Discuss how monitoring tasks contribute to the successful completion of tasks and proactively addressing tasks that are behind schedule.

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Sidney Park Health System is experiencing a shortage of coders. Over the past five years, there has been a 30% vacancy rate for coders throughout the main hospital and satellite clinics within the healthcare system. The backlog and vacant positions has created an issue related to unbilled revenue, overworked coders and extended work hours and schedules. It is estimated that there is an annual loss of $12 million. It has also been communicated that many of the qualified coders that were offered a position declined because they are interested in working from home. To address the problem, the health information management department is proposing that there be an implementation of a home-based coding system. This concept is feasible, given that Sidney Park Health System utilizes an electronic health record and all patient information is available electronically. You have been assigned as the project manager to oversee the feasibility and implementation of this project.
The project manager is responsible for monitoring the completion and progress of tasks for the entire project. Based on the tasks defined in your timeline, develop a plan to monitor task completion. For instance, what activities will you set to communicate the completion and progress of tasks (i.e., weekly meetings, committee meetings, email updates, etc.)?
Hypothetically, assign estimates of completion and/or progress to each task.
Note: Some tasks should be accurately estimated while others are ahead of schedule and some behind schedule.
Summarize the differences in estimated completion and actual completion.
If the actual start or finish dates are later than originally estimated, select factors that may have caused a delay and evaluate the importance of the factors to the delay.
Discuss how monitoring tasks contribute to the successful completion of tasks and proactively addressing tasks that are behind schedule.
Outline the activities planned to communicate the completion and progress of tasks.

Describe the major concepts of the theory. How are they defined? (theoretically and/or operationally) Is the author consistent in the use of the concepts and other terms in the theory? Interpret how the concepts are defined. Implicitly or explicitly?

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The purpose of this assignment is to describe, evaluate and discuss application of a nursing grand or mid-range theory. This assignment also provides the learner an opportunity to connect theory and research to nursing phenomena. Learners will develop an 8-10 page paper (excluding the title page and references) using APA style to address the elements listed below. Theory/Author Name and Background Select a Grand or Mid-Range Theory that is appropriate to your practice setting. Describe the theorist’s background in detail and discuss how their experiences have impacted the theory development. Examine crucial references for the original and/or current work of the theorist and other authors writing about the selected theory. Identify the phenomenon of concern or problems addressed by the theory. Theory Description Explain whether the theory uses deductive, inductive or retroductive reasoning. Provide evidence to support your conclusion. Describe the major concepts of the theory. How are they defined? (theoretically and/or operationally) Is the author consistent in the use of the concepts and other terms in the theory? Interpret how the concepts are defined. Implicitly or explicitly? Examine the relationships (propositions) among the major concepts. Evaluation Identify explicit and implicit assumptions (values/beliefs) underlying the theory. On what assumptions does the theory build? Examine if the theory has a description of the four metaparadigm concepts of nursing. If so, how are they explained in the theory? If the metapardigm is not explained, what elements do you see as relevant to the theory and why? Discuss the clarity of the theory. Did it have lucidness and consistency? Application Examine how the theory would guide nursing actions. Describe specifically how you can use this theory in your area of nursing (Practice, Education, Informatics or Administration). APA Style/Format

 

Week 6 – Discussion Question Three

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Our Cross-Cultural Management text provides (on page 151) a "Rank Order of Work Goals Across Seven Countries"? chart. Discuss the fact that "Interesting Work"? rates VERY high with workers in all seven countries"?.yet "Working Conditions"? was rated of much lesser importance almost across the board. Why do you think that is?
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What kind of culturally appropriate care and/or resources should you think about (sociological and holistically)

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Internal Code: MAS3091 Sociology Assignment: A 58-year-old Aboriginal man with poorly controlled diabetes presents to the Emergency Department of the major urban hospital where you are working. This man is from the inner city urban area. Questions: 1) What kind of culturally appropriate care and/or resources should you think about (sociological and holistically) offering to keep him culturally safe whilst in the hospital environment? 2) This is not medical. Think about who, what, why, in regard to your bulletin points. This man is in an URBAN hospital. 3) Think further than basic nursing care, observations, documentation, making the patient comfortable. You would do that for any and all patients. WHY DO ABORIGINAL PEOPLE NEED DIFFERENT CARE? What do they need? 23 total views, 2 views today

 

What can your Learning Team or work team do to maximize its productivity? What is the value of…

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What can your Learning Team or work team do to maximize its productivity? What is the value of storming in the group development process? Click here for more on this paper……. Click here to have a similar A+ quality paper done for you by one of our writers within the set deadline at a discounted

Demonstrate the ability to work independently and take responsibility for seeking guidance in relation to completion of a literature review and research proposal

