Star Point 1: Discovery (Identify Topic and Practice Issue)

Topic: Preventing Central Line-Associated Bloodstream Infections (CLABSIs) Nursing Practice Issue: The critical need for enhanced infection control practices to prevent CLABSIs in patients with central lines, particularly focusing on consistent hygiene protocols and catheter care. Rationale for Topic Selection: Central Line-Associated Bloodstream Infections (CLABSIs) present a serious and preventable complication in healthcare settings, significantly impacting patient outcomes. CLABSIs not only extend hospital stays but also lead to increased healthcare costs and elevated mortality rates. The National Center for Biotechnology Information reports that approximately 250,000 bloodstream infections occur annually in the United States, with the vast majority being linked to intravascular devices, particularly central lines (Haddadin, 2020). Central lines, which include both tunneled and non-tunneled catheters, are essential for patient care but pose a high risk for infection. Non-tunneled catheters, being the most commonly used, account for the highest rates of infection. The pathogenesis of CLABSIs often involves the migration of bacteria from the skin surface along the catheter’s external surface to the skin exit site, and eventually into the intravascular space. This risk is exacerbated by the presence of biofilm, which can form on the catheter surface, providing a protected environment for bacteria to thrive and resist antimicrobial agents. The need for rigorous and evidence-based nursing interventions to prevent CLABSIs is paramount. These interventions include daily hibiclens bathing for patients with central lines, meticulous hand hygiene, the use of maximal sterile barriers during catheter insertion, and the consistent application of aseptic techniques during line access and maintenance. Additionally, “scrubbing the hub” with an alcohol wipe for at least fifteen seconds before each access is a critical step in reducing the risk of infection. The scope of this problem is vast, as CLABSIs contribute to substantial morbidity and mortality. They also place a significant financial burden on healthcare systems due to prolonged hospital stays, additional treatments, and the need for complex interventions to manage these infections. Therefore, implementing standardized, evidence-based protocols for the prevention of CLABSIs is crucial. By focusing on strict adherence to infection control practices, healthcare providers can significantly reduce the incidence of these infections, thereby improving patient safety and reducing healthcare costs. The rationale for selecting this topic is driven by the high prevalence of CLABSIs in healthcare facilities, particularly in intensive care units where central lines are frequently used. The consequences of these infections are severe, making it imperative to explore and implement effective preventive measures. This issue not only affects patient health but also has broader implications for public health and the sustainability of healthcare systems.