CLABSIs In Haemodialysis Patients Discussion
Central Line-Associated Bloodstream Infections (CLABSIs) are a significant and persistent threat to patient safety, especially in hemodialysis patients (Latif et al., 2024). Hemodialysis patients, particularly those using central venous catheters (CVCs) for dialysis access, have an increased risk for CLABSIs due to the frequent insertion, handling, and maintenance of catheters. According to Salih and Allo (2024), patients undergoing hemodialysis account for a substantial proportion of healthcare-associated bloodstream infections, with CLABSIs being a leading cause of morbidity, extended hospital stays, and increased healthcare costs. The compromised immune status of many hemodialysis patients further increases the risk, making them more vulnerable to severe infections, sepsis, and even death. Despite advances in infection prevention strategies, including the introduction of best practice bundles and catheter care protocols, CLABSI rates remain considerably high among patients undergoing dialysis. Therefore, the issue requires a comprehensive effort to ensure adherence to best practices for catheter insertion, maintenance, and removal. CLABSIs In Haemodialysis Patients Discussion
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While there is extensive literature on the importance of adhering to infection prevention protocols, the specific impact of clinician adherence to catheter care protocols on reducing CLABSIs in hemodialysis patients remains under-researched. Studies have shown that adherence to evidence-based guidelines can significantly reduce infection rates (Gomaa et al., 2024). However, few have explored how clinician adherence to available catheter care protocols, behavior, training, and organizational culture influence the success of these interventions in reducing CLABSI rates in the hemodialysis setting. The variability in clinical adherence to protocols across different healthcare settings is needed to tailor interventions effectively. Addressing the gap will help develop more targeted strategies to ensure consistent adherence to catheter care protocols, hence improving outcomes for hemodialysis patients.
Salih, A. N., & Allo, R. R. (2024). Evaluation of Nursing Intervention Measures in Infection Control at Dialysis Units in Mosul City Hospitals. Medical Journal of Babylon, 21(2), 245-250. DOI: 10.4103/MJBL.MJBL_360_22
Purpose: The study aimed to evaluate the intervention measures taken by staff nurses in Mosul City Hospitals on the dialysis unit to prevent Central Line Associated Bloodstream Infections. The study also focused on how well nurses followed World Health Organization guidelines to prevent infections among patients undergoing hemodialysis.
Sample (N=xx) and Demographics: A convenience sample of n=60 nurses was used. The nurses all worked in the dialysis units of three hospitals in Mosul. The demographic characteristics of the sample included age, gender, educational qualification, years of work experience, and involvement in an educational course related to infection control. CLABSIs In Haemodialysis Patients Discussion
Study Design type: The study employed a descriptive cross-sectional design. Observations were made on nursing practices related to infection control within dialysis units. The nurses were monitored using a checklist based on WHO infection control guidelines, evaluating their practices over multiple dialysis sessions.
Variables: The independent variable in the study is adherence to nursing intervention measures, which include wearing personal protective equipment, cleaning and disinfection, and monitoring patients. The dependent variables are infection control outcomes, specifically how well nurses follow infection control protocols in dialysis units.
Measurement methods of variables: The study employed a WHO guidelines checklist for infection control protocols/procedures. The tool is reliable since it has been used in several studies and reliable since it allowed the researchers to observe each nurse individually.
Major Study Findings / Results: Overall, the study found that there is a significant defect in adherence to some nursing procedures and measures to control the transmission of infection. For instance, 65% of nurses did not participate in related training, implicating poor knowledge of the infection control protocols. In addition, 52% of the nurses did not adhere to practices such as cleaning and disinfecting external surfaces and dialysis machines before and after dialysis. CLABSIs In Haemodialysis Patients Discussion
Overview/evaluation: The study highlights critical issues relating to CLABSI prevention among hemodialysis patients by identifying infection control deficiencies and emphasizing the importance of adherence to infection control protocols. Findings from this study underscore the need for improved infection control measures in dialysis units to reduce the risk of CLABSIs, especially among vulnerable patients such as those undergoing hemodialysis.
