PICOT Question On Reducing Infections in the Dialysis Department

This article is a PICOT question on reducing infections in the dialysis department. Study it to learn how to write PICOT question papers and gain insights into how you can get expert PICOT question paper writing help.

The Assignment

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

The Solution:

PICOT Question On Reducing Infections in the Dialysis Department

The PICOT Question

For patients undergoing dialysis at the dialysis department (P), can optimization of nursing infection preventive measures through direct supervision and stepwise check-list use during and after dialysis (I) compared to the practices (absence of step-wise checklist use) (C) reduce the number of infections to the lowest cases possible and by at least 50%   (O) over a period of nine weeks (T)?.

Evidence-based solutions and BSIs related to dialysis

Through research and assessment, the Centers for Disease Control (CDC) has developed treatments, auditing tools, and checklists for use in BSI infection prevention (CDC, 2020). BSIs have been demonstrated to be solved by strict implementation and adherence to such treatments and guidelines. Infection rates are reduced by 20-50 percent with these therapies (Fisher, 2020).

According to Lee et al (2018), the major cause of BSIs in dialysis units is an inconsistent hemodialysis tunneled catheter care (HTC) procedure, a lack of uniform audits for the protocols, and a lack of patient education. Infections were decreased by up to 50% when infection control methods such as ‘scrub the hub,’ systematic audits, and nurse and patient education were properly implemented (Lee K. G., 2018). In another study, infection control was achieved by using stringent aseptic procedures and sterile dressing, as well as nurse training and patient education. Within a month, infection levels in a 24-chair dialysis facility had dropped by more than half (Hoffman, 2018).

Dialysis Related BSIs and Nursing Interventions

The CDC developed treatments that are considered the gold standard preventative procedures for BSIs in collaboration with the American Society of Nephrology’s Nephrologists Transforming Dialysis Safety Initiative. Nurses can effectively avoid BSIs when they follow a stringent protocol.

The goal of this research is to fully execute these strategies. Hand hygiene, catheter exit-connection and disconnection using aseptic technique and antiseptic usage, catheter lumen and hub care, and three-month assessments of these procedures with nursing staff training and audits are among the treatments. Early patient referral to nephrologists, more specialized teams, and vascular access coordinators, as well as the insertion of early-stick grafts and early peritoneal dialysis, are all examples of nurse interventions (Fisher, 2020).

PICOT Question On Reducing Infections in the Dialysis Department.

Dialysis Related BSIs and Patient Care

Infection prevention requires careful patient care before, during, and after dialysis. It is critical to remove any restricting jewelry and clothing from the patient’s arm before to vascular access. Other doctors should be notified so that blood pressure measures and venipunctures are not performed on the same arm. Nurses should constantly clean their hands and use gloves while evaluating patients to avoid spreading illness. At least three times each day, the vascular access should be examined for patency and smooth blood flow (Rushing, 2019).

Following dialysis, the patient should be moved in such a way that no stress or pressure is placed on the arm. Swelling, pain, open sores and purulent discharge should all be looked for on a regular basis in the vascular access. The nurse is responsible for providing the patient with self-care and infection prevention information. In order to avoid infections linked with dialysis, patients must take care of themselves, and regular practice successfully minimizes infections. (Rushing, 2019)

Health Care Agency Involved in BSI Prevention

The CDC established a monitoring and feedback platform in conjunction with the National Safety Healthcare Network (NHSN) for data sharing and comparisons across various institutions in the United States. This helps to educate policymakers about mitigation strategies (CDC, 2020). The Agency for Healthcare Research and Quality also supports studies and institutions that attempt to reduce BSIs (AHRQ, 2020).

PICOT Question On Reducing Infections in the Dialysis Department

Nursing Practice and BSIs

In nursing practice, BSIs related to dialysis are a substantial problem. In the United States, BSIs are mostly caused by a failure to carefully adopt and follow the dialysis infection control nursing practices. This is mostly dependent on nurses and may be addressed in dialysis units by stringent nursing practice, legislation, and routine audits. This will result in fewer infections, shorter hospital stays, improved clinical results, and lower healthcare bills for patients (Fisher, 2020).

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Frequently Asked Questions (FAQs)

1. How do dialysis centers prevent infection?

Before and after touching you, wash your hands or use an alcohol-based hand sanitizer. To avoid clothing contamination, use gloves, and a clean cover gown. Cover any wounds with a bandage. Personal items and clothing should not be shared.

2. What are the universal precautions in the dialysis unit?

Gloves, handwashing, face shields, dedicated clean and dirty areas, segregation of machines and equipment, proper personal protective equipment (PPE), and other precautions recommended by the CDC for dialysis facilities should be followed consistently.

3. What is a PICOT question used for?

The PICOT question format is a standardized “formula” for creating researchable and answerable questions. When you write a good one, the rest of the process of gathering and analyzing evidence becomes much easier.

Additional content on the topic.

References

• AHRQ. (2020, June 08). Retrieved from https://www.ahrq.gov/patient-safety/settings/esrd/resource/clinicalcare.html
• CDC. (2020, June 07). Retrieved from https://www.cdc.gov/dialysis/prevention-tools/audit-tools.html
• Fisher, M. G. (2020). Prevention of Bloodstream Infections in Patients Undergoing Hemodialysis. . Clinical Journal of the American Society of Nephrology, 132-151.
• Hoffman, S. (2018). Reducing Blood Stream Infections from Tunneled Dialysis Catheters. . . Nephrology Nursing Journal.
• Lee, K. G. (2018). Reducing tunneled catheter-related infection in hemodialysis patients with nationwide standardization of catheter care protocol. The journal of vascular access, 110-111.
• Lee, K. G. (2018). Reducing tunneled catheter-related infection in hemodialysis patients with nationwide standardization of catheter care protocol. . The journal of vascular access, 110-111.
• Rushing, J. (2019). Caring for a patient’s vascular access for hemodialysis. Nursing Management, 47.