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negative attitude of healthcare professionals towards borderline personality disorder Hi, i would like you to write a dissertation 8000 words. please do not use american english, no colloquialism as last paper i receive comment about colloquialism . Harvard referencing. please use 10 -12 research article in the topic given for the literature review to criticise. Research article should be for the past 5 years if not can go a bit above. School of health Sciences Academic level: 6 Assessment Task: Students will complete a dissertation comprising a comprehensive literature review and a research proposal related to an area of interest within the student’s scope of practice. Students will not be expected to undertake the research proposed. The word count of the dissertation = 8000 words Percentage: 100% ? Learning Outcomes All learning outcomes for this module are listed below. The module learning outcomes that are being assessed through this assessment task have been highlighted with *. ?? Demonstrate a critical awareness of the key ethical issues in research and the role of ethics committees, as well as the principles of ‘good clinical practice’ within clinical research* ?? Appraise where different types of research sit within the hierarchy of evidence and the application of evidence to practice guidelines and policy* ?? Critically appraise qualitative research design, methods and analysis* ?? Critically appraise quantitative research design, methods and analysis including basic statistics* ?? Demonstrate understanding of research policy and funding, and the ‘research architecture’ of the NHS ?? Explain the benefits and importance of patient and public involvement in research ?? Utilise an appropriate search strategy to retrieve, review and critically appraise information and published literature within your field of practice and develop a research proposal* ?? Demonstrate the ability to work independently and take responsibility for seeking guidance in relation to completion of a literature review and research proposal* The following assessment criteria and guidance gives an indication as to how each outcome can be achieved: 1. Ability to identify and introduce a suitable topic ?? The extent to which you have clearly defined the topic area or problem for the focus of your dissertation ?? Ability to explain the relevance of the topic and its importance to practice. The introduction should set the context with reference to relevant background policy or theory 2. The quality of the literature review ?? Is the purpose of the literature review clear and is it appropriate to the chosen topic? ?? Ability to select and use an effective strategy to identify appropriate evidence relevant to the chosen topic within an area ?? How well you discuss the evidence and information currently available and consider how it helps to illuminate the topic or problem you have chosen ?? The depth and breadth of knowledge and your ability to critically appraise, rather than simply describe the evidence. This must include a discussion of the strengths and limitations of different study designs, methods or theories used in the evidence base. ?? How well the review is structured in terms of coherent themes or key issues identified ?? Ability to identify gaps in the evidence-base and to demonstrate how you have used the knowledge you have gained through the literature to support and justify the proposed research 3. The appropriateness and clarity of the research proposal ?? Ability to select and justify an appropriate research study that follows on from the gaps identified in the literature review ?? Clarity of research question/s or aims and objectives ?? How well you have described and justified the proposed research approach or paradigm (e.g. qualitative, quantitative or mixed method) ?? How well you have described your chosen study design, methodology, methods, sampling and study procedures and discussed the strengths and limitations of these. This should include any measures to manage validity, credibility or the robustness of the research. ?? How well you have considered use of data collection tools (such as interview schedules, questionnaire etc.) and addressed how results will be analysed ?? The extent to which you have discussed the ethical issues that may arise in relation to your proposed research and how these would be managed ?? Consideration for the governance procedures that the research would need to comply with. Relevant forms, such as consent forms and participant information sheets should be included in the appendices. ?? Address how you would include patient or public involvement within your research and why ?? How insightful is the discussion of the potential impact of the findings and how they will be disseminated ?? Consideration given to project costing and project planning/timeline 4. Level of original insight, independent thinking and clarity of presentation ?? The extent to which you demonstrate original thinking, insight and the ability to make links between research evidence and practice. ?? Completed progress record sheets included in the appendix Finally, we will consider how well the dissertation is structured, how fluent the work is and the clarity of the arguments presented. Comments: . WITH US .

 

Protecting the brand from counterfeits and forgeries is becoming increasingly difficult as many…

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Protecting the brand from counterfeits and forgeries is becoming increasingly difficult as many buyers throughout the world seek them. Why do the suppliers of fakes engage in deception and why do buyers display unethical behaviour in acquiring such goods?

identify both existing and potential health hazards for his Boat Building Company

