compossition paper

Develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: ( SEE ATTACHED WORK)

1. Background
2. Problem statement
3. Purpose of the change proposal
4. PICOT
5. Literature search strategy employed
6. Evaluation of the literature
7. Applicable change or nursing theory utilized
8. Proposed implementation plan with outcome measures
9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

APA Style required.

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Running head: PICOT
PICOT Statement
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PICOT
PICOT Statement
Should multiple interventions tailored to the population or individuals be utilized to prevent
Central Line-Associated Bloodstream Infections among the dialysis patients?
Population/patient
The population that is affected by the Central Line-Associated Bloodstream is the target
population in this project.
Intervention/indicator
Many studies have been carried out to verify the use of Alcohol Impregnated Caps to
reduce Central Line-Associated Bloodstream Infections. One research from NorthShore
University mentioned that “Catheter hub decontamination requires a thorough scrub and
compliance varies” (Wright et al., 2013). The researcher utilized sterilization caps with a less
sponge soaked in isopropyl with a concentration of 70%, which is wound on every lumen not
frequently in use and stays in position up to when the lumen is opened. Once the cap is detached,
it’s disposed of, and a new one is wound in onto the lumen as mentioned above.
In general, the research entails three stages, whereby the CLABSI rate was observed. The
first stage entailed the continuous use of alcohol wipe to clean the hub before gaining access to the
line. In the second stage, the fumigation caps were utilized on all the clients with the central lines.
The last stage needed disposal of all caps and repeating the phase one procedure. This research is
valid to address the question posted regarding the utilization of Alcohol Impregnated Central Caps.
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PICOT
The size of the sample is three healthcare centers and entailed 799 participants with a central line
that was big enough to establish the correlations (Wright et al., 2013). The findings reported that
the rate of contamination was around 12.7 amid the initial stage, and this changed to 5.5 when the
sterilization caps were utilized. The rate augmented to 12.0 % after the discontinuation of the caps,
and alcohol sponging was resumed. According to the finding from this study, the players in the
hospital settings must encourage the utilization of alcohol impregnated caps on a client populace
with many persons necessitating the utilization of central lines.
The nursing intervention will include the prevention and treatment of the condition. In the
treatment, the patient may use the prescribed antibiotics; such drugs include Systemic antibiotic
prophylaxis. The prevention strategy will involve practicing hygiene when dealing with patients.
The plan will likewise entail the provision of high-quality patient care that is patient-centered. The
Health Care Agency entails professional caregivers who will play a central role in the management
of the condition. Such an agency will play a vital role in managing the various conditions among
the patients. The nursing practices, in this case, will entail nurses making some efforts to handle
the problem are they make some efforts to prevent such incidents.
Comparison/control
For the chosen approach, a comparison can be made by evaluating the reported cases of
CLABSI before and after the utilization of Alcohol Impregnated Caps. Making a comparison after
the proposed plan has been implemented will be used to measure the effectiveness of the program.
Outcome
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PICOT
The targeted outcome is to record the reduced cases of CLABSI in the dialysis center after
the implementation of the sterile technique during various processes like route dressing, insertions
among the others in order to deter the development of the condition.
Time
The expected outcome should be measured within six months after the implementation of
the plan.
Reference
Wright, M., Tropp, J., Schora, D., Dillon-Grant, M., Peterson, K., Boehm, S., et al. (2013).
Continuous passive disinfection of catheter hubs prevents contamination and bloodstream
infection. American Journal of Infection Control, 41, 33-38. Retrieved November 28,
2013, from the Elsevier database.
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
Central Line-Associated Bloodstream Infections
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CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
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Central Line-Associated Bloodstream Infections
Introduction
Healthcare facilities have a responsibility to patients to provide the ideal environment for
recovery from different health issues. However, they are just as much likely to create an
environment in which the patients could develop more complications than they did coming into
the hospital. The extensive range of healthcare issues and infections that the patients at the facilities
have present opportunities for contracting healthcare-associated infections, thereby necessitating
attention towards potential such cases. Central Line-Associated Bloodstream Infections
(CLABSIs) form some of the potential healthcare issues that one could contract in healthcare
facilities, which has necessitated significant research into potential intervention methods to address
the problem. Notably, so, the use of alcohol impregnated caps, use of adequate antiseptics such as
chlorhexidine, proper handwashing techniques, proper way to provide catheter care and dressing
changes are one of the potential methods through which healthcare practitioners could help patients
recover from the infection sand achieve full health status.
Research Question
The research herein is based on the necessity to answer the question of the potential that
the impregnated alcohol caps could be an effective solution to CLABSI. Previous research into the
potential implications of the use of disinfectant caps points to a significant reduction in the
infection rates once the practitioners employed the intervention method (Merrill, Sumner, Linford,
Taylor, & Macintosh, 2014). However, it would be important to determine the potential impact of
the use of alcohol-related caps in addressing the issue. Particularly so, the research will compare
the outcome of using the alcohol-related caps and cases in which no such intervention is provided
to the patients. Data from the experiment would then form an integral basis of analysis into the
