Feb 23, 2024 Week 5 Discussion: Using Evidence-Based Practice to Improve Patient Care
Out of all of the health care issues we face on a daily basis, I think patient safety is highest. I think that catheter associated urinary tract infections are very important in my unit. The risk of developing CAUTI increases 5% each day that a patient has a catheter (CDC, 2001). I work in an intensive care unit and most patients either are admitted with a long term catheter or have one placed to keep accurate input and output. On our charting database, there is no where to chart that you have completed catheter care/cleaning. I think this is often forgotten about. I think that the statistics should be brought to managements attention, as well as the lack of “spot” to put that the care has been completed. There is no way to gauge who is or is not performing catheter care on a daily basis when there isn’t a spot for it. As far as researching, I would use PICOT to compare the amount of urinary tract infections acquired in the hospital and what percentages could decrease to with proper daily catheter care. PICOT would tell me the population most affected, interventions being used or that should be used, comparison between those that had catheter care and those that didn’t, what the outcome was for both sides, and the time frame studied (Hood, 2018). In EBSCO, I would inquire on catheter associated urinary tract infections and catheter care. Once the information was formulated, I would take the information to the administration to push for a system that holds nurses more reliable for catheter care on a daily basis.
Engineering out the Risk of Infection with Urinary Catheters – Volume 7, Number 2-April 2001 – Emerging Infectious Diseases journal – CDC. (2001, April). Retrieved from https://wwwnc.cdc.gov/eid/article/7/2/70-0342_articleLinks to an external site.
Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.
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I chose the nursing care issue of central line-associated bloodstream infections or CLABSIs. I chose this as a topic as it is a continuous area of awareness and seen more than I feel should be. The hospital I work in has a section of charting dedicated to documenting care and maintenance of central lines to prevent central line associated infections. When I worked in our ICU, we continuously were updated on new protocols for best practice in preventing CLABSIs and monthly were monitoring and recording such infections to find a better means for detection and prevention if it was warranted. According to the CDC, this preventable infection, is related to thousands of deaths every year and in addition, costs the healthcare industry billions of dollars (2010). As far as the patient, such occurrence increased length of stay and added additional complications to the patient.To find reliable and credible sources for research information to find best evidence based practice of how prevention of CLABSIs could improve, I would use the PICOT acronym finding the patient population affected, interventions or the issue of interest, compare interventions found, review the outcomes, and evaluate the time frame each intervention took to meet the outcome (Hood, 2017). I would search CINAHL in Chamberlain’s library for reliable research within a five-year time span to gather the most current practices in prevention of CLABSI. I would use search terms such as “patients affected by CLABSI” to find my population, “evidence based practice to prevent CLABSI” for various interventions and studies reviewing those interventions and outcomes.
CDC. (2010). Central line-associated bloodstream infection (CLABSI). CDC.gov. https://www.cdc.gov/hai/bsi/bsi.htmlHood, Lucy. (2017). Leddy & Pepper’s Professional Nursing (9th Edition). [Vitalsource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781496351388/cfi/6/24!/4/2/462/4/4@0:94.6
The topic I chose is bedside shift report, this is a concept that we have tried on and off of my nursing unit. It is the end of shift report for the oncoming staff that is done at the patient’s bedside. This practice can improve patient involvement, increase accountability between shifts, and can take less time; but nursing practice should not always be changed by a single study (Hood, 2017). The negatives to giving bedside report is the possibility of breaching patient privacy, if the patient is sleeping, and the amount of time report can take. However, according to one article that I found, patients feel involved in their care and they value having access to their medical information and it can also promote a safer and higher quality of care (Mcmurray et al., 2011).
The process I would use to search CINAHL for evidence, is to organize my key terms along with combining the specific concepts of my search question (What are the effects of bedside report on patient care vs. traditional bedside report?) in order to retrieve correct results. First of all, I would want to narrow the scope of my search otherwise I would end up with to broad of one and have thousands of sources (i.e. Bedside shift report, nursing handoff, nursing report and patients’ perspectives). You can also add search options by just clicking on each tab to define your search even more. I used the Chamberlain Library to search with CINAHL.
Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.
Mcmurray, A., Chaboyer, W., Wallis, M., Johnson, J., & Gehrke, T. (2011). Patients’ perspectives of bedside nursing handover. Collegian, 18(1), 19–26. doi: 10.1016/j.colegn.2010.04.004
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