NURS2006: Clinical Practice Improvement Project Report


Added on  2021-11-12

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CPI project on CLABSI
Name of the student:
Name of the university:
Author note:
NURS2006: Clinical Practice Improvement Project Report_1

Clinical Practice Improvement Project Report
Student Name, FAN and ID:
Type your assignment into the white spaces in the template and the rows will
expand as much as you need them to.ie Alex Smith smit0000 ID 1234567
Project Title:
Reduce the incidence of central line associated blood stream infections by 50% in the
health care unit by the end of next 6 months.
Project Aim:
The aims that has been decided for this CPI project includes :
To implement education and training based PDSA intervention program to reduce the rates
of the central line associated bloodstream infection in the health care unit within 6 months
by 50% using the target group of post-surgical unit nurses
Relevance of Clinical Governance to your project
Clinical governance can be defined as the framework which the NHS organizations utilizes
to accountability to continuously improve the quality of their services and in order to
safeguard the high standards of the care by creating an environment of excellence where
the clinical care can flourish. There are 7 pillars of clinical governance, namely clinical
effectiveness, risk management, patient experience and involvement, communication,
resource effectiveness, strategic effectiveness, and learning effectiveness (O’Brien 2015).
On a more elaborative note, clinical governance entails application of best practice
evidence while addressing the care needs of a patient with respect to the exact wishes and
preferences of the patient and carried out by an appropriately trained and resourced health
care professional or the member of the multidisciplinary health care team. The clinical
governance helps in enhancing the sense of accountability and responsibility of the care
professional so that they take full responsibility of their actions and the safety and
wellbeing of the patients in care is nor jeopardized under any circumstances (Uhb.nhs.uk.
4 main elements of clinical governance includes clinical performance and evaluation,
professional development and management, clinical risk and consumer value. The topic
that has been selected for this CPI topic is reducing the rates of CLABSI in the unit within
6 months by 50% addresses each of the vital 4 pillars of clinical governance. First and
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foremost, it has to be mentioned in this context that the solution that is being proposed in
project implements evidence based practice in the infection control program, addressing
the first pillar clinical performance and evaluation (Van Zwanenberg and Edwards 2018).
The intervention also focuses on the developing educational training for the staff to
enhance their knowledge of infection control, addressing the second pillar of clinical
governance. With respect to the third pillar, clinical risk, the incidences of CLABSI is
undoubtedly a vital risk to the safety and wellbeing of the patient population. The last pillar
of clinical governance addresses consumer value, where the health care professionals are
encouraged to improve their facilities to improving current practice and maintaining the
enhanced care standards in the future. The CLABSI intervention that is being implemented
also focuses on implementing a sustainable solution that not only improves the current
practice scenario but also implements changes that will help in maintaining the improved
care standards in the future (Uhb.nhs.uk. 2018).
Evidence that the issue / problem is worth solving:
The CPI project addresses a very important aspect of the health care scenario, the
nosocomial infections, especially the central line associated blood stream infections or the
CLABSI. It has to be mentioned in this context that the CLABSI pertains to an alarming
rate of adverse events and deaths in the health care scenario, especially the critical care
units (Afonso, Blot and Blot 2015). The nosocomial CLABSI leads to an alarmed rate of
clinical risk for the patients which not only is a massive threat to the health and wellbeing
of the patient due to the exacerbation event (Dombecki et al. 2017). Along with that, the
impact of the nosocomial infection also leads to enhanced hospital days which in turn
becomes an additional financial concern as well. Hence, it is a crucial clinical risk which
needs immediate attention to reduce it.
Central line associated bloodstream infections have been reported to cause thousands of
deaths in the hospitals (Patel et al. 2018). According to the report shared by CDC, it also
causes a considerable reflux in the health care costs both nationally and globally. Many of
the global and national health authorities have identified these catheter associated
nosocomial as a global challenge which demands to be added to the public health priorities
all across the world (Payne et al. 2018). Close to 4000 incidences of CLABSI is reported
every year in the intensive care units in Australia, most of which terminates in tragic
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mortality (Safetyandquality.gov.au). A recent study by Payne et al. (2018), the more than
55% of the total ICU patients have been reported to have CLABSI infections and at least
30% of the patients outside ICU had developed CLABSI. Hence, it is crucial to develop a
goal oriented intervention to reduce the rates of CLABSI,w hich will not only reduce the
mortality and adverse event rate due to HIAs and will also improve the consumer
satisfaction and reputation of the facility (Zingg et al. 2015).
CLABSI prevention bundles have been introduced by many health care facilities to reduce
the instance of Central line associated blood stream infection in intensive care units
(Reyes, Bloomer and Morphet 2017). Although, the contents encompassing the different
CLABSI prevention bundle are different, the most commonly reported had been the
combination of a systemic change and an educational intervention. In this case, we are
introducing the use of chlorhexidine gluconate impregnated washcloths while insertion and
management of catheters as one part of the prevention bundle (Hansen et al. 2014).
Although, it has to be mentioned that the lack of training with respect to using a
chlorhexidine impregnated washcloths often leads to unprecedented results which does not
meet the expected goals as mentioned by the authors the lack of training and skill
enhancement of the existing staff in using the chlorhexidine impregnated washcloths
properly. There is mounting evidence that indicates that the implementation of a systematic
staff education plan involving a particular infection control regime specifically designed
for preventing CLABSI results in reducing the incident of infection by 20 to 30%. Hence,
main intervention of the bundle will be an educational training to enhance the knowledge
of the staff regarding using the washcloths (Blot et al. 2014).
Key Stakeholders:
Nursing workforce:
The first and foremost internal stakeholder for the infection control scenario would be the
nurses of the intensive care unit which had been selected for the CPI project. Nurses are the
primary point of contact for the patients and they carry out the most of the patient care,
including insertion, removal and management of the catheters for the patients. The
registered nurses in this case will be the most impactful stakeholder that will be utilized in
this case will be the registered nurses employed in the post-surgical ward.
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