Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

In patients with central lines, what is the effectiveness of daily chlorhexidine bath compared to weekly or as needed dressing changes to reduce infection within the first three months of insertion?

Referenes has to be:

Furuya, Y., Dick, A., Perencevich, E., Pogorzelska, M., Goldman, D., & Stone, P. (2011). Central line bundle implementation in US intensive care units and impact on bloodstream infections. PLoS ONE, 6(1), 1-6.

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Graling, P., & Vasaly, F. (2013). The effectiveness of 2% CHG Cloth Bathing for Reducing Surgical Site Infections. AORN Journal, 97(5): 547-551.

Kim, J., Holtom, P., & Vigen, C. (2011). Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences. American Journal of Infection Control, 39(8), 640-646.

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Klinworth, G., Stafford, J., O’Connor, M., Leong, T., Hamley, L., Watson, K., Kennon, J., Bass, P., Cheng, A. C., & Worth, L. (2014). Implementation of a successful hospital-wide initiative to reduce central line–associated bloodstream infections. American Journal of Infection Control, 42(6), 685-687.

McAlearney, A., Hefner, J., Robbins, J., Harrison, M., & Garman, A. (2013). Preventing central line-associated bloodstream infections: A Qualitative Study of Management Practices. Infection Control & Hospital Epidemiology, 36(5), 557-563.

Power, J., Peed, J., Burns, L., & Davis, M. (2012). Chlorhexidine bathing and microbial contamination in patients’ basin. American Journal of Critical Care, 21(5), 338-342.

Quach, C., Milstone, A, Perpe, C., Bonenfant, M., Moore, D., & Perreault, T. (2014). Chlorhexidine Bathing in a tertiary care neonatal intensive care unit: Impact on central line–associated bloodstream infections. Infection Control & Hospital Epidemiology, 35(2), 158-163.

Richardson, J., & Tjoelker, R. (2012). Beyond the central line-associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes. The Journal of Advanced Nursing Practice, 26(4), 205-211.

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Scheithauer, S., Lewalter, K., Schroder, J., Koch, A., Hafner, H., Krizanovic, V., Nowicki, K., Hilgers, R.-D., & Lemmen, S. (2014). Reduction of central venous line-associated bloodstream infection rates by using a chlorhexidine-containing dressing. Infection, 42(1), 155-159.

U.S. Department of Health and Human Services. (2011). Health-care-associated infection (HAI). Retrieved 10/21/2016 from http://www.hhs.gov/ash/initiatives/hai/index.html

This criterion is linked to a Learning Outcome Abstract: Brief summary of the direction of the project.

This criterion is linked to a Learning Outcome Introduction to problem or issue in practical setting. Overview, purpose, plan for paper.

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
This criterion is linked to a Learning Outcome Literature Review: 12 single, original research articles (NO systematic reviews, meta- analyses, or meta-syntheses). Discuss purpose, question, methodology, analysis, and results. Tabular format must be added as Appendix A.

This criterion is linked to a Learning Outcome Analysis: Systematically analyze and evaluate relevance and validity of articles.

This criterion is linked to a Learning Outcome Gaps in research identified during the literature search.

This criterion is linked to a Learning Outcome Research Question(s): Flow(s) directly from the review of literature and posed for pilot study.

This criterion is linked to a Learning Outcome Summary: Explain how this paper met the purpose stated in the introduction.

This criterion is linked to a Learning Outcome Standard English for spelling, grammar, punctuation, paragraph formation, and paper formation used

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
This criterion is linked to a Learning Outcome References (within past 5 years): current and relevant to topic-Utilize at least 12 appropriate scholarly research sources beyond textbooks.

This criterion is linked to a Learning Outcome Follows appropriate APA format. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

M4 Tabular Summary

Author, Date, Title Method and level of evidence Types of patients and the enrolment period Content of intervention Study Findings Outcomes
Fouka, G. & Mantzorou, M. (2011). What are the Major Ethical Issues in Conducting Research? Is there a Conflict between the Research Ethics and the Nature of Nursing?Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay This is a systematic review of the data base of the Medline and the Nursing Cinahl

Level of evidence is 1. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

There is no control study used there were no specific period used but it was based on the review of the data base. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay None The most common types of ethical issues during the performance of a research work are informed consent, beneficence, respecting the anonymity as well as the confidentiality, and respecting the privacy. The nature of the nursing which focuses on the caring, prevention of the harm, and protection of the dignity as well as advocating the role of the nurses which is required in defending the rights of the participants, are from time to time incongruent with the ethics in the research work. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Furuya, Y., Dick, A., Perencevich, E., Pogorzelska, M., Goldman, D., & Stone, P. (2011). Central line bundle implementation in US intensive care units and impact on bloodstream infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay A cross-sectional study survey on the National Healthcare Safety Network (NHSN) hospitals

