Table 1 shows the Hospital KPI performance graph on CHG bathing from the organization’s Nursing Data Portal. The table shows the prior month and current month percentage labeled 0% to 100%. Moving from left to right, the graph shows the organization’s divisional average at 50% and next the HCA corporate average of 70%. Aspiration goals for CHG bathing are set for the 75th percentile with higher aspirational goals set at 100% or in the 90th percentile.
In the present project, a CVC maintenance bundle checklist (Appendix D) was used to observe nurses in the adult ICUs of an acute Texas hospital. The observation will involve the Central Line Audit Form (Appendix B) comparing nurse’s compliance regarding CVC maintenance and any significant definite statistical decrease in the reported standardize infection rates and was done for one month (Table 3). In 2019 in the first two quarters, the facility has already reported 20 HAIs, according to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) (Painter, 2018). From May to September (five-month trend) the Texas hospital was at 96% overall performance, and the division in which it belongs, the Gulf Coast Division, was at 97% with the goal of overall performance being 98% of all HCA hospitals (Table 2). [A2] The next five-month trend from August to November, the Texas hospital was at 95% overall performance, and the division in which it belongs, the Gulf Coast Division, was at 89% with the goal of overall performance being 98% of all HCA hospitals (Table 2). CLABSI infection and prevention are a factor in the overall performance both at the local, division and national levels. Other size hospitals in Texas have an average of 15 CLABSI per year (Liu et al., 2016). The present project will apply the quantitative approach, which was used in data collection and analysis. The present project will consist of audit tools on awareness and compliance, like the AHRQ CUSP CLABSI Central Line Maintenance Audit Form and CUSP toolkit (appendix B) in which maintenance of CLABSI is ensured (Baldassarre, Finkelston, Decker, Lewis, & Niesley, 2015). A CUSP CLABSI Central Line Maintenance Audit Form (appendix B) on the nurses providing care on those patients with CVCs was used within the adult ICU at Texas hospital, to help in determining CLASBI maintenance CHG bathing compliance. The results of the project were analyzed using the necessary statistical methods to help in establishing the conclusion of the results. CUSP CLABSI maintenance audit tool (Appendix B) (Heale & Twycross, 2015). Statistical significance was calculated at a p-value of < .05 at 5.59 or 5% and a 95% confidence interval. The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety [A3] Network (NHSN) developed and used standardized infection ratios (SIRs) to measure healthcare-associated infection (HAI) incidence (Soe, Gould, Pollock, & Edwards, 2015). The Infection rate calculation calculated using the overall percentage of infection by dividing the number of new cases by the average census and multiplying by 100. For more specific rates, divide the number of new cases by total resident days and multiply by [A4] 1000, which gives you the number of infections per 1000 resident days (Liu et al., 2016). Using comparative analysis, if the CUSP CLABSI Central Line Maintenance Audit Form (appendix B) shows 90 percent compliance, the data met the KPIs for a decrease in CLABSI. In the present project, a CVC maintenance bundle checklist (Appendix E) was used to observe nurses in the adult ICUs of an acute Texas hospital. The observation involved the Central Line Audit Form (Appendix B) comparing nurses’ compliance regarding [A5] CVC maintenance and any significant definite statistical decrease in the reported standardize infection rates and was done for one month.
The following clinical question will guide this quantitative project:
Q: In adult patients with central line catheters, how does staff training on the CUSP CLABSIs maintenance CHG bathing to reduce the incidence of CLABSIs (Central Line-Associated Blood-stream Infections) compared to standard care over one month?
Standard care here is defined as procedural pause, aseptic techniques, hand hygiene, and optimal site selection, to protect the insertion site and to take maximal sterile precautions (Advani, Lee, Long, Schmitz, & Camins, 2018).
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