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Introduction
Patients health and safety is an issue of great concern in the healthcare system because varied statistical studies reveal that negligence and ignorance of healthcare professionals cause unnecessary loss of many lives in healthcare institutions. According to Leape and Berwick (2005), it became evident in the year 2000 when the Institute of Medicine released a report showing that about 98,000 patients die annually due to medical errors resulting from negligence and ignorance on the part of healthcare professionals (p.2384). The report justifies that increasing cases of adverse health practices and deaths due to medical errors are quite significant and have prompted the healthcare system to seek appropriate solutions to address the issue. Thus, educational practicum experience, being an evidenced-based solution, ensures that nurses are competent in their medical practices to avoid the occurrence of adverse health practices that often result in avertable deaths. The issue of patients health and safety under the care of medical professionals affects patients, families, healthcare professionals, and the healthcare system because of persistent medical errors that result from professional negligence and ignorance. Due to medical errors emanating from medical negligence and ignorance, this research paper examines the causes of catheter-related bloodstream infections and explores how evidence-based intervention of central line bundle is effective in the prevention of central line-associated bloodstream infections.
Practicum Learning Agreement
Practicum learning agreement aims at providing a comprehensive educational curriculum to nursing students by equipping them with critical knowledge and skills, which are essential in the prevention of catheter-related bloodstream infections among older adult patients who frequently use catheters. Given the statistics that over 98,000 patients die annually in the United States due to medical errors emanating from medical negligence and ignorance on the part of medical professionals, educational practicum experience is therefore imperative in enhancing the professional competence of nurses and preventing undue adverse health practices and deaths of patients. Catheter-related bloodstream infections pose a great threat not only to patients in intensive care units but also to the entire capacity of the health care system in improving patients health and safety. Since nurses are to blame for increasing adverse health practices and deaths of patients entrusted under their care, they need a comprehensive and effective practicum learning agreement, which will help them to gain more knowledge and skills that are essential in the prevention of catheter-related bloodstream infections.
The educational practicum experience as stipulated in the practicum learning agreement is critical in the nursing curriculum because it helps nurses to gain hands-on nursing experience and ultimately shapes their career development. During the nursing practicum, nursing students get the opportunity to interact and engage with mentors and nursing experts who direct and guide them in carrying out complex nursing practices, which would otherwise have resulted in adverse health effects or even caused deaths. According to Berenholtz, Pronovost, and Lipsett (2004), catheter-related bloodstream infection is a major issue facing the healthcare system because approximately 250,000 cases occur annually in the United State out of which about 80,000 cases occur in intensive care units (p. 2016). In this view, medical professionals are responsible for increased adverse effects of healthcare practices and deaths due to catheter-related bloodstream infections. Therefore, to enhance patients health and safety, nurses need to undergo educational practicum experience to improve their safety skills and prevent undue adverse health practices and deaths of patients.
Practicum learning agreement that involves the prevention of catheter-related bloodstream infections is very effective because it provides a comprehensive educational curriculum that will boost the practicum capacity of nursing students. The practicum learning agreement intensively evaluates nursing students in terms of objectives and strategies of learning. Through practicum learning agreement, nursing students are able to explore the importance of catheter-related bloodstream infections, design preventive programs, implement them and evaluate their effectiveness. Exploration of catheter-related bloodstream infections is essential because it makes nursing students carry out a comprehensive literature review and get an overview of the issue in the healthcare system. After conducting an extensive literature review, nursing students will be in a position to design preventive programs that utilize central line bundle interventions that aim at preventing catheter-related bloodstream infections among older adult patients, especially those who are in the intensive care unit as aforementioned. The practicum learning agreement also requires a student to implement central line interventions in healthcare institutions and evaluate their effectiveness in the prevention of catheter-related bloodstream infections.
Catheter-Related Bloodstream Infections
Catheter-related bloodstream infections are infections that emanate from the nature of healthcare offered to patients during treatment, particularly to older adult patients who are in the intensive care units and who frequently utilize catheters. There are two categories of catheter-related bloodstream infections viz. primary and secondary infections. The primary bloodstream infections have no specific cause and thus occur due to complications of many infections, while secondary bloodstream infections occur due to specific infections that cause systemic illness in which diagnostic analysis can easily detect specific pathogens. In this case, central line-associated bloodstream infections are a class of infections that belong to the category of primary bloodstream infections. According to Maki, Kluger, and Crnich (2006) central line-associated bloodstream infections increase complications of patients who are in the intensive care unit, prolong their hospitalization and increase mortality risk (p.1163). The infections have significant impacts on the population as they do not only lead to adverse health effects and loss of lives but also increase medical costs because patients take longer time than necessary to recover. Hence, central line-associated infections are some of the major issues facing the healthcare system in the United States because approximately 250,000 cases of the infections occur annually and out of these cases, about 80,000 happen in the intensive care units.