Level of evidence of this study is 1

Patients at the Intensive Care Units (ICU)

The enrolment period was ICU with a minimum of 500 device days

The use of Central Line (CL) Bundle elements throughout the US intensive care units Hospitals had reported ICU-specific quarterly CLABSI rates as reported to the NHSN. Facilities were able to follow particular surveillance protocol which defines CLABSIs using the standard CDC terms. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Graling, P., & Vasaly, F. (2013). The effectiveness of 2% CHG Cloth Bathing for Reducing Surgical Site Infections A prospective cohort study

Level of evidence is 3

Patients who had been taken through a general, vascular, and orthopedic surgery

There is no mentioning of the period used for the enrolment. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

Using preoperative bathing with chlorhexadine gluconate (CHG) cloths in reducing the surgical site infections There was an overall reduction in the rate of infection in the group that received 2 percent chlorhexidine gluconate bath before surgery. There was a reduction in the postoperative organ space infection even though the numbers of samples were smaller. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Jeanes, A., & Bitmead, J. (2015) Reducing bloodstream infection with a chlorhexidine gel IV dressing Randomized controlled trial

Level of evidence is 4

The patients were those who had been admitted and were exposed to the intravenous catheter-related bloodstream infections

No specification of the enrolment period. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

The intervention was the used of the Tegaderm chlorhexidine gel IV for the Central Venous Catheters as well as the arterial line dressings Tegaderm chlorhexidine gel IV for the Central Venous Catheters as well as the arterial line are effective for use in the high dependency and intensive care units for the reduction of the catheter related bloodstream infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Kim, J., Holtom, P., & Vigen, C. (2011). Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay A case and a cohort study

Level of evidence is 4

Patients in the intensive care units and are at risk of acquiring catheter related bloodstream infections.

The period of the study was three years. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

The use of the central venous lines to control the catheter related bloodstream infections There was a decrease in the infection rates. There was an improvement in the catheter related blood stream infection in all the intensive care units patients who participated in the study. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Klinworth, G., Stafford, J., O’Connor, M., Leong, T., Hamley, L., Watson, K., Kennon, J., Bass, P., Cheng, A. C., & Worth, L. (2014). Implementation of a successful hospital-wide initiative to reduce central line–associated bloodstream infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay Randomized control trial study

Level of confidence is 4

The intensive Care Units (ICU) Patients who are at risk of acquiring the catheter related bloodstream infection

The time enrolment was 20 month period

Hospital-wide initiative (intensive care unit bundle) Reduced rates of the catheter related bloodstream infections.
Kramer, N. (2016). Monitoring Central Line-Associated Bloodstream Infections [CLABSI] in Home Infusion This is a systematic review of the descriptive as well as the qualitative studies

The level of evidence is 5

Patients at ICU who are exposed to the Catheter related bloodstream infections

No enrolment period mentioned

Monitoring Central Line-Associated Bloodstream Infections [CLABSI) in Home Infusion The crafting of the surveillance system at home is somehow daunting. Working in isolation as home infusion provider is one of the great strides being made in the patient care leading to a reduce infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
McAlearney, A., Hefner, J., Robbins, J., Harrison, M., & Garman, A. (2013). Preventing central line-associated bloodstream infections: A Qualitative Study of Management Practices. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay Extensive qualitative cases study

Level of the evidence is 3

A total of 94 participants such as administrative leaders, clinical leaders, professionals, and the frontline physicians as well as nurses were interviewed Comparing the higher and lower performing healthcare facilities on the basis of reducing the rate of central line associated blood stream infections There were top level of commitmet, alignment of the physician and nurses, systematic education, use of the data, and the rewards as well as recognition in the high performing healthcare facilities. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Mermel, L. (2014). MRSA and CLABSI Compendium updates offer additional focus on implementation This study is based on looking at the evidence produced by the Society for Healthcare Epidemiology of America based on the CLABSIs

