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Running head: LITERATURE RESEARCH 1 PICOT Statement and Literature Search NRS 433V: Evidence Base Practice & Nursing Research Grand Canyon University 09/24/2017
CLABSI PREVENTION PICOT Statement and Literature Search Nursing Practice Problem Central Line associated Blood stream infections (CLABSI) is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of (or within 48-hours prior to) the onset of symptoms and the infection is not related to an infection from another site. Central line-associated bloodstream infections happen when a central line is not put in correctly or not kept clean. This allows the central line to become a way for germs to enter the body and cause deadly infections in the blood. (CDC, 2016). Central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable type of health care associated infections. CDC has provided guidelines and tools to the healthcare community to help end CLABSIs. (CDC, 2016). PICOT Statement Would adult patients in the cardiovascular ICU have a decreased incidence of CLABSIs if clinical staff utilized CLABSI bundle (hand hygiene, barrier precautions, use of chlorohexidine, optimal site selection, avoidance of femoral sites, and daily review of line necessity protocols as opposed to clinical staff dealing with central lines without a protocol, during the duration of the ICU stay? P- adult patients in the cardiovascular ICU I- Use of CLABSI bundle protocol C- No protocol, individual basis O- decreased rate of CLABSIs 2
CLABSI PREVENTION T- during ICU stay Literature Search The topic writer chose for this week deals with CLABSIs (Central Line Associated Blood Stream Infections), as this is something that nurses deal with quite often in the ICU and are consistently informed of how may CLABSIs each unit has had each month. Nurses then will try to see where the problem is occurring (education, implementation, understanding, etc.) This lead writer to want to use the following PICOT question. CLABSI is associated with increased morbidity and has mortality rates of 10 – 20%. The increase in medical cost is significant and is estimated at >$28,000 due to prolonged length of stay (mean of 7days). CLABSIs are serious but preventable infections when we understand the mechanism of why they happen and institute evidence based guidelines to combat them. It is unfortunate that CLABSI is still prevalent in the acute care setting and most commonly in ICU despite the use of preventive measures. CLABSI has always been the topic of interest for me as I have seen a lot of infection and has applied measures to prevent it. The strategies changes from time to time as per the evidence based practice to get the better outcome in our hospital where I work. One can hope that prevalence of CLABSI will be zero someday-in future with extensive research of its measure for prevention. The following articles discuss about the existing condition

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