The Assessment of Chlorhexidine Bathing Practices Medical-surgical Settings

The Rationale for the Methods Used in Collecting the Outcome Data

            The research method used in collecting the outcome data for this study encompasses a semi-structured interview of the nurses working within the intensive care unit of the one hundred and twenty-nine-bed Veteran Hospital in Wisconsin, United States. Veteran Hospital offers surgical and tertiary care as well as a full scope of outpatient services to U.S. citizens (Centers for Disease Control and Prevention, 2014). During the period of this project, the Veteran Hospital comprised two intensive care the cardiac ICU, having six beds, and the medical-surgical ICU, with seven beds (Centers for Disease Control and Prevention, 2014).

            In this method, nurse leaders introduced the initial author to the department and granted him the authority to access the unit. The personnel were presented with the aim of the project and were invited to contribute to the project's execution. Interviews were then organized with the entire agreeable nurse personnel.

            Means of the Systems Engineering Initiative extensively defined the questions in the interview directive for the Patient Safety Model (SEIPS) as the primary outline. The Systems Engineering Initiative for Patient Safety Model involves a sociotechnical organization methodology that can be exploited to efficiently address the related features needed for the effective plan as well as the execution of an intervention (Holder & Zellinger, 2013).SEIPS centers on five interacting constituents of the work scheme, which include the organizational factors, physical settings, available technologies and equipment, tasks to be performed, and the people involved in the project implementation (Holder & Zellinger, 2013). The interactions of these components can influence care processes such as patient bathing with the chlorhexidine gluconate that leads to patient results such as patient safety as well as the quality of care and organizational outcomes, for example, acceptance and efficiency of the intervention (Bleasdale et al., 2013). These five constituents served as the key themes within the interview directives. This enables the enquiring of relevant questions concerning who was engaged in the practice (the person), what action they performed (the Tasks), what type of technology or equipment they exploited (the technologies or equipment), matters pertinent to the client rooms as well as the department in general (the physical setting); and the organizational factors, for instance, hospital leadership that affects the chlorhexidine gluconate bathing procedures (Organization).

Ways in which the Outcome Measures Evaluate the Scope to which the Project Objectives are achieved.

            This intervention aims to achieve demonstrate that the use of chlorhexidine bathing practices in medical-surgical settings can reduce the CLLBSI rates. Therefore, this project illustrates the vital stance that nurses possess in the fight against HAIs as well as patient safety. Given the above fact, it is clear that the project outcomes are linked to goal seven of the 2015 Hospital National Patient Safety Goals (NPSG.07.06.01): to decrease the risk of healthcare-acquired illness, mainly from central line-related bloodstream illnesses (Dixon & Carver, 2015).

Measuring Outcomes

            The project outcomes will be measured and evaluated via the use of SPSS version 22.0. The results will be reviewed via the exploitation of inferential and descriptive statistics. Besides, Spearman correlation assessment will be done to assess the link between directive adherence and patient traits such as central line dwell days, age, and CLLBSI rates (Climo et al., 2013). The Kruskal-Willis will also be used to evaluate the relation between adherence and the anatomical site of the central line (Climo et al., 2013).

Strategy to Take if Outcomes Do Not Provide Positive Results

            Summarizing that nothing new was detected cannot add to or advance the current knowledge regarding the use of chlorhexidine bathing practices in medical-surgical settings to reduce CLLBSI rates. Consequently, if the project outcomes do not give positive results, it will be vital to evaluate the factors that led to the failure (Holder & Zellinger, 2013). Whether it is the methodological factors, it is essential to commence the project again, although via the use of diverse methods (multi-approaches) (Holder & Zellinger, 2013).

The Implications for Practice and Future Research

            The mitigation of healthcare-acquired illnesses, including CLLBSIs, necessitates a multi-disciplinary tactic. Nevertheless, bedside nurses are in a critical spot to oversee the mitigation actions and enhance patient outcomes. The current policy at Veteran Hospital is that all patients, regardless of age, are to undergo chlorhexidine bathing, leading to the reduction of the CLLBSI rates from 3.7 per 100 patient days. This result implies that a significant quality enhancement enterprise is justified to improve chlorhexidine bathing practice adherence. Given the evidence mentioned above, service line directors, together with nurse managers, need to address the nursing personnel who are linked to low policy adherence.

References

Bleasdale, S. C., Trick, W. E., Gonzalez, I. M., Lyles, R. D., Hayden, M. K., & Weinstein, R. A. (2013). The effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Archives of internal medicine, 167(19), 2073-2079.

Centers for Disease Control and Prevention. (2014). Vital signs: central line-associated bloodstream infections-United States, 2001, 2008, and 2009. Annals of Emergency Medicine, 58(5), 447-450.

Climo, M., Diekema, D., Warren, D. K., Herwaldt, L. A., Perl, T. M., Peterson, L. ... & Tokars, J. (2013). Prevalence of the use of central venous access devices within and outside of the intensive care unit: results of a survey among hospitals in the prevention epicentre program of the Centers for Disease Control and Prevention. Infection Control & Hospital Epidemiology, 24(12), 942-945.

Dixon, J. M., & Carver, R. L. (2015). Daily chlorohexidine gluconate bathing with impregnated cloths results in a statistically significant reduction in central line-associated bloodstream infections. American journal of infection control, 38(10), 817-821.

Holder, C., & Zellinger, M. (2013). Daily Bathing with Chlorhexidine in the ICu to Prevent CentralLine–Associated Bloodstream Infections. JCOM, 16(11), 509-13.