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health hazards health hazards You have been asked to identify health hazards and potential hazards for the following scenario. As a group discuss, research, develop and report on the areas listed. You will be responsible for turning in a group paper at least 6 pages, double spaced using APA formatting. Please list on the top of the paper the group members that activity participated and have earned credit for the project. If a group member did not participate Do Not list them for credit. Your group will also be presenting your findings in a 10-15 min presentation. Please take turns during the presentation. You may use YouTube to briefly (1-2 minutes maximum) show your industry. Assume that health hazards exist and that employees are overexposed. This assignment is worth 50 points per student. Scenario: You and your team have been hired by the company CEO to identify both existing and potential health hazards for his Boat Building Company. He wants you to fix the problems and perform training for his employees. Employees are complaining of headaches, asthma, back pain, dermatitis, eye irritation and ringing in their ears. The plant runs two shifts per day. The lamination department is experiencing the most injuries and illnesses. There is a variety of machines and chemicals used. The CEO has told you he does not want to spend a lot money fixing stuff. He thinks his employees may be faking it to get off work. There is a high turnover rate and high rate of absenteeism. The process: Fiberglass is used to build boats. It is a strong and light material. Molds are made specific to the type and size boat that is to be made. Once the mold is completed employees apply Fiberglass and Resin (casting) with a spray gun. Employees may also use small rollers to make sure every part of the boat is covered with the fiberglass/resin mixture. The fiberglass will harden and another material is applied to reinforce and the fiberglass resin layer. During this process employees are exposed to fiberglass, benzene and styrene. Employees must also sand and polish boats until the surface is smooth for a perfect finish. The following questions must ALL be answered in your written report. 1. What health hazards may be present from working with boat manufacturing products? 2. What types of issues should you be concerned with regarding tools and equipment? 3. What are the PEL’s, TLVs and/or NIOSH REL for the health hazards identified? 4. Please describe the OSHA medical monitoring program for Benzene. What biomarkers are used to determine exposure? 5. What types of controls should be in place to control dust and noise? 6. What personal protective equipment should employees be using during the boat building process? 7. You must interview both employees and management to gain important information and insight. What types of questions will you ask? Please list. 8. Determine what industrial hygiene equipment (example: photoionization detector/Anderson sampler/combustible gas detector) you need to perform industrial hygiene sampling for air and noise contaminants. 9. Are there any safety hazards in this industry? If so, please list 10. Based on your findings, what type of controls should be used? (Engineering, Administrative, PPE). Please describe. For your class presentation please discuss the items listed below. All group members must participate in the presentation. 1. Describe your industry. 2. Discuss the health and safety hazard your team identified. 3. Discuss any PEL/TLVs’ as appropriate. 4. What recommendations did you make for exposures and controls? 5. You have been asked to develop a training program to help employees understand the health hazards present in their workplace. Please develop a short program (PowerPoint) to present. 6. What information will you present to the CEO to help him understand the seriousness of the problem and the benefits of reducing exposures?

 

