Question Description
Please Respond to these discussions APA format with a reference
Discussion 1
Two areas where evidence-based practice has been effective is hand hygiene and central venous assess device. Using evidence based practice in these areas has greatly improved patient’s outcomes. The knowledge of evidence-based practice will empower and enrich nurses to practice more safely.
According to research conducted by Mathers, D (2011), adequate flushing od central venous assess devices improve catheter potency and prevent the use of heparin in the flushing solution. Flushing the device with heparin has been associated with increased risk for HIT and hemorrhage in patient and also erroneous lab results has been associated with heparin use. According to the study, there will be reduction in healthcare costs due to the cost difference in saline and heparin. Also, preventing possible adverse effect associated with heparin use in CVAD’s by using saline will help save financially. To repent line occlusion while also preventing potential complications associated with heparin, non-heparin saline flush has been shown to effective.
Hand hygiene has also been shown to greatly improve patient’s outcome both in home and community settings. Proper hand hygiene helps breaks the chain of infection thereby improving patient’s outcome. Huge patient’s outcome has been recorded in facilities where proper hand hygiene with the use of water and soap and alcohol-based hand sanitizer. Its effect can be seen in wound healing, reduction in cross-infection, respiratory tract infection and GI infection.
Mathers, D (2011) The Journal of the Association for Vascular Access. Evidence-based Practice: Improving outcomes for Patients with a Central Venous Access Device retrieved from http://www.avajournal.com/article/S1552-8855(11)70…
Sally F. Bloomfield, BPharm, PhD, Allison E. Aiello, PhD, MS, Barry Cookson, FRCP, FRCPath, Carol O’Boyle, PhD, RN, Elaine L. Larson, RN, PhD American Journal of Injection Control. The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including hand washing and alcohol-based hand sanitizers. Retrieved from http://www.ajicjournal.org/article/S0196-6553%2807…
Discussion 2
Two noticeable areas of evidence based practice that have benefited greatly to improve patient outcome are that of preventing central line-associated blood stream infections (CLABSIs) and ventilator-associated pneumonia (VAP). The complex pathophysiological conditions of the ICU patients sometimes demands use of central venous lines. “Despite the potential benefits central venous lines can have for patients, there is a high risk of bloodstream infection associated with these catheters” (Reyes, Morphet, & Bloomer, n.d). After conducting studies with use of antimicrobial catheter and interventions such as dressing changes every 7 day and PRN, closed infusion systems, aseptic skin preparation, central venous line bundle checking, education, an extra staff in the Intensive Care Unit for auditing and follow up, it was evidenced that such measures have positive outcomes in reducing central venous line associated bloodstream infections rates.
VAPs prevention strategies is another evidenced based practice that has shown drastic positive outcome related to nursing care. There was a research conducted on a sample of 86 mechanically ventilated patients with 43 patients each in the control group and the intervention group. Subglottic secretion suctioning, intake of single-dose antibiotics within 4 hours after intubation, chlorhexidine mouthwash on oral hygiene, elevation of the head of the bed 30 to 45 degrees and monitoring the bed position twice a day, Proper daily examination of the patient for early extubation, check for correct positioning of nasogastric tube before each feeding, closed-circular ventilator etc. were the strategies considered. Although there was no changes observed for the first 4 days of study, signs of early pneumonia were evident in the control group from day 5. This has revolutionized the VAPs prevention techniques. Most hospitals including the place where I work follow these guidelines strictly to improve patient outcomes.
References:
Nasiriani, K., Jarahzadeh, M. H., & Souroush, M. (2017). EFFECT OF COMPREHENSIVE STRATEGIES FOR PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA ON INCIDENCE OF THE DISEASE IN HOSPITALIZED PATIENTS IN INTENSIVE CARE UNITS. Journal Of University Medical & Dental College, 8(4), 20.
Reyes, D. V., Morphet, J., & Bloomer, M. (n.d). Prevention of central venous line associated bloodstream infections in adult intensive care units: A systematic review. Intensive And Critical Care Nursing, 4312-22.