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Gomaa, A. A., Zeid, A. M., & Nagy, I. M. (2024). Study of hemodialysis catheter infections in Menofia University Hospital. The Egyptian Journal of Internal Medicine. https://doi.org/10.21203/rs.3.rs-4915242/v1
Purpose: The study aimed to decrease the incidence of catheter-related bloodstream infections, including CLABSIs, among hemodialysis patients at Menofia University Hospital by improving infection control practices and protocol adherence among healthcare providers using an educational intervention.
Sample (N=xx) and Demographics: The sample entailed 100 end-stage renal disease patients undergoing hemodialysis through central venous catheters in the study setting. The sample demographics were gender, age, and comorbidities. It included 53 males and 47 females, with a mean age of 53.5, ranging from 21-82. 37% of the participants had multiple comorbidities, with diabetes and hypertension being common.
Study Design type: The study employed a prospective interventional design that was completed in two phases: the pre-intervention and post-intervention phases. At the pre-intervention phase, the infection rates were monitored between January and March 2024. The intervention was educating nurses on adherence to infection prevention and control protocols to reduce CLABSIs and other CRBSIs. The post-intervention phase entailed reassessing the adherence to infection prevention and control practices, and the infection rates. CLABSIs In Haemodialysis Patients Discussion
Variables: The independent variables in this study include educational intervention and adherence to infection control practices such as hand hygiene and disinfection. The dependent variables include the incidence of CLABSIs and other CRBSIs, as well as the patient’s clinical symptoms.
Measurement methods of variables: Infection control practices were measured using questionnaires and direct observation. Blood cultures were also used to detect bacterial or fungal infections within 48 hours after catheter placement. CRBSI diagnosis was based on the national guidelines. These tools are generally considered valid in assessing real-time infection prevention practices. Reliability may, however, vary depending on the consistency of responses and the observer’s training.
Major Study Findings / Results: The significant findings include the infection rate being 42% pre-intervention and reduced by 14% post-intervention. The study found a significant increase in proper infection control practices and adherence to related protocols. It also identified CLABSI risk factors such as prolonged catheter use, difficult insertion, and poor personal hygiene.
Overview/evaluation: The study is directly related to CLABSIs in hemodialysis patients since it offers valuable insights into reducing CLABSIs in hemodialysis and has proven the effectiveness of educational interventions in increasing adherence to infection control protocols in reducing CLABSIs. The study also emphasized the hygiene and sterility of catheters in reducing infections among hemodialysis patients. CLABSIs In Haemodialysis Patients Discussion
Latif, A., Ali, W., Haleem, S., Mahmood, F., Munir, T., Virani, N., Khan, H., Qadir, M., Roshan, R., Hooda, K., Khan., N., Zafar, A. & Pronovost, P. (2024). Implementation and long-term efficacy of a multifaceted intervention to reduce central line-associated bloodstream infections in intensive care units of a low-middle-income country. American Journal of Infection Control, 52(7), 819–826. https://doi.org/10.1016/j.ajic.2024.02.001
Purpose: The study aimed to determine whether a multifaceted intervention was associated with the reduction in CLABSI incidence and whether the reduction would be sustained in the long term. The intervention included ensuring high adherence to infection prevention recommendations and protocols, measuring CLABSIs data monthly, and supplying collected data to stakeholders.
Sample (N=xx) and Demographics: A convenience sample of 5 Intensive Care Units (ICUs) at a tertiary care facility in Pakistan was used for the study over a period of 9-years. The study setting is a 750-bed tertiary care teaching hospital that has medical, surgical, neonatal, and cardiac ICUs.
Study Design type: The study employed a prospective cohort study over nine years. The study implemented a bundle intervention approach to prevent CLABSIs. The bundle consisted of a comprehensive unit-based safety protocol (CUSP), which was implemented in all the ICUs in the study setting. There was a pre-intervention, intervention, and post-intervention phase.
