Protecting Patients against CVC and PIV-Related Infections: An ED Survey
Nuno, Mary Kay
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Evidence-based Practice Abstract Purpose: Background: As regulatory requirements related to infection control practices and reimbursement continues to expand, emergency nurses can play a vital role in infection prevention before, during, and after IV therapy. Since peripheral intravenous (IV) therapy and central line insertion is often initiated in the Emergency Department (ED), it is essential to determine emergency nurse knowledge regarding infection control practices. Purpose: The purpose for this study is to examine and evaluate how well Emergency Department (ED) nurses know and apply evidence based practice (EBP) guidelines in preventing infections associated with peripheral and central venous catheter (CVC) access. Design: Design: This evidence based practice project (EBP) explores how well ED nurses know and apply EBP guidelines in preventing infections associated with peripheral and CVC access through a pre and post survey of registered nurses in an urban Level II academic center Emergency Department. Setting: The study site is a 60 bed urban Level II academic ED in Chicago serving an average of 65,000 patients a year. Subjects/Participants: The subjects for this EBP project include registered nurses of an urban Level II academic center Emergency Department in Chicago. Methodology: Institutional Review Board approval from the academic center was obtained prior to the implementation of the study. Permission was obtained from Delahanty and Myers to use their survey tool with some modifications added to focus on peripheral and CVC access maintenance. The survey tool contains 15 questions with multiple choice answers; and 3 demographic questions that pertain to years of experience, education level and age. The voluntary participation of staff in both pre- and post-survey will serve as assumed consent. The study involves surveying nurses on their knowledge and application of EBP guidelines on maintenance and prevention of infection related to peripheral and CVC access. Pre-survey results will not only be used to assess and evaluate knowledge of staff on EBP guidelines on preventing infections associated with peripheral and CVC access; but will also be used to develop effective educational resources. Literature review will be used to provide education as well as offer recommendations associated with institutional nursing standards of practice regarding peripheral and CVC access. The post-education survey will provide a comparison analysis of staff knowledge and application of EBP guidelines on preventing infections associated with peripheral and CVC access based from interventions provided. Results/Outcomes: Survey results suggest that although education and staff training is intuitive and necessary in improving safety practices, hardwiring best practices such of central line infection prevention bundles in the emergency department can greatly decreased infections and improve safety practices. Implications: Emergency nurses play a role in protecting patients from infection. As emergency nurses are exposed to the most recent literature, the improvement of general safety guidelines when accessing and utilizing PIV catheters and CVCs may greatly reduce infection rates. Emergency nurses’ knowledge and evidence based safety practices could decrease hospital and ED cost related to nasocomial infections and improve both patient safety and care.