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
3
potential impact of the intervention measure, thereby aiding in answering the research question as
is.
Sample Population
One of the most effective methods of comparing the research outcomes in such cases is the
use of run charts to compare cases prior to and after the intervention. Particularly, following the
identification of the health facility to be used for the research, the research team will collect
information related to the rates of infection among the patients. Ultimately, the team will collect
the same data following the intervention process to de3termine the implications if using the alcohol
impregnated caps as a form of intervention to reduce CLABSI. Most importantly, the results ought
to indicate a significant change in the recorded cases based on the nursing practice intervention.
The method is especially appropriate as it does not put anyone’s health in peril as would be the
case had the team used a different group of respondents with CLABSI, but to whom no form of
intervention is offered.
Limitations of the Study
In as much as the research herein could be as straightforward, limitations such as the
chances of confounding factors influencing the research results are likely. There are limited
chances that the nursing teams involved in the research will be perfectly effective in adapting to
the practices necessary in the implementation of the intervention. Ultimately, such a factor could
influence the outcome based on the observed cases but would not be appropriately analyzed in
analyzing the results from data collection. Such confounding factors could influence the study but
receive limited credibility in analyzing the results, which would affect their generalization.
Another limitation with a potential impact on generalization would be the population
sample size used in the research, in which case an extensive sample, drawn from different cultural
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
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environments would be most effective for the study’s external validity. However, resource
constraints make it hard to draw such a large sample and effectively affect the research study.
Particularly, it would be important to conduct the research based on samples from different
healthcare organizations scattered across the country to guarantee that the results therein appeal to
the general healthcare environment. However, such research calls for extensive investment in
training the practitioners to adopt the intervention measure, which would increase the number of
resources necessary to complete the project. The absence of such resources creates limitations for
the research to the extent of affecting its application in policy development efforts.
Recommendations and Conclusion
Irrespective of the challenges, the research outcomes create a basis for adaptation of the
intervention methods in addressing CLABSIs. Notably so, one of the primary factors used in
confirming the validity of research has always been the potential relationship between the study
and previous research conducted in the field of interest. In this case, research already points to the
potential for a positive outcome following interventions that include the use of disinfectant caps
in solving CLABSIs. Hence, it would be appropriate if healthcare facilities considered adopting
the intervention measure as a means of addressing the rates of healthcare-associated infections.
In conclusion, the research herein offers significant insight into addressing an issue that
has affected the quality of outcomes in healthcare interventions in the past. Consequently, an
explicit effort by healthcare management teams to adopt measures such as those recommended
herein, which are based on evidence and research, could be consequential to improving patient
experiences and quality of services at the said facilities.
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
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References
Merrill, K. C., Sumner, S., Linford, L., Taylor, C., & Macintosh, C. (2014). Impact of universal
disinfectant
cap
implementation
on
central
line–associated
bloodstream
infections. American journal of infection control, 42(12), 1274-1277.
Flynn, E. R. (2016). We’re Not in ICU Anymore: Long-term Care and Dialysis Units Collaborate
on Process Improvement to Reduce Central Line-Associated Bloodstream
Infections. American Journal of Infection Control, 44(6), S47-S48.
Krishnan, A., Irani, K., Swaminathan, R., & Boan, P. (2019). A retrospective study of tunnelled
haemodialysis central line-associated bloodstream infections. Journal of Chemotherapy,
1-5.
Ling, M. L., Apisarnthanarak, A., Jaggi, N., Harrington, G., Morikane, K., Ching, P., … & Lee,
C. M. (2016). APSIC guide for prevention of central line associated bloodstream
infections (CLABSI). Antimicrobial Resistance & Infection Control, 5(1), 16.
Neu, A. M., Richardson, T., Lawlor, J., Stuart, J., Newland, J., McAfee, N., … & Foster, D.
(2016). Implementation of standardized follow-up care significantly reduces peritonitis in
children on chronic peritoneal dialysis. Kidney international, 89(6), 1346-1354.
Nguyen, D. B., Shugart, A., Lines, C., Shah, A. B., Edwards, J., Pollock, D., … & Patel, P. R.
(2017). National Healthcare Safety Network (NHSN) dialysis event surveillance report
for 2014. Clinical Journal of the American Society of Nephrology, 12(7), 1139-1146.
Patel, P. R., Sarah, H. Y., Booth, S., Bren, V., Downham, G., Hess, S., … & Jernigan, J. A.
(2013). Bloodstream infection rates in outpatient hemodialysis facilities participating in a
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collaborative prevention effort: a quality improvement report. American Journal of
Kidney Diseases, 62(2), 322-330.
Rhee, Y., Heung, M., Chen, B., & Chenoweth, C. E. (2015). Central line-associated bloodstream
infections in non-ICU inpatient wards: a 2-year analysis. infection control & hospital
epidemiology, 36(4), 424-430.
Sarah, H. Y., Kallen, A. J., Hess, S., Bren, V. R., Lincoln, M. E., Downham, G., … & Lines, C.
(2016). Sustained infection reduction in outpatient hemodialysis centers participating in a
collaborative bloodstream infection prevention effort. infection control & hospital
epidemiology, 37(7), 863-866.
Saran, R., Robinson, B., Abbott, K. C., Agodoa, L. Y., Bhave, N., Bragg-Gresham, J., … &
Gaipov, A. (2018). US renal data system 2017 annual data report: epidemiology of
kidney disease in the United States. American journal of kidney diseases: the official
journal of the National Kidney Foundation, 71(3 Suppl 1), A7.