CLC-EBP Research Table
CLC: EBP Research Table
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Citation
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Abstract/Purpose
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Research/ Study
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Methods
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Setting/ Subject
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Findings/ Results
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Variables |
Implications for Practice |
| Curlej, M. & Katrancha, E. (2016). One Rural Hospitalʼs Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections. Journal Of Trauma Nursing, 23(5), 290-297. http://dx.doi.org/10.1097/jtn.0000000000000235 | The researchers drew their motivation from the contextual factors such as the presence of Highmark Quality Blue Initiative, which details the central line associated infection (CLABSI) rates and spearhead quality improvement programs. Their main purpose was thus to establish the rates and examine the preventive strategies after committing to utilize the Society for Healthcare Epidemiology for America (SHEA) guidelines. The research used a quantitative, descriptive retrospective study design to assess the (CLABSI) rates and preventive methods employed between prior and after the SHEA guidelines. The researchers cited a decrease in the CLABSI rates over the specified timeframe of the study. After evaluation of the adherence to the SHEA guidelines, the researchers put measures in place to strengthen the practice. The study concluded by reporting that since then CLABSI has been below the recommended baseline, 2.4.
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The study is a quantitative, descriptive retrospective study design, which examined hospital’s CLABSI rates and existent strategies of preventing the CLABSI.
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The source of the data showing CLABSI rates was mainly CDC National Healthcare and Safety Network database.
The study utilized descriptive statistics for the analysis of data.
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The study took place in a rural Level1trauma, a teaching hospital that has a bed capacity of 486. Its location is in Pennsylvania.
The study population included all admitted patients with CLABSI infection. The total number was 78. The researcher used a sample size of 76 patients who met the inclusion criteria of CLABSI infection prescribed the CDC upon admission between July 2007 and June 2010. The age range of the sample was between 26weeks and 91 years. 61% of the sample comprised of male patients.
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The CLABSI rates showed a decreasing pattern across the three evenly sequenced study periods (July 2007 and September 2010). The CLABSI rates across the study periods were 1.9, 1.7 and 1.3 respectively.
Besides, there was an increase in awareness after an in-service educational program among the nurses, but the knowledge levels of how to carry out various techniques remained the same over the three years. Also, the study established an inverse relationship between the length of stay and CLABSI rates
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Independent: Preventive strategies as prescribed by the SHEA guidelines
Dependent: CLABSI rates |
The study reinforced the importance of utilizing guidelines such as SHEA to reduce CLABSI rates.
Additionally, reliance on ongoing education and program evaluation are vital for keeping the CLABSI values below the recommended, 2.4.
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| Li, L., Fortin, E., Tremblay, C., Ngenda-Muadi, M., & Quach, C. (2016). Central-Line–Associated Bloodstream Infections in Québec Intensive Care Units: Results from the Provincial Healthcare-Associated Infections Surveillance Program (SPIN). Infection Control & Hospital Epidemiology, 37(10), 1186-1194. http://dx.doi.org/10.1017/ice.2016.150 | The research aimed at describing the epidemiology of CLABSI in Canada over the past 8years since the implementation of bundled practice and comparing the health care problem in Canada with American benchmarks.
The principle source of the data was Surveillance Provinciale des Infection Nosocomiales (SPIN) program, which gave the CLABSI incidence rates and the Central Venous Catheter Utilization Ratios (CVCURs) for each year in Canada and America. The study demonstrated a low level of CLABSI rates across all ICUs except PICU by the year 2014. Also, the rates were lower in both adult teaching and adult non-teaching ICU as compared to the PICU and NICU. The researchers concluded that there is a need for continued surveillance and further study to highlight the factors contributing to the high rates in the PICU and NICU.
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The research utilized a quantitative retrospective longitudinal cohort study analysis of the SPIN program as the study design.
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The Surveillance Provinciale des Infection Nosocomiales (SPIN) program provided the data of CLABSI incidence rates and the Central Venous Catheter Utilization Ratios (CVCURs) for each year in Canada and America.
The researchers then followed it up by comparing the SPIN IRS data of Canada and America using the Standardized Incidence Ratios (SIRs). In data analysis, the researchers used descriptive statistic to establish SIR for each type of ICU (adult teaching or non-teaching, PICU and NICU).
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The location of the study area was Quebec in Canada.
The study area comprised of a study population of 70 ICUs (969 beds). Only 57 ICUs (851beds) participated in all the 8years of the surveillance, and thereby the study considered their SIR. However, the benchmarking process considered all ICUs regardless of their full participation in the monitoring.
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In overall terms, the rates of CLABSI rates in both adult teaching, and non-teaching ICUs reduced throughout the study period with 2014 showing a significant decrease in them all regardless of the benchmark used.
In the NICU, there was no depiction of a significant change in the rates. PICU’s CLABSI rates remained stagnant across all years.
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Independent: Central Venous Catheter Utilization Ratios (CVCURs)
Dependent: CLABSI incidence rates |
Consideration of different ICU types is an important aspect of making the right generalizability.
Moreover, future studies must consider establishing factors that result in the high rates of CLABSI in NICU and PICU.
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