Introduction
The problem of central line-associated bloodstream infections (CLABSIs) often contributes to deaths and high rates of infestations among patients during their hospital stays. According to the statistics on infection-associated deaths, mortality rates linked to CLABSIs can range from 5% to 35%, which points to the need to carefully choosing appropriate preventative measures for settling the problem (“Central line-associated bloodstream infections (CLABSI),” 2016). Nursing management is a crucial factor that can improve the situation when designed in a way that implies the evaluation of patients’ likelihood of being infected, the introduction of preventive measures, and the management of central lines for the purpose of improving patient outcomes. Thus, it has been proposed to invest in interventions targeted at educating nursing professionals on how to reduce the risk of CLABSIs’ development during patient stays. The research conducted by Glogren et al. (2013) suggested that educational interventions, with the introduction of infection prevention guidelines, were effective in not only saving patient lives but also at providing facilities with cost-saving opportunities.
Change Model Overview
The ACE Star Model Evidence-Based Practice Process is used for illustrating different knowledge clusters in the form of a sequence, in which research evidence has to go through several cycles to be combined with existing knowledge and be integrated into a practice setting (AAHS, n.d.). Previous scientific work on nursing is placed within the context of evidence-based practice in the ACE Star Model, which plays the role of an organizer that examines and applies nursing knowledge to formal evidence-based practice networks. Using the model for facilitating change in nursing has been shown to bring beneficial outcomes that resulted from the combination of cycles that are associated with the knowledge that nursing professionals use at different stages of transformation. The effectiveness of the model can be explained by its placement of relevant research on a particular issue within the context of a specific evidence-based practice paradigm.
EBP Scope
The issue of central line-associated bloodstream infections (CLABSIs) needs resolving because of the higher rates of infections occurring each year: an estimated 250,000 cases, which are predominantly associated with the use of intravascular devices, as found by Haddadin and Regunath (2017). The occurrence of CLABSIs is a persistent problem that can also arise from the lack of nurses’ education and training on how to prevent it from occurring. Not only do such infections contribute to patient mortality but also increase healthcare spending for the government on a broader scale; this spending can be directed at the improvement of healthcare overall if the problem of CLABSIs is resolved.
Stakeholders
Relevant stakeholders that should be involved in the intervention targeted at enhancing healthcare specialists’ knowledge on the prevention of CLABSIs should come from interdisciplinary teams for the enhanced dissemination of information. Nurses, pharmacists, nurse informaticists, surgeons, and anesthesiologists will create a multidisciplinary team for reducing the occurrence of CLABSIs.
The Responsibility of Team Members
Within the identified team, nurses will play an important role in monitoring patient statistics for determining risks of CLABSI development. Nurse informaticists will be responsible for researching and disseminating evidence to support the intervention’s implementation. Surgeons and anesthesiologists will be held accountable for the appropriate use of medical equipment to ensure that no errors occur and contribute to CLABSIs development. Pharmacists will be responsible for finding appropriate medications for preventing and/or mitigating the impact of infections.
Evidence
The problem of CLABSI has been extensively researched, with types of evidence ranging from EBP guidelines to systematic reviews. The research conducted on this issue found that multi-dimensional and differentiated strategies were needed for preventing infections from occurring. Therefore, relevant studies provide a great advantage to the current change model because it offers multiple ways of resolving the problem of CLABSI development.
Evidence Summary
A systematic review conducted by Flodgren et al. (2013) analyzed the findings of five studies. It was found that infection prevention guidelines decreased the occurrence of CLABSIs by forty percent and saved the health care industries more than fifteen million dollars (“Central line-associated bloodstream infections (CLABSI),” 2016). In addition, Flodgren et al. (2013) emphasized the importance of introducing education-oriented interventions for training staff on appropriate procedures for eliminating CLABSI occurrence.
Recommendations for Change
Based on the research findings, it is recommended to implement a multidimensional intervention to combine education for practitioners and the establishment of effective guidelines on preventing hospital-acquired infections through strategies such as hand hygiene, aseptic techniques, skillful insertions, sterile precautions, and so on.
Translation
Action Plan
Since the recommended intervention will be divided into two components, the first stage is educating relevant stakeholders on general procedures that could reduce the likelihood of CLABSI development. Based on the collected information, a guideline on best practices for practitioners should be developed in order to influence the outcomes of patients and prevent them from developing CLABSI. It is expected that the plan will take up to six months and more, depending on professionals’ adherence to the program and whether additional education for nurses is needed.
Process, Outcomes Evaluation, and Reporting
The desired outcomes of the intervention are associated with the reduction of CLABSI occurrence within the hospitalized population. Pre- and post-interventional patient outcomes will be measured in order to evaluate the plan’s success; moreover, hospital-wide surveys for practitioners can be introduced for evaluating nurses’ outlooks on the benefits of the intervention and determining whether the newly-integrated guidelines on CLABSI prevention work. With regards to the reporting of results to stakeholders, a written report will be composed for the efficient dissemination of results. An oral presentation given by a nursing manager is also recommended.
Next Steps
On a larger scale, the collaboration between healthcare facilities needed to ensure the widespread adherence to the program. It is recommended for hospital managers to conduct seminars and meetings on deciding how the successful program can be integrated into different environments.
Findings Dissemination
Internally, the findings of the intervention will be disseminated through the distribution of printed material such as leaflets that both patients and healthcare providers can access. With regards to communicating the outcomes of the intervention outside the organization, a website dedicated to the success of the intervention should be created.
Conclusion
CLABSI is a persistent problem that occurs due to the lack of professionals’ education as well as the absence of a cohesive framework of guidelines that regulate best practices that nurses can use. With the help of the ACE Star Change Model EBP, a change initiative was created in order to resolve the problem of central line-associated bloodstream infections through the translation of relevant evidence into an action plan, processes and outcomes, next steps, and the dissemination of findings. Process, outcomes evaluation, and reporting are essential aspects of the ACE Star Change Model that will be maintained in the plan through the introduction of procedures targeted at the dissemination of findings. It was recommended to implement a multidimensional intervention that combines nurses’ education with a guideline on best practices targeted at the reduction of CLABSI risks.
References
AAHS. (n.d.). The ACE Star Model. Web.
Central line-associated bloodstream infections (CLABSI). (2016). Web.
Flodgren, G., Conterno, L. O., Mayhew, A., Omar, O., Pereira, C. R., & Shepperd, S. (2013). Interventions to improve professional adherence to guidelines for prevention of device‐related infections. The Cochrane Database of Systematic Reviews, 28(3), 1-106.
Haddadin, Y., & Regunath, H. (2017). Central line associated blood stream infections (CLABSI). Web.