Variables: The research variables in the study are CLABSI rates, which is also the dependent variable since the study seeks to determine whether the intervention reduces CLABSI incident rates, and clinical adherence to the infection prevention and control guidelines line as a critical component of the intervention, an independent variable. There is also a control variable, a comparison of ICUs that did not undergo the study intervention.
Measurement methods of variables: The CLABSI rates variable was measured using the CDC’s National Healthcare Safety Network (NHSN), which was used to identify and confirm cases. The clinical adherence to protocols and guidelines was measured using an assessment analysis of the local barriers to protocol adherence.
Major Study Findings / Results: The study intervention was associated with a 36% overall reduction in the rate of CLABSIs and sustained a reduction in the 5-year study period. Enhanced adherence to infection prevention and control protocols was associated with a decrease in CLABSI rates in the neonatal ICU by 77% CLABSIs In Haemodialysis Patients Discussion
Overview/evaluation: Even though the study was conducted in ICU settings, it relates to hemodialysis patients since they also use central line catheters, and the underlying mechanisms of infection control and the importance of adhering to central line care protocols are highly applicable to hemodialysis settings, where patients have similar risks. The findings could be adapted to infection control measures to the specific challenges hemodialysis patients face and serve as a foundational model for reducing CLABSI rates in a hemodialysis context.
Overview
A Review of Literature is conducted to generate an understanding of what is known and not known about a topic of interest. You have identified a topic/problem in Module 1 Discussion Board – Research Problem. In this assignment, you will create an annotated bibliography of study articles as part of a Review of Literature (Chapter 3 and 7). Follow the guidelines in Gray & Grove (2021) Chapter 18 related to the Article Appraisal. You will share your findings using the template provided.
Submitting your assignment
- Save this document to your desktop as a Word document.
- Open the document from your desktop and review the assignment instructions and grading rubric.
- Create a Word document for your paper using the template provided.
- Return to CANVAS and upload your paper to the assignment link in Module 4. Submit a second submission including the three articles (in pdf format) used in the annotated bib. If you do not submit the articles there is a 5 point penalty for each. CLABSIs In Haemodialysis Patients Discussion
Instructions for Completing Your Assignment
Step one: Choose the topic, identify a nursing clinical practice problem that you would like to explore. You should have done this in week one.
Step two: Complete the readings from Module 1, 2 & 3, focusing on Chapter 7 Stages of a Literature Review pp.126-134, Chapter 18, and information provided by the nurse librarian.
Step three: Using the information that you discussed in Module 1 Discussion- Research Problem, briefly discuss the significance and identify the gap in the literature. (Why do you need to study this problem?) Enter into the template. Make sure that it identifies a gap in the literature and has a citation.
Step four: Use your three articles that you found in Module 4 for the Annotated Bib. These studies need to relate to your topic and clinical problem. Your studies must be quantitative research articles (for example: quantitative descriptive, correlational or quasi-experimental or experimental designs). At least two studies must be prospective (data actually collected at the time of the study). The other may be retrospective or prospective. Your studies may NOT be a qualitative study, a quality improvement study, a systematic review, meta-synthesis, meta-analysis, meta-summary, or integrative review. Do not use a thesis or dissertation. No animal studies or pilot studies. The article should not be a general information article without the elements of a study (e.g.: must include a review of literature and a methods section with results and discussion) CLABSIs In Haemodialysis Patients Discussion.
- Studies/ articles must be current, within 5 years.
- Include the article reference at the beginning of the Annotated bib. Citations are to be written in APA format.
- The articles you use must meet the following mandatory requirements noted in Chapter 3 (Types of Quantitative Research).
Step five: Find the elements in your articles that are named in the format and type them into your paper. Use paragraphs as needed in the Bib to separate ideas.
Step six: If you have questions about your work, post them to the Q & A discussion board for feedback from your peers / instructor.