Develop the format and framework for your final project

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Widjpejeof[eofeo[pfepfepgrp]gr]pgrp]grp]gkr4pgkr4o[gjr[ogj[ogkoggorejkgorejkgorjkgreogjkogjerogjreogrejmgorjgorjgrgjrgmDevelop the format and framework for your final project. Your submission should be a single document which includes:· APA formatted Title Page· Outline summarizing the main topics and sub-topics of the final project (be sure to refer to the lecture from Week 1)· APA formatted References page· include an introduction, you must include scholarly research and in-text citations.Your paper should reflect scholarly writing and current APA standards. Please include citations within your outline to support your ideas.Refresh from bibliography.BibliographyMiller, T. W. (2012 ). The Praeger Handbook of Veterans’ Health: History, Challenges, Issues, and Developments, Volume 1. Santa Barbara: ABC-CLIO.This book is an important source of the research as it provides the background information, relevant to the research on veteran healthcare. Before carrying out the study and coming up with recommendations for VA, it’s important to get a view of veterans’ healthcare past, present, and future, and Miller’s book avails this information. The book is also important as it discusses the issues and challenges affecting veterans’ health care.This book is an important source because; before proposing recommendations for VA, there needs to be an understanding of veterans’ healthcare; its history, present, future, challenges, issues, and developments.U.S. Department of Veterans Affairs. (2018). U.S. Department of Veterans Affairs. Retrieved April 4, 2018, from https://www.va.gov/This site will avail information regarding current state Veterans’ healthcare. For this research, it’s important to understand the benefits, services, and other forms of assistance that VA administers to its members. The organization oversees one of the largest healthcare systems in the country. This site will also be used to avail other information such as VA’s membership and budget which are relevant to the study.Estes, A. (2017, September 16). VA hospitals flooded with complaints about care. Retrieved April 3, 2018, from Boston Globe: https://www.bostonglobe.com/metro/2017/09/16/staff-veterans-hospitals-lead-federal-government-criticizing-their-employer-far/gHc8SYqcVze3tk2Xn8YAeI/story.htmlIn her article, Estes evaluates the lapses in VA hospitals. The country has witnessed an increase in the number of complaints filed by VA employees with the Office of Special Counsel (the federal agency that oversees employee concerns). These complaints highlight the deplorable conditions in VA hospitals. In some hospitals, patients had died while in bed and in some VA nursing homes, residents go without food and sleep with soiled pants. These are the deplorable conditions that the article evaluates in its discussion of the state VA hospitals.This article is an important source to the study as it highlights the problems experienced in VA facilities. Before proposing recommendations of how an organization can improve its processes, structure, and environment, it’s imperative to understand the problems it faces and the specific areas that need addressing.Potocki, K. A., & Brocato, C. r. (2005). A System of Management for Organizational Improvement. JOHN HOPKINS APL TEACHING DIGEST, 16 (4), 402-1412.In their study, Potocki and Brocato (2005) seek to propose models for organizational improvement. Organizations from different sectors are being faced with similar issues such as escalating costs, cutbacks in funding, competition and so on. They have all felt the pressure to perform more effectively and as such, organizational improvement has been necessitated. Potocki and Brocato (2005) propose five guiding principles to be used to make improvements in organizational performance: leadership, process improvement, measurements/benchmarking, employee improvement, and customer focus.Potocki ‘s and Brocato’s study is an important source which will be used when discussing the ways through which VA can improve processes. Using the guiding principles proposed by Potocki and Brocato, this research will discuss the managerial and leadership changes that are needed at VA.Immordino, K. M. (2013 ). Organizational Assessment and Improvement in the Public Sector Workbook. Boca Raton: CRC Press.Public agencies (at federal, state, and local levels) are realizing the importance of improving their performance. Designed specifically to meet the needs of public agencies, Immordino’s book evaluates various options and considerations for improving public agencies. It provides examples of challenges faced by public agencies and how to address themThe book is an important resource for this study as it will be used in the discussion of recommendations that can be adopted by VA to improve its performance. Specifically, the book deals with public agencies and so suits the needs of this study.Reference:Miller, T. W. (2012 ). The Praeger Handbook of Veterans’ Health: History, Challenges, Issues, and Developments, Volume 1. Santa Barbara: ABC-CLIO.U.S. Department of Veterans Affairs. (2018). U.S. Department of Veterans Affairs. Retrieved April 4, 2018, from https://www.va.gov/Estes, A. (2017, September 16). VA hospitals flooded with complaints about care. Retrieved April 3, 2018, from Boston Globe: https://www.bostonglobe.com/metro/2017/09/16/staff-veterans-hospitals-lead-federal-government-criticizing-their-employer-far/gHc8SYqcVze3tk2Xn8YAeI/story.htmlPotocki, K. A., & Brocato, C. r. (2005). A System of Management for Organizational Improvement. JOHN HOPKINS APL TEACHING DIGEST, 16 (4), 402-1412.Immordino, K. M. (2013 ). Organizational Assessment and Improvement in the Public Sector Workbook. Boca Raton: CRC Press.——————————————————————————————————–Important to reference from this first documentThe organization I selected is the United States Department of Veterans (VA), a cabinet-level agency that provides various healthcare services to eligible military veterans at VA outpatient clinics and medical centers across the country. The agency requires assistance with its processes, structure, and environment.A reason that this was my topic by choice, the VA as the target of organizational change is due to its massive role in the health affairs of the millions of military veterans in the U.S. The VA mainly plays a crucial role rendering very much needed assistance to veterans who fall under a unique poverty line, and hence, are not eligible for, or cannot afford any other healthcare plan. Being that many elements or disabilities veterans their military life with require specialized long-term care and at times a peculiar primary care physician may not hold the tools to render the immediate attention the vet needs, hence leaning on the VA to fulfill those vial care roles. However, despite this vital role in the nation’s healthcare, most VA facilities are old with relatively inefficient physical functions. Furthermore, there have been numerous complaints about the quality of service delivered at VA facilities.Some of the problems experienced in VA facilities include long wait times, misdiagnosis, wasteful procedures, undue cancellation of medical appointments, and downgrading of veterans’ VA disability ratings. It seems that the problems experienced at the VA were so many that employees from this departments ranked first in the number of complaints submitted to the Office of Special Counsel. In 2016, VA employees filed over 1,800 allegations, which were more than those presented by employees from the following four most-complained-about departments, namely the Departments of Homeland Security, Army, Navy, and Defense (Estes, 2017).What one of the leading changes I believe needs to occur is leadership and managerial one. Most of the problems experienced at the VA happen with the full knowledge of the top leaders and managers of the various VA facilities, as well as the agency itself. This fact is demonstrated by the harassment and backlash that whistle-blowers receive when they point out inefficiencies and problems within the system. Another significant change that is warranted is an organizational culture upgrade. The VA must overhaul its corporate culture and introduce one that is more patient-centered and value-driven, as opposed to the current one that mainly views the patients as commodities rather than people.Veteran Affair were so many that employees from this departments ranked first in the number of complaints submitted with the Office of Special Counsel. In 2016, VA employees filed over 1,800 complaints, which were more than those filed by employees from the following four most-complained-about departments, namely the Departments of Homeland Security, Army, Navy and Defense (Estes, 2017).Reference Estes, A. (2017, September 16). VA hospitals flooded with complaints about care. The Boston Globe. Retrieved from https://www.bostonglobe.com/metro/2017/09/16/staff-veterans-hospitals-lead-federal-government-criticizing-their-employer-far/gHc8SYqcVze3tk2Xn8YAeI/story.html#
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Does an increase in nurse’s knowledge concerning CLABSIs infections reduce the number of infections in the Intensive Care Units?

