Reducing Central Line–Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach.

Background: Despite implementation of central catheter bundles, central line [catheter]–associated bloodstream infections (CLABSIs) remain a preventable hospital-acquired infection. Local Problem: A new population of patients with pulmonary artery catheters was introduced to the cardiac progressive...

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Publicado en:Critical Care Nurse Vol. 44; no. 4; pp. 27 - 37
Autores principales: Hoke, Linda M., Mathen, Gracy C., Beckett, Ellen
Formato: CEU research Journal Article
Publicado: American Association of Critical-Care Nurses Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
      vid: 44
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        10.4037/ccn2024493
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        atl: Reducing Central Line–Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach.
      aug:
        au:
          Hoke, Linda M.
          Mathen, Gracy C.
          Beckett, Ellen
        affil: Linda M. Hoke is a unit-based clinical nurse specialist and serves on the cardiac progressive care unit's nurse leadership team at the Hospital of the University of Pennsylvania, Philadelphia
      sug:
        subj:
          Catheter-Related Bloodstream Infections Prevention and Control
          Central Venous Catheters Utilization
          Catheter-Related Bloodstream Infections Nursing
          Human
          Pulmonary Artery Catheters
          Coronary Care Units
          Critical Care Nurses
          Quality Improvement
          Nursing Staff, Hospital
          Patient Education
          Chlorhexidine
          Algorithms
          Education, Continuing (Credit)
          Risk Assessment
          Academic Medical Centers
          Patient Safety
          Wound Care
          Multidisciplinary Care Team
      ab: Background: Despite implementation of central catheter bundles, central line [catheter]–associated bloodstream infections (CLABSIs) remain a preventable hospital-acquired infection. Local Problem: A new population of patients with pulmonary artery catheters was introduced to the cardiac progressive care unit, increasing central catheter days, device use, and CLABSI rate. Methods: A quality improvement project was conducted. Nursing staff implemented a standardized central catheter rounding process 3 days a week to critically assess all central catheter dressings, deter-mine the necessity of each central catheter, and educate patients on the importance of keeping central catheter dressings clean, dry, and intact. Data were collected during central catheter rounds for each patient, entered in an electronic survey tool via mobile devices, and analyzed. Results: From July 2019 through June 2022, a total of 2692 rounds were conducted for 707 individual patients with 3064 central catheters. Main interventions were dressing management, monitoring insertion site bleeding that extended beyond edges of the chlorhexidine gluconate pad, treating patients' allergies to products, and maintaining sustainability within the unit. Central catheter rounds decreased the CLABSI rate from 1.86 to 0.0 despite the continued increase in central catheter days. Conclusions: Central catheter dressing assessment, intervention, and education help reduce CLABSIs. Central catheter rounds are an important adjunct to the CLABSI bundle. A central catheter dressing management algorithm helps nurses decide when to change a dressing and which type of dressing to use.
      pubtype: Academic Journal
      doctype:
        CEU
        research
        Journal Article
      ougenre: Article
    language: English
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