Step seven: Write up your assignment. Should be no more than 1 page per Bib
Annotated Bibliography – Write up your findings in the template and submit them to CANVAS by the due date and time listed in your syllabus. Here’s how to write up your findings:
- This is to be submitted in WORD dox
- All of your articles will be written in one paper. No more than one page per article.
Don’t forget to use the group discussion board for additional questions about your paper.
Turn in your Annotated Bibliography (docx format only) and the three articles (PDF format only) in to the assignment submission link under the Assignments Tab in Module 4 at the due date and time listed in your syllabus. CLABSIs In Haemodialysis Patients Discussion
Grading Rubric
Use this rubric to guide your work the assignment. Points are awarded for each section based on content and clarity of expression.
| Accomplished
(Maximum points awarded) |
Proficient
(Points awarded based on content) |
Needs Improvement
(Minimum points awarded) |
|
| Clinical
Problem (15 pts)
|
Clinical problem is discussed with citations. Gap in the research literature is identified and described.
15-13 points |
Significance of problem vague. Gap in the research literature is not well described. No citation given.
12-3 points |
Problem or gap is not discussed.
2-0 points |
| Article #1
If the study does not meet design criteria outlined in the assignment instructions, 10 points will be deducted. 5 points deducted if article PDF not attached with assignment. There are 25 points allotted for each article.
(25 pts) |
Uses the AB format to identify current study and fully describe the elements presented in the study.
-Elements for each article include: -Reference (2 points) -study purpose (2 points), -sample description including size and demographics (2 points), -study design type (2 points), -variables listed and identified by type (research, DV and/ or IV) (4 points), -measurements of the variables (4 points), -major study findings/results (4 points). -study overview/evaluation (critique)and how it relates to the problem (5 points) Elements are described fully Article is included. (-5 if not)
25 – 20 points |
Vague explanation of elements given. Missing article.
19-10 points |
Study does not meet the criteria for the assignment.
10- 0 points |
| Article #2 Appraisal
If the study does not meet design criteria outlined in the assignment instructions, 10 points will be deducted. 5 points deducted if article PDF not attached with assignment.
There are 25 points allotted for each article.
(25 pts)
|
Uses the AB format to identify current study and fully describe the elements presented in the study.
-Elements for each article include: -Reference (2 points) -study purpose (2 points), -sample description including size and demographics (2 points), -study design type (2 points), -variables listed and identified by type (research, DV and/ or IV) (4 points), -measurements of the variables (4 points), -major study findings/results (4 points). -study overview/evaluation (critique)and how it relates to the problem (5 points) Elements are described fully Article is included. (-5 if not)
25 – 20 points |
Vague explanation of elements given. Missing article.
19-10 points |
Study does not meet the criteria for the assignment.
10- 0 points |
| Article #3 Appraisal
If the study does not meet design criteria outlined in the assignment instructions, 10 points will be deducted. 5 points deducted if article PDF not attached with assignment.
There are 25 points allotted for each article.
(25 pts) |
Uses the AB format to identify current study and fully describe the elements presented in the study.
-Elements for each article include: -Reference (2 points) -study purpose (2 points), -sample description including size and demographics (2 points), -study design type (2 points), -variables listed and identified by type (research, DV and/ or IV) (4 points), -measurements of the variables (4 points), -major study findings/results (4 points). -study overview/evaluation (critique)and how it relates to the problem (5 points) Elements are described fully Article is included. (-5 if not)
25 – 20 points |
Vague explanation of elements given. Missing article.
19-10 points |
Study does not meet the criteria for the assignment.
10- 0 points |
| APA Style
(10 pts) |
Follow the instructions on the template provided and below. |
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APA STYLE grading
APA formatting for this assignment will follow the guidelines for general formatting, for example: in text-citations, margins, font type and size, grammar, punctuation and the references (in the bib)
Helpful Hints:
- Do not use 1st person in a formal paper.
- Do not use direct quotes, instead summarize and paraphrase what you are reading.
Maximum number of points deducted for APA errors, 10 points CLABSIs In Haemodialysis Patients Discussion