The level of the evidence is 7

No enrolment period but it is based on looking at the CLABSIs infections to the patient at ICU Engaging, educating, executing, ad evaluating the aspects of the CLABSIs. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay The updated guidance contains special parts with implementation, emphasis engagement with the healthcare personnel and vocal leaders who shares data with workers on the frontlines to help in tracking the prevention progress. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Power, J., Peed, J., Burns, L., & Davis, M. (2012). Chlorhexidine bathing and microbial contamination in patients’ basin. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay Well designed controlled trial

Level of evidence is 3

The study was based on using patient’s bath basins with microbial contamination

The period for the culturing process was 5 days

Using Chlorhexidine in removal of the microbes for the purposes of preventing infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay Out of the 90 culture basins, there were 4 basins with positive microbial growth. The three organisms were identified as coagulase negative staphylococcus. This reveals that chlorhexidine is 95 percent effective for the prevention of the microbial infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Pyrek, K. (2015). Experts Address the Promise and Challenges of CHG Bathing Interventions This was a review of the descriptive studies related to addressing the challenges of the CHG bathing interventions

The level of evidence of this study is 5

No enrolment period. The targeted patients in this case those who are exposed to CLABISs especially in ICU Chlorhexidine gluconate interventions Healthcare facilities are appropriately using the chlorhexidine gluconate to reduce the infections as well as controlling the spread of the antibiotic resistant microorganisms. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Quach, C., Milstone, A, Perpe, C., Bonenfant, M., Moore, D., & Perreault, T. (2014). Chlorhexidine Bathing in a tertiary care neonatal intensive care unit: Impact on central line–associated bloodstream infections. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay This was a randomized control trial study

The level of evidence is 4

Infants with the central venous catheter admitted to the neonatal intensive care unit

The enrolment period was April 2009 to March 2013

Chlorhexidine bathing in a tertiary care neonatal intensive care unit There was a reduction I the CLABSI rates during the period of the intervention for the Chlorhexidine gluconate neonates. There were no reported adverse events.
Richardson, J., & Tjoelker, R. (2012). Beyond the central line-associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay This is Retrospective cohort analysis study

The level of the study is 3

Patients in the critical care unit

The period of enrolment was 1000 line days.

Value of the clinical nurse specialist (CNS)-led efforts in optimizing the patient outcomes by having a progressive monitoring and the management The infection rate of the critical care unit patients reduced from 1.5 per 100o line days to 0. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Sandoval, C. (2015). Three practice bundles to reduce CLABSIs This is a study based on the use of evidence from a single descriptive study. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

The level of the evidence is 6

No enrolment period. No patient since it was not a case study or randomize trial study Central-line insertion bundle Healthcare acquired infections remain a significant challenge for most of the healthcare facilities. This is due to the CLABSI whose control still remains a problem
Scheithauer, S., Lewalter, K., Schroder, J., Koch, A., Hafner, H., Krizanovic, V., Nowicki, K., Hilgers, R.-D., & Lemmen, S. (2014). Reduction of central venous line-associated bloodstream infection rates by using a chlorhexidine-containing dressing A randomized controlled trial

Level of evidence is 4

Patients in admission and at risks of acquiring the CLABIS.

The period of enrolment was from November 2010 to May 2012

Reduction of the central venous associated blood stream infection rates through the use of the chlorhexidine-containing dressing. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay 40 CLABIS occurred in 34 patients leading a significant reduction in the overall CLABIS rate in patients with dress containing chlorhexidine. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
Wilder, K. A., Wall, B. Haggard, D. & Epperson, T. (2016). CLABSI Reduction Strategy: A Systematic Central Line Quality Improvement Initiative Integrating Line-Rounding Principles and a Team Approach. Retrospective cohort analysis study

Level of evidence is 4

Neonatal intensive care patients

The period for the enrolment was 1000 line days

Systematic Central Line Quality Improvement initiative integrating line-rounding principles and the team approach The CLABIS rate was effectively reduced from 3.9 in 2011 to 0.3 per 1000 line days in 2014. There was an overall improvement of 92 percent. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay
U.S. Department of Health and Human Services. (2011). Health-care-associated infection (HAI). Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay This is a systematic review study on descriptive and qualitative studies.

The level evidence of this study is 5

Patients are those who are exposed to the healthcare acquired or associated infections Antibiotic stewardship, making connections, partnering to heal, and improving patient safety Antibiotic stewardship improves the antibiotic use through optimizing the clinical outcomes and reducing the unintended impacts. Having a focused prevention activities and the improvement of the antibiotic use are synergistic. Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay

Effectiveness of Chlorhexidine Bath in Preventing Central Line Infection Essay