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Morbidity has been defined as how often a disease occurs or is reported in a population. The morbidity rate is determined by examining the number of patients with a certain disease at a given period (Kim & Biorn, 2017). Reduced cases of a disease mean that preventive and treatment measures are effectively implemented by all stakeholders involved. CLABSIs infections are no exceptions here. The literature work of the previous authors appreciates that the health care institutions that have adopted the interventions measures above report few and reduced cases of the infection.
CLABSIs SymptomsSite DischargeThe area where the catheter is placed should remain dry, and no discharge should be coming from the area. Some patients, however, may notice yellow or green discharge (Conley et al., 2018). The drainage should be a cause for alarm, and the authors have identified the discharges as some of the top indicators that something has gone wrong and healthcare providers should act up. Discharges show that the area is not fresh and has been exposed to bacteria and germs, something that should be of great concern.
Site SwellingPatients may experience additional swelling at the place where the catheter line has been inserted. The swelling is an indicator that there is no healing that is taking place and that there is every reason to worry about the well-being of the patient (Castagna et al., 2016). The authors suggest that nurses should give attention to the recovery process of patients and ensure that such instances are noted and addressed. In cases where there is no close relationship between the health caregivers and the patients, such incidents may be hard to notice, and the patients end up suffering and worse still, be exposed to the ugly infection which may even cost them their lives.
Site RednessA patient may develop red streaks at the area where the line has been inserted. Another warning sign that the patient may be headed to a CLABSIs. Again, if there is no close interaction between patients and their caregivers such may be hard to notice (Chesshyre et al., 2015). Worse still if the patient is not aware that such are causes for alarm. They may never report the same and end up risking their lives. Adult patients and children are at the greatest risk of these symptoms because in most cases they do not know what should be made known to the health care providers and what should not be a cause for worry.
Research QuestionsHow does the training of health-care providers on the risks and the preventive measures of CLABSIs impact the overall infection rates?What is the level of knowledge of nurses regarding the use of evidence-based guidelines to prevent central venous catheter bloodstream infections?Does an increase in nurse’s knowledge concerning CLABSIs infections reduce the number of infections in the Intensive Care Units?Sample PopulationsThe authors have utilized different study populations to accomplish their objectives. The two major categories of respondents that are common to all authors are healthcare professionals and adult patients suffering from or who have suffered the CLABSIs infections in the past (Hsu et al., 2014). These two categories have a rich knowledge on the study topic. Such enables researchers to collect adequate data for their research topics and also draw logical conclusions.
There are several processes through which people sample information in studies. For Alfonso et al. (2016) the search of the various database using key terms gave 291 records, however, based on relevance only 4 articles were suitable for the study. In a study by Dougherty, there was convenience sampling of a population of registered nurses in the LTACH setting after completion of orientation to the unit. Out of 52 eligible nurses, 31 participated in the survey response. The study by Lin et al (2015) utilized a cross-sectional design in the qualitative analysis of sources based on the key concepts of the study. Moreover, O’Grady et al. (2011) used data from a variety of available studies. Perin et al. (2016) explored a purposive sampling and selection of 34 studies that formed a set through which to assess results after a systematic review of academic and health database. In the sampling process, Esposito (2017) utilized a cross-sectional design in 16 non-teaching and teaching public and private hospitals with units utilizing CVCs for oncological patients. The target group was 472 nurses in the oncology and outpatient chemotherapy units of the selected hospitals. Likewise, Oliveria et al (2016) samples were collected through a cross-sectional study with questionnaires to 76 professionals in the intensive care. Zu & Wu (2017) utilized the qualitative process and a systematic search of databased on CINAHL, ABI INFORM, and OVID through which they established more than a hundred articles before applying the exclusion-inclusion criteria and utilizing ten articles in the study. Han et al (2010) searched from a variety of available studies for healthcare workers