Central Line-Associated Bloodstream Infections
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCscatheter, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles , wereere left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related ,journal articles. Other search tools include The National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research. having done years ranging from 2012 and backwards, and lacking openness to the public. Therefore, 29 were used in the study.
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have. Kadium, M. (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Dougherty (20142) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva, Zong, Jeong, & Lee , (2015), and Esposito, Guillari & Angelillo (2017) concur..
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O’Grady, Alexander, Burns, Delilnger, Garland, Heard, Lipsett, Masur, Mermel, Pearson, Raad, Randolph, Rupp, & Saint (20151), the inquiry focused into how Positive blood culture shows the relationship between CLABSI and CDC surveillance. Other researchers inquire into the CLABSI-related preventive measures implemented among adult patients hospitalized in an ICU. Such studies are by people like Perin, Erdmann, Higashi, Sasso, Bianco, et al. (2016), Masse, Edmond, & Diekema (2018), Oliveira, Stipp, Silva, Frederico, & Duarte (2016). In a research by Basinger, (2014), the research question questions into the causal effects of the Comprehensive Unit-based Safety Programs (CUSP) on the reduction of CLABSIs within the relationship CUSP team member webinar attendance has with the reduction of CLASBIs. Other questions were on how knowledge and education of the family and patient could help in the prevention of CLABSIs attack. Among such studies are; Kadium, (2015) and Powell (2018).
Other studies focused on how evidence-based practice, insertion, and maintenance of CVC could protect the patients from CLABSIs. Such research was done by Bianco, Coscarelli, Nobile, Pileggi, & Pavia (20143), WHO (2018) and Xu & Wu (2017). The final research is by Han, Liang, & Marschall, (20150), who question how the involvement of education to the family and the patient can help prevent CLABSIs attacks among patients on CVC care. Another study by Yazan & Regunath (2018) questions examines the relationships between Positive blood culture and CLABSI with CDC.
From this, there are various subthemes that emerge in this study. These include; Hygiene and impact of this on the CVC situation. Most studies show that the more hygiene is considered and practiced, the lower the cases of CLABSI. Another concept is the knowledge that is necessary among nurses and patients handling CVC. Through knowledge m the care for CVC improves and infections reduce. Besides, there are Policies which enhance the correct application of knowledge and maintenance of hygiene in the health care, hence decreasreducing cases of infections.
Moreover, nurse experience is an essential subtopic for due to evidence that supports that with higher experience in the CVC wardsunits;, nurses tend to takeadhere and follow ptoticls and precautions and which help prevent infections that those without. Finally, there are Eevidence- Based Practices/Interventions such as proper fitting, disinfection and sterilization, iInsertion bundle, maintenance bundle, and quality improvement.
The reviewed literature has shown that the nurse, patients, family, and evidence versus non-evidence-based practice are important in the analysis of the situation. Besides, the setting, the type of catheter, and conditions affect the entire discussion.
Risk Factors Associated with CLABSIs
a. Contamination on Insertion
The catheter may gain entry into the bloodstream during the insertion of the line into the body of the patient. The rate of infections during insertion is substantially dependent on the hygiene levels that are put in place by the health care providers (Dick et al., 2015). The rates of infection during insertion happen to be high showing ignorance or lack of professionalism among the health caregivers. Contamination during insertion may also result from the instruments used and how sterilized they are.
b. Contaminated Skin of the Patient
The insertion is done on the body of the patient. A contaminated skin of the patient may contain germs which may enter the body during the insertion (Dombecki et al., 2017). The fact that patients have negligible knowledge concerning the different ways the infection may occur means that there is so much responsibility placed on the health caregivers. The infection rates due to unsanitary practices of the patients seem to have drawn the attention of the authors of the different articles analyzed. With the rates of CLABSIs rising each year, mortality rates have also increased. Researchers have made CLABSIs prevention a priority to address such risk factors to avoid or reduce infection rates.
c. Non-Compliance with the Central Line Maintenance
There are guidelines for healthcare professionals meant to reduce the chances of CLABSIs infection. Such guidelines include not using antiseptics and ensuring complete dressing changes (Orwoll et al., 2018). As much as these guidelines and policies are in place does not mean that compliance is definite. Cases of caregivers who do not comply with the stipulated guidelines are common and such levels of unprofessionalism have cost patients their lives.
a. Removal of Unnecessary Lines
The authors agree that there are times patients will have lines which are no longer being used for any medical purpose. These are mainly patients who have spent so much time in the hospitals, and the chances of being discharged seem minimal (Sodek, 2016). The caregivers are meant to remove lines once they have served the purpose. The more these lines remain on the body of the patients the more the chances of infection. Bacteria and all other associated germs will easily enter the body.
b. Health Care Providers to Follow Recommendations
Healthcare professionals are trained on the best practices that are meant to ensure that the chances of patient infections are minimized or even eliminated entirely. Unfamiliarity creeps in at times, and the well-being of the patients is jeopardized (Stone et al., 2014). Just like any other profession, health care ties the professionals around practices which ensure ethical undertakings to safeguard the lives of the patients. The authors are for the idea that health care professionals should be just to patients and do what their work ethics dictates them to do. Such will ensure improved health and safety of the patients.
c. Encouraging Teamwork
In any health care setting, there are two main participants. These are the health caregivers and the patients. One of the authors suggests that teamwork between these two parties will go a long way in reducing the rates of these infections (Stone et al., 2014). Teamwork will ensure that there is knowledge sharing, that key concerns and risks that may be known to one of the parties are made known to the other. The impact teamwork will have ontowards preventing the cases of CLABSIs in hospitals is immeasurable. The same should be embraced and upheld.
CLABSIs associated infections/Transmissions
a. Hematogenous Transmission
This is an infection that is characterized by a primary tumor penetrating into blood vessels. They then get transported in the blood vessels and eventually into the distant parts of the body of the patient (Stone et al., 2014). Once at the distant sites, the cells will penetrate the walls of the vessels again and build a basis for another, a new tumor on the new site. Such are the same cases that happen with CLABSIs. Examples include catheter-associated Urinary Tract Infections (CAUTI) that can lead to CLABSI’s
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