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Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...

... middle of paper ... valves also proved effect in reducing CLABSIs.
Goeschel (2011) described one collaborative cohort study that almost eliminated CLABSIs in over 100 ICUS across the United States, which implemented lessons from a Johns Hopkins collaborative project, called Matching Michigan. The results of this study were so astounding nursing leaders across the globe pushed to match their efforts, but found themselves at a cross-roads when implementing these changes. Some found it difficult to implement change policies due to technical and adaptive challenges. Goeschel stated nurse leaders needed to step forward, in all patient care settings, to bridge the gap between evidenced-based practice and current nursing care. She believed nurses should be at the forefront of change, pushing evidence-based practice standards forward to provide quality and safe patient care practices.
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