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CNA345 Evidence Based Practice: A Nursing Research Assignment

   

Added on  2020-05-28

11 Pages2848 Words306 Views
Running head- EVIDENCE BASED NURSING RESEARCHCNA345 Assessment Task 1Name of the StudentName of the UniversityAuthor Note

1EVIDENCE BASED NURSING RESEARCHIntroductionThe essay will illustrate the factors that might have contributed to the occurrence ofCVAD in Jim Karas and will use evidences from literatures to identify possible measures thatcan be implemented to prevent the onset of associated complications. Upon admission to thehospital, Jim was showed symptoms of hypotension that present as a major issue. Furthercomplications were associated with delirium, agitation, infection and difficulty in breathing. Hehad developed CVAD infection that can be attributed to the insertion of central venous catheterin the left internal jugular vein. Thus, the potential role of evidences in managing thecomplications will be discussed in the following sections.Central Line Associated BloodStream Infection (CLABSI) prevention and managementThe term CVAD encompasses different types of catheters that are inserted and positionedinside the veins of the body for delivering therapies to the bloodstream. These catheters have anend outside the body (Hadaway 2012). On the other hand, ports are surgically placed beneath theskin and can be accessed using special needles (Cotogni and Pittiruti 2014). In the case scenario,Jim Karas, the patient was brought to the hospital, after being found unconscious inside his car.He was initially manifested symptoms of unconsciousness, and breathing difficulties. Onassessment, he was diagnosed with hypotensive symptoms and was administered with ventilationmasks that used 100% oxygen, for ventilation. An intravenous (IV) cannula and oropharyngealairways were also used to treat him. Although he demonstrated symptoms of hypertension afterbeing put under mechanical ventilation and started becoming stable, the medications were stillcontinued. There was an elevation observed in his heart rate and he also demonstrated anincreased body temperature (38.8°C). There are several evidence based research knowledge that

2EVIDENCE BASED NURSING RESEARCHif applied accurately, can prevent the onset of bloodstream infections. The intrinsic risk factorsthat increase the susceptibility of acquiring these infections are namely, gender and age of thepatient, and underlying conditions or diseases (Rinke et al. 2013). However, there are a range of extrinsic factors that govern the prevalence of such infections.These are associated with parenteral nutrition, heavy colonization of microbes at the catheterinsertion site, lack of minimum sterile barriers for the insertion and internal jugular or femoralaccess site (Chopra et al. 2013). Furthermore, prolonged hospitalization of the patient beforesuch insertion procedures and multilumen CVC also increase risks of complications. Accordingto the guidelines formulated by the Centre for Disease Control and Prevention that are based onpost-insertion care of such catheters, there are several aspects that should be emphasized uponfor prevention of these infections (Mutalib et al. 2015). The guidelines focus on the followingaspects:Scrubbing of the hub or the access port with an antiseptic before the insertionUsage of sterile equipments for accessing the catheters and portsChanging the dressings at the site of infection using gloves and under aseptic or sterileconditionsShowing adherence to hand hygieneRegular replacements of soiled dressingsUse of Aseptic Non-touch Technique (ANTT) is an intravenous technique that focuses on theprocedure that involves easy and hassle-free handling of sterile equipments and instruments thatare brought in direct contact with the hub or port access sites. This technique is advised for suchcomplications owing to its non-touch nature, which helps to maintain asepsis (Mutalib et al.

3EVIDENCE BASED NURSING RESEARCH2015). The clinical guidelines and steps related to the dressing policies and hygiene maintenanceshould be followed for eliminating associated health complications. A wide range of researchevidences emphasise on the application of central line procedures during utilization of aseptictechniques for catheter insertion (Conley 2016). Failure to selecting sterile gloves is alsocontentious issue in these therapies. Demonstrating poor practice in following aseptic techniquesare considered as the primary reasons that contribute to healthcare acquired infections. An action plan can be formulated for preventing and managing the onset of complicationsthat were observed in Jim, as mentioned below:Showing compliance to hand washing procedures and always using sterile gloves whileadministering catheters at the veins.Maintaining adequate dry periods during the time interval between insertion of twocatheters. This will facilitate easy and rapid wound healing and would reduce the chancesof associated infections. Scrubbing the access ports and hub for a minimal time duration of 15 seconds that shouldbe succeeded by a drying time of 30 seconds (Blot et al. 2014).Using alcohol wipes that contain 70% isopropanol, in combination with 2%chlorhexidine for cleaning the ports (Khawaja et al. 2013).Sterilising all instruments that are meant to be used for the insertion, by usage of aseptictechniques. This would prevent entry of pathogens at the access port, thereby preventingfurther microbial infections.An additional step that can be implemented in the action plan involves creatingprovisions for providing adequate training to the healthcare staff that would help themrealize the necessity of zero central line.

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