in all units using CVCs in the Calabria region of Italy. Bianco et al. (2013) used samples from a number of CLABSIs which were collected by the hospital-based IP in line with the NHAN approach and definition of CLABIs. The CUSP teams of hospitals receive monthly feedback on infections and quarterly feedback on rates of infection per 1,000 catheter days. Basinger (2016) samples were collected through a cross-sectional study with questionnaires to 76 professionals in the intensive care. In another study by Chidambaram (2015) the samples used were acquired from existent studies. On the other hand, Kadium (2015) utilized a convenience sampling of registered dialysis nurses in the hemodialysis unit was used in a pre and post-test educational interventional design among 60 registered dialysis nurses. CDC and NCBI (2011) worked by using the patients aged 1 year and above in the inpatient, outpatient and ICU settings. The acquisition of the participants was through Fistula First breakthrough initiative. Finally, Srinivasan, et al. (2011) used the ICU, inpatient ward, and hemodialysis facility records for years 2007, 2009 and 2001 to establish the rates of infection.
LimitationsThere are several obvious limitations in the studies. For example, Esposito et al. (2017) opine that self-reported questionnaires affected accuracy in response. Questionnaires ought to be anonymous to encourage correct reporting. He also notes that a cross-sectional study hindered establishing a causative relationship with outcomes of interest. Future studies need to focus on non-evidence-based practices and dressing of catheters and how they relate with CLABSI (Han et al., 2013). Also, the study by Basinger (2014) was limited by failure to separate the efforts that aim at improving the use of CUSP, related approaches, and technologies that reduce compliance.
In the study by Afonso et al. (2015) the limitation was in the use of cumulative analysis on line-associated HABSI types while reporting the catheter culture is a diagnosis of infection. Moreover, another study by Lin et al. (2015) showed that the limited time and consideration of barrier towards quality, an aspect that needed adequate time hindered acquisition of enough information. Furthermore, Perin et al. (2016) note that the use of one type of catheter hindered generalization of information to other health departments.
Chidambaram (2015) assert that the limited evidence and utilization of exploratory method when conducting a study on CLABSIs. According to Kadium (2015) the small sample size and short duration within which it was conducted limited the results that were acquired. Another problem emerged because there was no assessment of the learning styles of the patients. CDC and NCBI (2011) states that even though there has been a reduction in the infections of CVC users, there is a need for more solutions to preventing this According to Srinivasan et al. (2011), there is a need for continuous studies on CLABSIs as they enhance establishing the preventive mechanism.
the Conclusions and recommendationsOverall, there are various issues that are addressed in the various papers in this analysis. From the literature review Afonso et al. (2016) conclude that hospitals achieve zero infections of CLABSI rates meaning the continued usage of surveillance together with a washcloth bathing for they curtail Gram-positive bacteria. Thus, hospitals with high baseline hygienic standards of care and lower CLABSI rates might benefit less from CHG washcloth bathing. Additionally, Lin et al. (2015) note that the adherence to the current evidence-based practice guidelines, education, and consideration or compliance to hygiene, and use of chlorhexidine antiseptic bathing instead of the soap helps in the prevention of CLABSIs. For example, according to O’Grady et al. (2011), maximal sterile, cautious insertion of catheters, avoidance of routine catheter replacement, usage of the antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine-impregnated sponge dressings help to prevent and manage CLABSIs.
Similarly, Perin et al., (2016) opine that the consideration of necessary interventions on the catheters can prevent infections. According to Esposito et al. (2017) in situations where nurses have a positive attitude, and perceive hygiene as a risk in CLABSIs as well as where evidence-based practice programs are used, infection is likely to be prevented. There is still a low adherence to handwashing. Xu & Wu (2017) note that patient cooperation and knowledge of proper care for CVC prevent infections. There is a need for studying practical clinical nurse interventions in the care for CVC. In the study by Han et al (2013) state that blood culture is necessary for managing CVC patients. Formal training, years of experience, written policies, enhance compliance to proper CVC care and reduce infections (Han et al., 2013). In a study by Bianco et al. (2013), there is a conclusion that less costly evidence-based education, CUSP prevent infections. It is also indicated that multidisciplinary education programs improve assistance to patients (Oliveira et al., 2016)
