reply 1

2

My clinical inquiry is related to central line-associated bloodstream infections, also known as CLABSIs. I chose this topic because I currently work in the cardiac surgical intensive care unit, and CLABSIs are one of the most common hospital-acquired infections I see in practice. Central venous access is essential in my patient population because the patients are immediately post-operative open heart surgery, and hemodynamically unstable. Central lines on my unit are most used for vasopressor administration, fluid resuscitation, inotrope administration, and administration of blood products. It is estimated about 80,000 CLABSIs occur in the United States in a year, and 12-25% of patients diagnosed with CLABSI result in death (Samonte & Vallente, 2020). 

PICOT question: In hospitalized patients requiring central venous catheters (P), does bundle care implementation (I) or no bundle care (C) increase central line-associated bloodstream infections (O) during hospitalization (T)?

Initially, my PICOT question involved the effects of exchanging central lines every 14 days, specifically CLABSI rates. I first attempted to search CLABSI in the CINAHL database, which resulted in hundreds of results that did not relate to the replacement or exchange of central lines after a specific time. The CINAHL database was utilized to search CLABSI and central line exchange, which resulted in articles from over ten years ago. I filtered my results by papers published in the last five years, and no results addressed my clinical inquiry. I then used the MEDLINE database and used the exact search and filter. However, there were no research articles relating to my topic that resulted. After two databases failed to produce recent credible research, I then reflected on my clinical inquiry. 

After making my PICOT question more generalized, more research articles were identified utilizing the same search methods. According to Walden University (n.d.), CINAHL and MEDLINE databases have advanced limiters to search for specific types of publications, such as systemic reviews. In the future, the advanced limiter will be used to find the kind of research article publication that I am searching for. An excess amount of time was spent analyzing what type of research the article was; using this search filter would save time and energy to focus on research articles that are best transformed into evidence-based practice. According to Ingham-Broomfield (2016), systemic reviews are the highest form of clinical evidence. In the future, to continue to implement evidence-based practice, I will be utilizing the advanced limiters on databases to search for systemic reviews to identify the most reliable and current research. 

References  Ingham-Broomfield, R. (2016). A nurses’ guide to the hierarchy of research designs and evidence. Australian Journal of Advanced Nursing, 33(3), 38–43. Samonte, P. R. V., & Vallente, R. U., PhD. (2020). Central Line-Associated Bloodstream Infections (CLABSI). Salem Press Encyclopedia of Health. Walden University Library. (n.d.). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved December 21, 2022, from https://academicanswers.waldenu.edu/faq/72670

 Reply