2013 As far as bloodstream infections it was categorized into three groups

2013 as far as bloodstream infections it was

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bloodstream infections, it was categorized into three groups which were hospital-acquired, central-catheter-associated and primary incidence. The study revealed that hospital-acquired
RESEARCH CRITIQUES AND PICOT10bloodstream infections were 28% lower and primary bloodstream infections were 31% lower during the intervention period (Climo et al., 2013). The cases of central-catheter-associated bloodstream infections were found to be 53% lower at the time of the intervention period. Climo et al. (2013) discussed that there was no significance in the unit type and the unit's characteristics that affected the rates of primary bloodstream infections. Medical ICUs were found to have the highest rates of reduction in primary bloodstream infections with 40% lower rates during the intervention period. In comparison to other units, the reduction rates of primary bloodstream infections were at 17% during the intervention period (Climo et al., 2013). An accidental finding according to the authors was that chlorhexidine-impregnated cloths have biphasic antifungal activity which resulted in lower rates of central-catheter-associated fungal bloodstream infections (Climo et al., 2013). It has been known that chlorhexidine was effective against gram-positive cocci, but the findings with fungal isolates being reduced was not expected. The authors reported that topical use of chlorhexidine had not been suggested in the past as systemic antifungal prophylaxis was typically relied on by healthcare personnel (Climo etal., 2013). If the results from this study are confirmed that topical usage of chlorhexidine can prevent fungal infections, then the authors reported it could be added to the strategies (Climo et al., 2013). Based on the findings from this study, it would be beneficial for nurses to incorporate chlorhexidine bathing in many unit settings, especially for patients that have extended ICU stays (Climo et al., 2013). Proposed Evidence-Based Practice ChangeThe PICOT statement, research articles, and nursing practice problem all relate to one subject of significance and that is the use of CHG bathing and reductions in CLABSI. The articles provided evidence of why nurses should incorporate CHG bathing in ICU patients due to
RESEARCH CRITIQUES AND PICOT11their higher risks of infections. A great amount of nursing staff continue to have their own beliefson the difference between CHG bathing and ordinary soap and water but compliance rates could improve with formal training, implementation of a routine and improvement of working conditions. The proposed evidence-based practice change includes supplying ICU settings with chlorhexidine-impregnated cloths and ensuring the bathing practice is a primary routine for nurses. This can be implemented by the use of the barcoding system and administered during medication rounds. Also, staff education on this practice can be reinforced through required CEUcourses and during annual nursing competencies through the hospital. Although some patients

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