According to Afonso et al. (2016), an analysis into the topic requires separate primary, secondary and central line-associated HABSI types in reporting catheter culture during the diagnosis of bloodstream infection that increases certainty and lowering of risks of bias as a result of improper attribution of blood culture contaminants.
Furthermore, Dougherty, (2012) suggests that in future research there is a need for an investigation into the personal motivation in adherence to the clinical practice guidelines of CVC care. Further examination into the required time, barriers towards quality care. Another important area of analysis is the LTACH specific practice in the assessment of CLABSI and prevention strategies towards CVC infections (Dougherty, 2012).
In the study by Chidambaram (2015), the conclusive view offers that the dental care process is necessary for pediatric CKD patients if studies on CVC are being held. Besides, CVC benefits CKD patients but poses a threat for long-term candidates due to negligence on disinfection and sterilization processes. According to Kadium (2015), high education levels do not affect pretest, but the completion of infection control course affects pretest scores. Another argument is that evidence-based care allows students to work purposefully. Moreover, the provision of continuous education enhanced retention and application of knowledge in tasks. In another study by CDC and NCBI (2011), it is indicated that while 2009 has about 25000 (58%reduction) fewer than 2001 but substantial numbers of infections caused by Staphylococcus aureus continue to exist. Ultimately, Srinivasan et al. (2011) opines that HAI best practices help prevent CLABSI cases. It is thus necessary for future studies to focus on more than one type of catheter for results to be relevant to various departments of health.
From the above literature review, it is clear that evidence-based practice, policies, hygiene, education and attendance of workshops are important aspects that need to be studied. Besides, the consideration of study population, using the adequate time for the study, having confidential questionnaires are part of the essentials of conducting a useful study on CVCs and CLABSI’s.
The conclusions and recommendations are drawn from what the authors had from their results. There is the need for continued monitoring and feedback concerning compliance with the set hygiene practices aimed at preventing CLABSIs infections. The infection basics, such as patient and health care providers’ education, should be addressed (Beverly et al., 2018). Public health funding has also been suggested as a recommendation towards the prevention of the infection. Further areas of the study should address different ways of tracking infections, whether they are high at the emergency rooms or the operation rooms. The areas for further research should also focus on strategies aimed at removing barriers in policies and practices.
References
Afonso, E., Blot, K., & Blot, S. (2016). Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: A systematic review and meta-analysis of randomised crossover trials. Eurosurveillance, 21(46). doi:10.2807/1560-7917.es.2016.21.46.30400
Basinger, M. A. (2014). The Reduction of Central Line-Associated Bloodstream Infections in Intensive Care Units through the Implementation of the Comprehensive Unit-Based Safety Program. Retrieved from https://digitalscholarship.unlv.edu/thesesdissertations/2057/
Beverly, A. L., Hill, M. M., Camins, B. C., & Lee, R. A. (2018). Decreasing CLABSI incidence associated with decreasing MRSA Bacteremia LabID Incidence. American Journal of Infection Control, 46(6), S82.
Bianco, A., Coscarelli, P., Nobile, C. G., Pileggi, C., & Pavia, M. (2013). The reduction of risk in central line-associated bloodstream infections: Knowledge, attitudes, and evidence-based practices in health care workers. American Journal of Infection Control, 41(2), 107-112. doi:10.1016/j.ajic.2012.02.038
Castagna, H. M. F., Kawagoe, J. Y., Gonçalves, P., Menezes, F. G., Toniolo, A. R., Silva, C. V., … & Correa, L. (2016). Active surveillance and safety organizational goals to reduce central line-associated bloodstream infections outside the intensive care unit: 9 years of experience. American journal of infection control, 44(9), 1058-1060.
CDC, & NCBI. (2011). Vital Signs: Central Line–Associated Blood Stream Infections—United States, 2001, 2008, and 2009. Annals of Emergency Medicine, 58(5), 447-450. doi:10.1016/j.annemergmed.2011.07.035
Chesshyre, E., Goff, Z., Bowen, A., & Carapetis, J. (2015). The prevention, diagnosis, and management of central venous line infections in children. Journal of Infection, 71, S59-S75.
Chidambaram, R.(2015). A cautionary tale on the Central Venous Catheter: medical note for oral physicians. The Malaysian Journal of Medical Sciences, 22(5), 78-84.
Conley, S. B., Buckley, P., Magarace, L., Hsieh, C., & Pedulla, L. V. (2017). Standardizing best nursing practice for implanted ports. Journal of Infusion Nursing, 40(3), 165-174.
