The nursing profession has witnessed some of the greatest changes from the healthcare reform being undertaken in the recent years. It is a process that has been designed to prepare nurses to deal with complex patients’ conditions in the hospitals as well as in the community. According to the American Association of Colleges of Nursing, this sphere of services must be equipped to sufficiently deal with the medical challenges of the society through advanced nursing practices. It is widely anticipated that this upgraded training will expand opportunities for professional nurses. According to relevant literature, central line infections arise from infusion tubes that are inserted into the circulatory system. Thus, microorganisms can move along the tubes and cause infections to the body, especially when there is immune-suppression. This paper investigates the emerging trends in “central-related infections of the bloodstream” in hospital wards, as well as in the intensive care units.
Implementation of Evidence-Based Interventions
Initially, most hospitals and other healthcare facilities used to utilize outdated clinical practices that promoted the growth and flourishing of “central line-association bloodstream infections”. However, the implementation of evidence-based interventions has introduced standardized practices in all healthcare facilities with a view to reducing the rate of central line infections. The standardized practices include absolute hygiene as this is the best way to mitigate the spread of germs. For instance, nurses handling patients are required to regularly wash their hands, as well as their garments, which are known to harbor infective pathogens. When making central line insertions, practitioners are supposed to rub the ports with 70% isopropyl alcohol for approximately 15 seconds. This is to ensure sterility and to clear off any bacterial flora that may cause central line infections. In cases where dressings are involved, the protocol requires that they are regularly changed to prevent microorganisms from accumulating at the port of insertion. According to the protocol, nurses are obliged to have premade kits that should include sterile gloves and bio-patch, especially for emergency situations (Wenger, McDermott & Snyder, 2002).
Collaborative Care in Central Line Bloodstream Infection
There has been a significant decline in “central line-associated bloodstream infection” (CLABSI) in the recent past. This has been attributed to a combined approach medical professionals have adopted, with nurses clearly playing a pivotal role. These infections cause a significant social and economic burden to people in the United States. According to medical statistics, around 1.7 million cases of healthcare-associated infections were reported in 2002, of which 10% were severe cases of “central line-associated bloodstream infections”. The economic report estimates that the losses attributed to these medical conditions amounted to around $12,000. Two years earlier, a team of control experts, who had a meeting in Pennsylvania, proposed a collaborative approach to combat CLABSI in the United States. Right from that moment, multifaceted interventions have been the only hope of reducing the risk of these infections, with the benefits starting to be witnessed almost a decade later (Wenger, McDermott & Snyder, 2002).
It all started with the efforts undertaken by hospitals, especially those dealing with coronary care and intensive care unit programs. The focus since then has significantly shifted to the promotion of the best medical practices in central line care in accordance with the official guidelines of the Centre for Disease Control and Prevention. Indeed, the use of full-barrier precautions, 70% isopropyl alcohol preparations, as well as 2% chlorhexidine gluconate, when handling the sites of insertions came into full force in the process of implementing the collaborative approach. The idea behind comprehensive care was to ensure that the appropriate practices were followed right from diagnoses to treatment of infections. In the past, these medical conditions got worse because of inadequate consensus accumulating among the medical professionals. It is because it has become widely acknowledged that the roles of nurses, nutritionists, pharmacists, as well as physicians, are vitally important in the proper management of the cases. For instance, a misdiagnosis by physicians could aggravate the problem when the entire therapeutic intervention is directed towards the wrong condition. The causative agent has to be determined first, and this requires the combined expertise of clinicians, as well as laboratory technologists. According to the available relevant literature, some of the previously faced challenges included drug-related complications and drug interactions. It was a better idea to include pharmacists into the team in order to provide patients with the best therapy and also follow up on their medical progress. Essentially, the idea of collaborative approach has become even more relevant today than the people who initiated it expected it would be. The rapid decline of the abovementioned infections has been attributed mainly to the better approach that definitely results from the collective efforts of different medical professionals. It is something that will definitely find application in other areas of medical complications (Gawande, 2009).
Expanded Role of Nurses in Trauma-Surgical ICU
The Health Department recommended that nurses took on a supervisory role in the ICU when it became apparent that the greatest barrier was the idea of making nurses directly responsible for the patients’ well-being. They realized that the implementation of the recommended practices improved tremendously when nurses went to the ICU units as supervisors rather than direct service-staff. According to the available literature, assigning them a supervisory role essentially acknowledges their professionalism and provides them with the recognition that they need to remain more dedicated to their field of service. Due to the fact that nurses usually handle patients in the ICU more than any other practitioners do, the quality of their services would have a considerable effect on the overall quality of healthcare accorded to patients in any hospital in the world. It is due to this that the Department of Nursing working together with the Committee on ICU decided to grant nurses with a more significant role in the management of “central line-associated bloodstream infections”. As a result, the mortality rate of patients with trauma conditions has continued to nosedive, giving an impression that the risks could soon be close to naught. In addition, the incidence of “central-line associated bloodstream infections” has tremendously reduced in the past decade from a worrying 6% in 2001 to 0.1% in 2012. According to the relevant literature, there was not a single similar case reported between January 2007 and July 2009. In the past decade, the high mortality rate was basically due to nosocomial infections that mostly resulted from professional negligence of nurses, as they felt less appreciated and valued. They felt they were not under any obligation to check on the sterility of their medical coats, as recommended in the ICU units. This greatly compromised the quality of the patients’ lives, as they persistently suffered from one infection after another. In fact, most of the patients then died of nosocomial infections, rather than the infections because of which they addressed the ICU. These are the reasons why the leaders involved decided to treat the root cause of the problem, and they seemed to have managed with the issue perfectly (Wenger, McDermott & Snyder, 2002).
Improvement of Surveillance Processes
In 2007, legislative changes in public health mandated healthcare facilities to conduct regular surveillance and report to the Centre for Disease Control and Prevention. They implemented a requirement for all the hospitals to standardize their surveillance programs in order to make them easy to be regulated by the government. According to these legislative changes, the National Healthcare Safety Network usually should choose areas of concern and conduct thorough surveillance for a specified period of time. In this manner, they are able to report on the progress of the control methods and recommend the best practices that should be adopted as a matter of public health. The general prognosis of the medical conditions enables healthcare providers to know when to initiate therapy and when to change the therapeutic regimen in order to receive the desired results. Ideally, this approach was meant to eliminate nosocomial infections as well as check against worsening of the patients’ medical conditions under the surveillance of practitioners. Usually, it is better to initiate therapy against any emerging medical complication if the conditions are to be treated and resolved amicably. Unless this is achieved, there could be a persistent resurgence of the same conditions, even if adequate therapy seems to have been conducted. Besides, the surveillance also intends to check on drug-related problems, because people respond to drugs in different ways due to the diversities in their genetic makeup. While some people get their medical conditions properly resolved from taking a particular regimen, conditions of others may worsen. This may be caused by idiopathic resistance to the drugs or the uniqueness of their medical conditions. This makes it necessary to not only institute medical surveillance, but also put in place an effective pharmaco-vigilance to report on the effects of drugs on patients. Right now, the idea of surveillance has tremendously been improved and provided with a completely new approach. The government spends considerable funds in this area as they realize it is the only way to ensure patients’ safety, even as they get medical attention (Gawande, 2009).
In conclusion, central line care is a key requirement for an ideally working healthcare system. It is the reason the government has taken a keen and active role in improving all aspects of central line care. Nonetheless, “central line–associated bloodstream infection” continues to be the greatest beneficiary because of its rampant occurrences in the United States.