Clinical Problem and Associated Change
The problem under discussion is central line-associated bloodstream infections (CLABSI). These infections belong to the healthcare-associated infections (HAIs) group. Patients are likely to get such infections in the course of their treatment in health care settings. CLABSIs represents a critical threat to patients’ safety and impede the process of recovery significantly. According to the Centers for Disease Control and Prevention (CDC), the burden of CLABSI has increased by 50% within the past six years (CDC, 2014).
There is a wide scope of negative outcomes associated with CLABSI. Thus, the Agency for Healthcare Research and Quality (AHRQ) reports that these infections lead to a considerable increase in morbidity and mortality among patients. It likewise results in additional expenses for health care units (AHRQ, 2014).
As a consequence, it is considered critical that the healthcare community puts a particular emphasis on finding solutions to reduce the risks of CLASBI within clinical settings. The CDC points out that the positive outcomes of effective prevention strategies are empirically proved. Hence, according to their research, the incidence of CLASBI might be reduced by over 70% in case doctors and nurses show high problem awareness and take the necessary measures (CDC, 2014). Therefore, the paper at hand targets to elucidate the successful experience of CLASBI prevention to provide a guideline for further activity.
Evidence-Based Solution
The proposed intervention implies that the change is carried out in two dimensions. First, it is essential to increase staff awareness of the implementation of significance and necessity. Second, it is proposed to implement alcohol port protectors. This approach is described by Wendy Kaler, who experienced infection prevention, who has had a chance to evaluate this method in practice.
Kaler decided to implement this change basing on the research she and her colleagues had previously performed. According to their findings, to eliminate the infectious organisms from the instrumental surface, it sufficed to expose the port to 70% alcohol for 15 seconds. This short period was enough to sterilize the port completely (Kaler, 2014).
The second part of the intervention implies increasing the awareness of the intervention necessity. This aspect of change is based on numerous studies that reveal the significance of high change motivation and awareness of its role in the treatment process. Thus, for instance, Schulman et al. (2011) note that one of the key determinants of the intervention efficacy is the responsible attitude that healthcare specialists are supposed to show.
The researchers point out that many interventions fail to bring positive change since nurses do not treat them seriously and neglect some of the guidelines knowing that no one controls them. Consequently, Kaler (2014) encourages healthcare organizations to consider this aspect especially carefully.
The Process Used By the Organization
The process of change implementation had several stages. First, Kaler introduced the 15-second cleaning standard in her clinic and explained the effect of this method. Second, she communicated the change to the management and alcohol port protectors were purchased. Kaler bought three different protectors to evaluate their efficacy and choose the most appropriate one. She likewise involved the nurses in the change implementation by organizing various surveys and interviews and encouraged them to share their impressions on the new method.
The researcher noticed that those nurses who were used to the 15-second disinfection were particularly positive about the change implementation. Gradually, all the nurses in the department were eager to use the new instruments, and it was decided to purchase port protectors for various lines, but not only for central-lines as it was initially done. To ensure method compliance, Kaler introduced a special management technique. She assigned the so-called “point person” that was responsible for monitoring the change progress (Kaler, 2014).
On the whole, the change implementation described above was carried out reasonably. Hence, the personnel was initially prepared for the change so that when the new equipment was introduced the staff awareness was already sufficient. In the meantime, it might be suggested that Kaler omitted the patient-related aspect. Hence, it is proposed that to minimize the CLASBI risk as much as possible, it is essential to involve all the parties. Thus, not only the personnel but the patients as well should have been informed about available preventative measures.
Potential Risks
Unless the relevant preventative measures are taken on time, the outcomes are likely to be negative. From the financial perspective, the healthcare center that shows high CLASBI rates is apt to bear additional expenses. According to Kaler (2014), the average cost of every CLASBI case makes about $45,000. Marschall et al. (2014) point out that this cost might vary from about $4,000 to $39,000. The researchers also note that patients exposed to CLASBI have to stay in hospitals longer, and their recovery process meets more challenges. Therefore, health care providers should take relevant measures to avoid potential complications and improve healthcare service (Marschall et al., 2014).
Reference List
AHRQ. (2014). Tools for reducing central line-associated blood stream infections.
CDC. (2014). HAI data and statistics.
Kaler, W. (2014, November 19). Making it easy for nurses to reduce the risk of CLABSI. Patient Safety & Quality Healthcare. Web.
Marschall, J., Mermel, L. A., Fakih, M., Hadaway, L., Kallen, A., O’Grady, O. P., Pettis, A. M., Rupp, E. M., Sandora, T., Maragakis, L. L., & Yokoe, D. S. (2014). Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infection Control and Hospital Epidemiology, 35(7), 753-771.
Schulman, J., Stricof, R., Stevens, T. P., Horgan, M., Gase, K., Holzman, I. R., Koppel, R. I., Nafday, S., Gibbs, K., Angert, R., Simmonds, A., Furdon, S. A., & Saiman, L. (2011). Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics, 12(3), 436-444.