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Chapter 4: Data Analysis and Results
This chapter will review the collected data, evaluate methods used to analyze the data, and appraise the findings of the study. The purpose of this quantitative project was to determine the degree of relationship between the independent variale of nurse’s participation in an evidence-based CLABSI prevention using CHG bathing and the dependent variables of lowering CLABSI rates in patients with CVCs in a healthcare facility in Texas. The quantitative research methodology was selected as a means to review the collected data, evaluate and analyze the data and to appraise the findings of the quality improvement project. The purpose of the project is to explore the problem of CLABSIs and examine available measures to prevent, control, reduce incidences, and to implement a quality improvement project set forth by this investigator to decrease CLABSIs. More importantly, the project seeks to contribute to the field of evidence-based practices in nursing by showing the role of the nurse in helping to reduce HAIs, such as CLABSIs, in the adult critical care setting. In particular, the present project proposes nurse training on the CUSP toolkit and additional CLABSI maintenance, including CHG bathing as an intervention to prevent CLABSI. Central line Venous Catheters (CVCs) are commonly used for inpatients hospitalized in acute care Intensive Care Units (ICU) to administer blood products, intravenous fluids, parenteral nutrition, and other types of medications, such as antibiotics. The use of catheters is, however, linked to the risk of developing a hospital-acquired infection (HAI), known as Central-line Associated Bloodstream Infection (CLABSI) mainly caused by microorganisms found on the external surface of the patient’s skin, improper hand hygiene, or in the fluid pathway post-catheter insertion. Notably, CVCs have been cited as the most frequent and costliest causes of bloodstream infections (Haddadin & Regunath., 2019). CLABSI prevention is one of seven requirements by the Joint Commission for hospitals to accredited nursing care centers and listed as a National Patient Safety Goal (NPSG) NPSG.07.04.01 (Yokoe et al., 2018).
Evidence-based practices, including CHG bathing, adequate hand hygiene, and clear de-escalation protocols for central lines that are no longer medically necessary, were utilized. The Comprehensive Unit-based Safety Program (CUSP) is a program designed to teach and enhance patient safety awareness as well as the quality of nursing care (Basinger, 2015). The project will implement CUSP, which is comprised of five basic steps. The CUSP process starts with providing education on the CUSP Central-line maintenance bundle that includes chlorohexidine gluconate (CHG) bathing, followed by the identification of weaknesses and risks in patient safety, then the partnering of a senior executive of the critical care unit, learning from the flaws, and the execution of communication and teamwork tools (Basinger, 2015). The core CUSP toolkit (appendix B) gives clinical teams the training resources and tools to apply the CUSP CHG bathing intervention for this project to prevent CLABSIs.