NURS 6101 -week 7 Essay

The central venous catheter (CVC) is a common device for hemodialysis patient that are not candidates for placement of arteriovenous graft (AVG) or arteriovenous fistulas (AVF). They are also frequently used in situation of the patient needing emergency hemodialysis and there is no time for other access to mature. Whichever the rationale for the CVC the patient is at a higher risk for Catheter related blood stream infection (Fysaraki et al.,2013). The purpose of this study is to show significant decrease in incidence and path to elimination of Catheter related blood stream infection (CRBSI).NURS 6101 -week 7 Essay

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Extraneous Variable
The sample population is a convenience sample. The sample selection all had CVC and received treatment in an in-center chronic dialysis clinic three to four times a week. This is a moderately controlled setting. A major extraneous variable will be the staffing of patient care technician and the time allotted for each patient. Some participants are non-compliant and often late for the allotted time and creates and issue for the proper step to be complete without increasing risk of infection control. In relation to staffing an issue comes about wen all partied assigned to work does not show up. This increased work load without an increase in time to complete task. This creates a rushed environment that increases the risk for cross contamination and spread of infection.
In controlling patient’s non-compliance effect on the care those will be reschedule if time is missed and the following patient will be cared for to decrease the risk for rushing and risk of infection. The staffing issue cannot be addressed prior to the actual occurrence. Another extraneous variable would be personal hygiene and care. At time patient will arrive with dressing removed from catheter exit site and leaving it exposed. Assessment of the cause of the impairment would prompt intervention or education.NURS 6101 -week 7 Essay

Instrument
What are the cause of CRBSI? There are many contributing factors but the major variable that will be assessed will be the environment, equipment, caregivers, and patient. Being that an observational approach has been determined to be used in this study; a tracking tool has also been selected. It is the goal to use an audit tool to collect data prior to intervention being implemented and then post intervention being implemented. This will identify the quality improvement in care.
According to Chu, Adams ,& Crawford (2013), this tool will show consistency by being able to be used in other clinic and possibly areas yielding similar results in computing data. The instrument will also be able to measure the relevant areas of the study. Addressing the contributing Factor noted above. The audit tool will address 3 specific areas of the process of initiating treatment through termination of treatment. These will be environmental, aseptic technique, and dressing. This will be observed pre and post intervention.NURS 6101 -week 7 Essay
The Audit tool will address environment by assessing the method of cleaning equipment before, during, and after treatment. This includes maintaining sanitary station as patient use the station. The proper donning, doffing, and wearing of personal protective equipment will also be considered. The aseptic technique portion of the tool will address set up of the dressing, application of the dressing, scubb of exit site, patient and staff talking during the process, hand hygiene compliance, and aseptic technique during connection.
The third area will be the dressing and it will be assessed for integrity prior to change including; moisture and whether it is intact. After care is completed the placement of the dressing will be address to ensure the exit site is properly covered. During the dressing application process, it will also be assessed whether the patient or staff talked or coughed as well as wore mask properly.NURS 6101 -week 7 Essay
Data Collection
There will be a total of 103 participants divided among five clinics. Each clinics participant will be observed over 3-4 days. Although consent was obtained from the participant prior to the beginning the study there will not be alerting prior to the pre-observation. This will allow the care and interaction to performed as natural and unmanipulated as possible. The data will be collected by addressing audit tool topic to identify what percentage of task were being complete properly. After initial observation, the data collected will be utilized to determine the intervention necessary to decreased risk of CRBSI and improve quality and standard of care. Followed by a post observation to render the result of improve based on the goal.
Intervention
The intervention will address the deficit by standardizing practices for CVC care and treatment procedure. All staff will review current policy and procedure and discuss the current error of practice. The will also be educated on new process procedure to standardize practices. Participant will also be re-educated on home care and care during treatment. With education and simulation with patient and staff the goal is to see a vast improvement in practice.
References:
Chu, G., Adams, K., & Crawford, S. (2013). Improving catheter-related blood stream infection in hemodialysis patients using a practice development framework. Renal Society of Australasia Journal, 9(1), 16-21. Retrieved from https://search-proquest-com.southuniversity.libproxy.edmc.edu/docview/1560339259?accountid=87314
Fysaraki, M., Samonis, G., Valachis, A., Daphnis, E., Karageorgopoulos, D. E., Falagas, M. E., . . . Kofteridis, D. P. (2013). Incidence, clinical, microbiological features and outcome of bloodstream infections in patients undergoing hemodialysis. International Journal of Medical Sciences, 10(12), 1632. NURS 6101 -week 7 Essay