Deason, S., & Gray, P. (2018). Beyond the walls: infection prevention expands to the outpatient environment. American Journal of Infection Control, 46(6), S82.
Dick, A. W., Perencevich, E. N., Pogorzelska-Maziarz, M., Zwanziger, J., Larson, E. L., & Stone, P. W. (2015). A decade of investment in infection prevention: a cost-effectiveness analysis. American journal of infection control, 43(1), 4-9.
Dombecki, C., Vercher, J., Valyko, A., Mills, J., & Washer, L. (2017). Implementation of a Central Line-associated Bloodstream Infection (CLABSI). Prevention bundle for adult hematologic malignancy and bone marrow transplant patients. American Journal of Infection Control, 45(6), S103.
Dougherty, M. (2012). Central Line-Associated Bloodstream Infection Prevention in the Long-Term Acute Care Setting. Retrieved from Grand Valley State University website: https://pdfs.semanticscholar.org/2f37/36ebad961157cf124aeadd67fee7efdd52af.pdf
Douglas, M. (2015). 25. The journey to zero CLABSI: Impact of unit-based CLABSI prevention program. Journal of the Saudi Heart Association, 27(4), 309.
Esposito, M. G. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLoS One, 1-11. doi:e0180473.
Hsu, Y. J., Weeks, K., Yang, T., Sawyer, M. D., & Marsteller, J. A. (2014). Impact of self-reported guideline compliance: bloodstream infection prevention in a national collaborative. American journal of infection control, 42(10), S191-S196.
Kadium, M. (2015). Improving Nurses’ Knowledge to Reduce Catheter-Related Bloodstream Infection in Hemodialysis unit. Walden Dissertations and Doctoral Studies, 1-133.
Kim, R., & Biorn, J. (2017). Healthcare-Associated Clostridium difficile Infection Solution Guide. American Journal of Infection Control, 45(6), S103.
Klintworth, G., Stafford, J., O’connor, M., Leong, T., Hamley, L., Watson, K.,& Worth, L. J. (2014). Beyond the intensive care unit bundle: Implementation of a successful hospital-wide initiative to reduce central line-associated bloodstream infections. American journal of infection control, 42(6), 685-687.
Lin, M.L., Apisarnthanarak, A., Jaggi, N., Harrington, G., Morikane, K., Thu, T.A., Ching, P.Villanueva, V., Zhiyong Zong, Jeong, J.S. & Lee, C. (2015). APSIC guide for prevention of Central Line-Associated Bloodstream Infections (CLABSI) 5(16). https://doi.org/10.1186/s13756-016-0116-5
O’Grady, N.P., Alexander, M., Burns, L.A., Delilnger, E.P., Garland, J., Heard, S.O., Lipsett, P.A., Masur, H., Mermel, L.A., Pearson, M.L., Raad, I.I., Randolph, A.G., Rupp, M.E., Saint, S. (2011). Clin Infect Dis. 52(9) e162_e193.
Oliveira, F. T., Stipp, M. A., Silva, L. D., Frederico, M., & Duarte, S. D. (2016). Behavior of the multidisciplinary team about Bundle of Central Venous Catheter in Intensive Care. Escola Anna Nery – Revista de Enfermagem, 20(1). doi:10.5935/1414-8145.20160008
O’Neil, C. B. (2016). A Central Line Care Maintenance Bundle for the Prevention of Catheter-Associated Bloodstream Infection in Non-ICU Settings. Infect Control Hosp Epidemiol., 692-698. doi:10.1017/ice.2016.32
Orwoll, B., Diane, S., Henry, D., Tsang, L., Chu, K., Meer, C., & Roy-Burman, A. (2018). Gamification and Microlearning for Engagement with Quality Improvement (GAMEQI): A Bundled Digital Intervention for the Prevention of Central Line-Associated Bloodstream Infection. American Journal of Medical Quality, 33(1), 21-29.
Patel, P. K., Gupta, A., Vaughn, V. M., Mann, J. D., Ameling, J. M., & Meddings, J. (2017). Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. Journal of Hospital Medicine. doi:10.12788/jhm.2856
Perin, D.C., Erdmann, A.L., Higashi, G.D.C., Sasso, G.T.M. Bianco A1, (2016) Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Rev. Latino-Am. Enfermagem 2016;24:e2787 DOI: 10.1590/1518-8345.1233.2787
Sodek, J. (2016). Examining the impact of standardization of central line nursing care. American Journal of Infection Control, 44(6), S91.
Srinivasan, A., Wise, M., Bell, M., Cardo, D., Edwards, J. Fridkin, S., J Jernigan, J., A Kallen, A., McDonald, L.C., & Patel, P.(2011). Central Line–Associated Blood Stream Infections. 60(08);243-248
Stone, P. W., Pogorzelska-Maziarz, M., Herzig, C. T., Weiner, L. M., Furuya, E. Y., Dick, A., & Larson, E. (2014). State of infection prevention in US hospitals enrolled in the National Health and Safety Network. American journal of infection control, 42(2), 94-99.
White, L. A., Brent, K., Eherenman, H., & Vance, C. (2016). Infection prevention and quality coordinators collaborating to decrease Central Line Associated Blood Stream Infections (CLABSI) by monitoring central line catheter maintenance. American Journal of Infection Control, 44(6), S94-S95.
Xu, H., & Wu, Y. (2017). Central Venous Catheter: care and prevention of infection. Retrieved from Centria University of Applied Sciences website: https://www.theseus.fi/bitstream/handle/10024/…/Han_Xu%20Yujia_Wu.pdf?…1..
Practice Hours Completion Statement DNP-820
I, Kerry Murphy, verify that I have completed (30) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.