal of Oncology Practice, 12(1), e83-e87. doi: 10.1200/JOP.2015.005751. Retrieved from http://ascopubs.org/doi/full/10.1200/jop.2015.005751

Perin, D., Erdmann, A., Higashi, G. & Sasso, G. (2016). Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Revista Latino-Americana De Enfermagen, 24, e2787. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016007/ Central Line–Associated Bloodstream Infection.

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