Empowering patients with central line venous catheters, utilizing Evidence-Based education
My Capstone Outline So Far ( WRITER- use this as reference to guide this Safety Assignmnent)
1) Identify the problem your project will address
2)Consult with preceptor, faculty, librarian, and other team members that can help you
3)Gather evidence and data to help you make a preliminary diagnosis of the problem (start checking out the literature for best practice evidence that addresses the problem or need you have identified)
4)Get feedback from Preceptor, faculty or others
Texts for Week 1 and 2
Chapter 15 pp 429-437 in text – Roussel, L. Harris, J., Thomas, T (2016) Management and Leadership for Nurse Administrators (7th ed.). Burlington, MA. Jones & Bartlett Learning.
Chapter 1 & 7 in – Harris, J. L., Roussel, L., Walters, S. E., & Dearman, C. 2nd Ed. (2016). Project Planning and Management: A Guide for CNLs, DNPs, and Nurse Executives. Sudbury, MA. Jones & Bartlett Learning
Text Book – Chapter 4 page 68 & Chapter 5 in Roussel, L. Harris, J., Thomas, T (2016). Management and Leadership for Nurse Administrators (7th ed.). Burlington, MA. Jones & Bartlett Learning.
Topic I chose:
Empowering patients with central line venous catheters, utilizing Evidence-Based education.
During my first four weeks of clinical hours I found there to be an educational deficit in English and Spanish speaking patients in respect to the care of their CVC device when receiving inpatient dialysis at Flushing Hospital Medical Center.
Please incorporate the hospitals mission statement in the safety assignment, here is a link to help;
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Example of a similar project I found online that I will use to guide me on this project
Please use any of this information to guide you
– As a med-surge Registered nurse I have been assigned to work on the 3 West unit with a preceptor to access the needs of patients with Central Venous Catheters receiving dialysis to meet their needs at Flushing Hospital in Queens NY which is a community-based hospital. I have collaborated with the Nursing Education department, unit staff members and my preceptor to work up a plan to educate these types of patients on ways to prevent CLABSI (Cental line associated blood stream infections). I have also used the hospital library to research evidence based information for this project.
Example of a similar project I found online that I will use to guide me on this project—
CVC Patient Survey, Purpose and Methods
To identify opportunities to improve overall CVC care and reduce CLABSI incidence and severity, dialysis patients surveyed to assess: their own knowledge of CVC home care and infection Signs&Symptoms / 10-question survey based on existing survey tool, administered verbally and recorded manually
Demographics n = 25 Age mean: approx. 58 yrs range: 50-80 yrs Gender 7 male 6 female Months since CVC was placed mean: 1.7 median: 2 range: 0 (as short as <1 week) to 5 (>4 months, <5)
QUESTIONS ABOUT CARE
Have you noticed any differences in how different staff at CCC care for your CVC line? If yes, what difference? Only 2 yes responses, neither including safety concerns Consistent care across nursing staff Reinforces that no one person is responsible for multiple PICC-related CLABSIs
When staff use an alcohol wipe to clean the hub (connection points) before connecting anything to the line, do they scrub that connection point, or wipe it off? 2 responses that indicated “wiping” as opposed to scrubbing Has anything about the way the staff here at Flushing Hospital cared for your CVC ever concerned you or struck you as unusual? If so, what specifically? 2 yes responses
Patient Knowledge and Home Practice Questions ( 10 Question Survey)
1) How did you learn about how to care for your CVC at home? 12 responses that they learned by instruction from a nurse 2 responses that they also received written material 2 responses included mention of also relying on a caregiver for CVC care at home 1 response that no instruction was received at all Suggests that written material should be offered to take home
2) If the dressing became loose or opened on one side before a scheduled dressing change, what would you do? 8 responded that they would call Flushing Hosp or another specific hospital or clinic that was closer to them or had to do with their PICC placement or care 5 responded that they would (or would also) go to CVC, another specific hospital or clinic that was relevant to their CVC or would contact an RN caregiver 1 responded that they would contact their doctors office 1 responded that they would tape it up themselves 1 responded that whether they went to Flushing Hospital, would depend on if it appeared infected or how close they were to their dressing change appointment
3) What do you do when showering or bathing? 12 responded that they cover it in saran wrap, press’n’seal, an arm-length glove, or a plastic sleeve 1 replied that they also typically take a bath and when they do that they just hold their arm out of the water 1 responded that they only take a sponge bath
4) Do you know what symptoms you might have if your CVC line was infected? If so, what are they? 9 responses of redness at the site 7 responses of pain or soreness at the site 2 responses of drainage at the site 3 responses of swelling or warmth at the sight 5 responses of fever 2 responses of malaise 1 response of “No, I really don’t.” 8 surveyed patients replied with 2 signs/symptoms or less 8 surveyed patients included only site-specific signs/symptoms
5) I will MAKE 6 More questions before or after these examples, coordinate responses to the sample size I will use. Keep in mind this is being done during a four month semester. I am doing 10 clinical hours a week with inpatient dialysis clients that are with us for an average of 1-2 weeks before discharge. These patients receive 3 dialysis sessions a week Monday Wed and Friday, my professor suggested I do an initial 10 question survey and then reassess during one of their future sessions to gather analysis regarding improvement in patient education that will empower patients to prevent CLABSI infections, reducing hospital costs and readmissions.
I will be generating a 10 question survey in PDF form for patient knowledge assessment
I will be providing a Patient education Pamphlet handout
I will then reassess their knowledge before discharge, this information will allow me to conclude the success rate and outcome of my project.