Improving outcomes for Patients with a Central Venous Access Device Essay Assignment Paper
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Improving outcomes for Patients with a Central Venous Access Device Essay Assignment Paper
Question Description
Please Respond to these discussions APA format with a reference
Discussion 1
Two areas where evidence-based practice has been effective is hand hygiene and central venous assess device. Using evidence based practice in these areas has greatly improved patient’s outcomes. The knowledge of evidence-based practice will empower and enrich nurses to practice more safely.
According to research conducted by Mathers, D (2011), adequate flushing od central venous assess devices improve catheter potency and prevent the use of heparin in the flushing solution. Flushing the device with heparin has been associated with increased risk for HIT and hemorrhage in patient and also erroneous lab results has been associated with heparin use. According to the study, there will be reduction in healthcare costs due to the cost difference in saline and heparin. Also, preventing possible adverse effect associated with heparin use in CVAD’s by using saline will help save financially. To repent line occlusion while also preventing potential complications associated with heparin, non-heparin saline flush has been shown to effective.
Hand hygiene has also been shown to greatly improve patient’s outcome both in home and community settings. Proper hand hygiene helps breaks the chain of infection thereby improving patient’s outcome. Huge patient’s outcome has been recorded in facilities where proper hand hygiene with the use of water and soap and alcohol-based hand sanitizer. Its effect can be seen in wound healing, reduction in cross-infection, respiratory tract infection and GI infection.
Mathers, D (2011) The Journal of the Association for Vascular Access. Evidence-based Practice: Improving outcomes for Patients with a Central Venous Access Device retrieved from http://www.avajournal.com/article/S1552-8855(11)70…
Sally F. Bloomfield, BPharm, PhD, Allison E. Aiello, PhD, MS, Barry Cookson, FRCP, FRCPath, Carol O’Boyle, PhD, RN, Elaine L. Larson, RN, PhD American Journal of Injection Control. The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including hand washing and alcohol-based hand sanitizers. Retrieved from http://www.ajicjournal.org/article/S0196-6553%2807…
Discussion 2
Two noticeable areas of evidence based practice that have benefited greatly to improve patient outcome are that of preventing central line-associated blood stream infections (CLABSIs) and ventilator-associated pneumonia (VAP). The complex pathophysiological conditions of the ICU patients sometimes demands use of central venous lines. “Despite the potential benefits central venous lines can have for patients, there is a high risk of bloodstream infection associated with these catheters” (Reyes, Morphet, & Bloomer, n.d). After conducting studies with use of antimicrobial catheter and interventions such as dressing changes every 7 day and PRN, closed infusion systems, aseptic skin preparation, central venous line bundle checking, education, an extra staff in the Intensive Care Unit for auditing and follow up, it was evidenced that such measures have positive outcomes in reducing central venous line associated bloodstream infections rates.
VAPs prevention strategies is another evidenced based practice that has shown drastic positive outcome related to nursing care. There was a research conducted on a sample of 86 mechanically ventilated patients with 43 patients each in the control group and the intervention group. Subglottic secretion suctioning, intake of single-dose antibiotics within 4 hours after intubation, chlorhexidine mouthwash on oral hygiene, elevation of the head of the bed 30 to 45 degrees and monitoring the bed position twice a day, Proper daily examination of the patient for early extubation, check for correct positioning of nasogastric tube before each feeding, closed-circular ventilator etc. were the strategies considered. Although there was no changes observed for the first 4 days of study, signs of early pneumonia were evident in the control group from day 5. This has revolutionized the VAPs prevention techniques. Most hospitals including the place where I work follow these guidelines strictly to improve patient outcomes.
References:
Nasiriani, K., Jarahzadeh, M. H., & Souroush, M. (2017). EFFECT OF COMPREHENSIVE STRATEGIES FOR PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA ON INCIDENCE OF THE DISEASE IN HOSPITALIZED PATIENTS IN INTENSIVE CARE UNITS. Journal Of University Medical & Dental College, 8(4), 20.
Reyes, D. V., Morphet, J., & Bloomer, M. (n.d). Prevention of central venous line associated bloodstream infections in adult intensive care units: A systematic review. Intensive And Critical Care Nursing, 4312-22.
Discussion 3
Evidence-based nursing practice (EBP) is crucial to the delivery of high-quality care that optimizes and improves patients’ outcomes. Studies continue to show improved outcomes when best evidence is used in the delivery of patient care. To achieve excellence in practice, critical care nurses must apply EBP as the norm. We cannot knowingly continue clinical practice interventions that are not supported by current best evidence, particularly if those actions are known to be unhelpful and possibly injurious. Therefore, EBP should be integrated all the time in nursing daily activities.
Two areas where evidence-based practice has been effective in nursing practice are the followings:
1- The use of oxygen in patients with COPD; it is shown and proved that for patient health and safety, it is essential that nurses follow evidence-based practice in nursing when it comes to giving oxygen to patients with COPD. Despite the belief of some people that providing oxygen to these patients can cause severe problems such as hypercarbia, acidosis or even death, the evidence-based protocol is to provide oxygen to COPD patients. This practice can help prevent hypoxia and organ failure; and the carbon dioxide level is not elevated because of hypoxic drive. Therefore, giving oxygen, which is the correct treatment based on the evidence, can improve COPD patients’ quality of life and help them live longer.
References:
Scott O, Tidy C. Use of oxygen therapy in COPD.http://www.patient.co.uk/doctor/Use-of-Oxygen-Therapy-in-COPD.htm. Revised January 21, 2011. Accessed March,28 , 2018. Google Scholar
2- The last thing a patient wants when going to a hospital for treatment is a hospital-acquired infection. To protect the patients against hospital -acquired infection, nurses play a significant role in helping to prevent illness before it happens by following the evidence-based infection-control policies. It has been proved that by keeping the healthcare environment clean, wearing personal protective clothing, using barrier precautions and practicing correct handwashing the chain of transmission of infectious diseases diminishes/reduces significantly. Although nurses are busy with many responsibilities, the time it takes to control infection is well worth the effort.
References: Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention; May 2009. http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf. Google Scholar
Discussion 4
Nursing informatics is one in are in which evidence-based practice has had an impact on patient outcomes. The other area is in the nursing of chronic diseases and management. Informatics is becoming increasingly present in our profession due to rapidly changing technologic advances. Healthcare systems are assimilating technology into daily practice at a quick pace. Security and patient privacy must be upheld while achieving the goal of transforming data into useful knowledge.
On the other hand, the use of evidence-based practice in the research of chronic disease management has led to discovery of new ways of dealing with chronic infections. There is a large gap between evidence and practice within health care, particularly within the field of chronic disease. This thus led to devising effective ways of dealing with chronic diseases such as asthma, diabetes and obesity, which have been discovered thus providing better patient outcomes. There is hence the development of a collaborative partnership and its evolution into producing a valuable resource for the translation of evidence into practice in the areas of chronic disease management.
The effective of the two on my practice is evident. First, the use of information technology devices is mandatory and effective in simplifying my daily work. At the same time, there is now a proper coordination and management of patient information as informatics allow easy communication. Management of chronic diseases has also seen a decrease in the number of new infections significantly.
References
Lee, A. (2014). The role of informatics in nursing. Nursing Made Incredibly Easy!, 12(4), 55. doi:10.1097/01.nme.0000450294.60987.00
Khalil, H., Chambers, H., Munn, Z., & Porritt, K. (2015). Improving Chronic Diseases Management Through the Development of an Evidence-Based Resource. Worldviews on Evidence-Based Nursing, 12(3), 139-144. doi:10.1111/wvn.12087
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