Given that medical negligence and ignorance by healthcare professionals degenerate into adverse health effects and lead to an exponential increase in a number of deaths that occur due to medical errors, catheter-related bloodstream infections that occur due to contamination pose a great threat to patients who are in intensive care units. Unhygienic conditions of inserting catheters and administering drugs are major sources of pathogens. Usually, older adult patients who are in the intensive care unit are very susceptible to catheter-related bloodstream infections because they frequently have catheter insertions and administration of drugs. Goetz, Wagener, Miller, and Muder (1998) note that the type of catheters, presence of pathogens, site of inserting catheters and frequency of manipulating catheters determine predisposition to the central line-associated bloodstream infections (p.843). This means that the appropriate design of catheters is essential and that insertion of catheters and administration of drugs need the highest standard of hygiene to prevent transmission of pathogens from surfaces into the bloodstream of the patients.
To prevent and reduce incidences of catheter-related bloodstream infections, the educational practicum experience employs a central line bundle as an effective intervention. The central line bundle consists of multiple interventions targeted at preventing the occurrence of catheter-related bloodstream infections. The interventions of the central line bundle are evidence-based and their effective implementation depends on the capacity of healthcare and academic institutions to educate nurses collectively through the educational practicum experience. Joch (2008) affirms that the central line bundle is an effective preventive program for it can zero-rate catheter-related bloodstream infections in a health institution within a short period (p.8). Therefore, the central line bundle consists of multiple evidence-based interventions designed to zero-rate incidences of catheter-related bloodstream infections. The central line bundle consists of five interventions viz. hand hygiene, skin antisepsis using chlorhexidine, a constant review of central lines, optimal selection of catheter sites and maximal barrier protection (Joch, 2008, p.7). These interventions work collectively in the effective prevention of catheter-related bloodstream infections. Since nurses are advocates of patients, they play a significant role in implementing central line bundle programs as a critical educational practicum experience for nursing students.
Conclusion
The educational practicum experience is an integral part of the nursing curriculum as it provides an opportunity for nurses to gain hands-on experience through active interaction and engagement with mentors and medical experts. Following the revelation that about 98,000 patients in the United States die annually due to medical errors emanating from professional negligence and ignorance, practicum experience has become an effective strategy for reducing such errors. In this instance, catheter-related bloodstream infections are examples of infections that occur due to poor medical practices. The poor medical practices of inserting catheters and administration of drugs to patients under unhygienic conditions provide avenues for pathogens to cause catheter-related bloodstream infections. However, in spite of the increasing prevalence of catheter-related bloodstream infections in healthcare institutions, medical practitioners can easily prevent such infections by using evidence-based interventions through the application of the central line bundle.
References
Berenholtz, S., Pronovost, P., & Lipsett, P. (2004). Eliminating Catheter-Related Bloodstream Infections in the Intensive Care Unit. Critical Care Medicine, 32(10), 2014-2020.
Goetz, A., Wagener, M., Miller, J., & Muder, R. (1998). Risk of Infection Due to Central Venous Catheters: Effect of Site of Placement and Catheter Type. Infection Control and Hospital Epidemiology Journal, 19(1), 842-845.
Joch, A. (2008). Sutters Bundle of Joy: Hospital Cuts Catheter-Related Bloodstream Infection. Materials Management in Health Care, 17(6), 7-9.
Leape, L., & Berwick, D. (2005). Five Years After To Err Is Human: What Have We Learned? Journal of the American Medical Association, 293(1), 2384-2390.
Maki, G., Kluger, M., & Crnich, J. (2006). The Risk of Bloodstream Infection in Adults With Different Intravascular Devices: A Systematic Review of 200 Published Prospective Studies. Mayo Clinic Procedures, 81(1), 1159-1171.
Mermel, L. (2000). Prevention of Intravascular Catheter-Related Infections. Annals of Internal Medicine, 132(5), 391-402.
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