Department of Health and Human Services, 2010)

Department of Health and Human Services, 2010)

Running Head: Decreasing CLABSI Infections 1

PICOT Statement and Literature Search

24/10/2018

INSTRUCTOR’S FEEDBACK

· Ensure that you are only using third person language for APA format.

· The only change that needs to take place is for you to ensure you are in the proper order. It will sound weird, but it is truly the best format. PICOT.

In researching articles for this paper, I turned to both Qualitative and Quantitative peer reviewed articles. I also performed a lot of independent research, so I could knowledgably select the best articles for this research. According to the United States Centers for Disease Control and the Society for Healthcare Epidemiology of America and the Disease Society of America (SHEA-IDSA) report, the third most common Healthcare Associated Infection are Central Line Associated Blood Stream Infections or CLABSI.

Hospital-acquired infections (HAIs) affect 1.7 million patients annually and result in 99,000 deaths each year (US Department of Health and Human Services, 2010). CLABSIs are a subset of bloodstream infections, and while Klevens et al (2007) estimated that the deaths caused by or associated with a HAI were 98,987 per year, one-third of these were secondary to CLABSIs resulting in a 12.3% mortality rate (U.S. Department of Health and Human Services, 2009). CLABSIs result in prolonged stays in the intensive care unit (ICU) with medical costs averaging an additional $11,971 per patient (Warren et al., 2006). The overall effect of CLABSIs results in annual expenditures of 2.3 million dollars in U.S. hospitals (Blot et al., 2005). However, with preventive measures, these costs could be greatly reduced and perhaps eliminated.

CLABSI – Centers for Disease Control and Prevention (CDC) definition: CLABSI is a surveillance definition used by the CDC and defined as recovery of a pathogen from a blood culture (a single blood culture for organism not commonly present on the skin, and two or more blood cultures for organism commonly present on the skin) in a patient who had central line at the time of infection or within 48 hours before development of infection. The infection cannot be related to any other infection the patient might have and must not have been present or incubating when the patient was admitted to the facility.

The research on CLABSI indicates the most common pathogens are Staphylococcus Aureus, Enterococci, and Candida. According to further CDC guidelines, LCBIs are divided into LCBI 1, LCBI 2, and LCBI 3 (in patients < 1 year of age), An LCBI 1 is defined as a patient with a recognized pathogen cultured from one or more blood cultures, and these cultured bacteria is not related to an infection at any other site. This confirms that the bloodstream infection is not related to another source of infection and is therefore determined to be caused by the central line. LCBI 2 requires that the patient have either fever (>38°C), chills, or hypotension, alongside positive blood lab results (cultures) that are not related to infection at another site. Finally, bacteria must be cultured from two or more blood tests drawn within a 24-hr period. LCBI 2 allows for diagnosis of a CLABSI when blood cultures reveal a microorganism that is not strictly pathogenic in nature (CDC, 2016).

PICO Parts and PICO Question

· P: Population/patient – Patients developing central line associated bloodstream infections (CLABSI).

· I: Intervention/indicator – Handwashing, Antimicrobial catheters and chlorhexidine baths to decrease CLABS.

· C: Comparison/control – Regular bath with soap and water

· O: Outcome – Decreased rates of CLABSI infections in patients with Central vein catheters.

Research Question: In hospitalized patients with central access devices (P), what is the effect of daily chlorohexidine baths (I) on decreasing incidence of CLABSI infections (O) compared with daily baths with soap and water (C) within a hospital stay (T)?

Six (6) Peer Reviewed Research Articles

Quantitative with Abstract-

1) Curlej, MH. 2016. One Rural Hospital’s Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections. Journal of Trauma Nursing. 23 (5):290-297.

ABSTRACT

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