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A Multi-Level Intervention Using Learning and Education (MILE) to Improve Chlorhexidine Gluconate Use and Reduce Central Line- Associated Bloodstream Infections
A Multi-Level Intervention Using Learning and Education (MILE) to Improve Chlorhexidine Gluconate Use and Reduce Central Line- Associated Bloodstream Infections
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103056
- ISBN
- 9798315713951
- DDC
- 610.73
- 저자명
- Kuroki, Mika.
- 서명/저자
- A Multi-Level Intervention Using Learning and Education (MILE) to Improve Chlorhexidine Gluconate Use and Reduce Central Line- Associated Bloodstream Infections
- 발행사항
- [Sl] : The University of North Carolina at Chapel Hill, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 65 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
- 주기사항
- Advisor: Coombs, Lorinda.
- 학위논문주기
- Thesis (D.N.P.)--The University of North Carolina at Chapel Hill, 2025.
- 초록/해제
- 요약Problem: Approximately 28,000 preventable deaths in the United States result from central line-associated bloodstream infections, contributing to over $2 billion in healthcare costs. These infections primarily develop from gram-positive organisms entering the bloodstream through central venous catheters. Current infectious disease guidelines recommend daily antiseptic chlorhexidine gluconate use to reduce infection rates in individuals requiring these catheters due to elevated morbidity and mortality risks.Purpose: At an academic Southeastern U.S. hospital on an adult inpatient Bone Marrow Transplant unit, central line-associated bloodstream infection rates (2.15/1,000 device days) were higher than the hospital-wide rate (1.28/1,000 device days). Overall documented chlorhexidine gluconate adherence on the Bone Marrow Transplant unit was lower than the hospital-wide chlorhexidine gluconate adherence rate at 53.54% compared to 63.31%. Given the increased risk in this vulnerable population, this project aimed to address the low chlorhexidine gluconate adherence and elevated central line-associated bloodstream infection rates.Methods: This 12-week quality improvement project implemented the chlorhexidine gluconate Multi-level Intervention using the Learning and Education (MILE) pilot program. The program identified barriers among nursing staff and provided staff and Bone Marrow Transplant patients with evidence-based training on chlorhexidine gluconate usage and documentation. Daily chart audits were conducted to monitor adherence.Results: Overall chlorhexidine gluconate adherence increased from 53.54% in the preintervention phase to 64.82% by the end of the implementation period. Zero central line-associated bloodstream infections were detected during the first eight weeks of the study period, while two infection events occurred during the final four weeks. Overall, the Bone Marrow Transplant unit lowered the infection rate to 0.66/1,000 device days compared to the baseline of 2.15/1,000 device days.Discussion and Further Considerations: Analysis suggests that implementing the MILE program improved chlorhexidine gluconate adherence and reduced overall central line-associated bloodstream infection rates on the Bone Marrow Transplant unit. Regarding the two infection events, a hospital shortage of IV fluids in late October 2024 due to Hurricane Helene resulted in temporary practice changes to conserve resources. This included less frequent IV changes to preserve fluids, suggesting an association between the impact of natural disasters and infection rates as planetary disasters can disrupt data collection.
- 일반주제명
- Nursing
- 일반주제명
- Oncology
- 일반주제명
- Cellular biology
- 일반주제명
- Biochemistry
- 기타저자
- The University of North Carolina at Chapel Hill Nursing
- 기본자료저록
- Dissertations Abstracts International. 86-11B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■006m o d
■007cr#unu||||||||
■020 ▼a9798315713951
■035 ▼a(MiAaPQ)AAI31932620
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610.73
■1001 ▼aKuroki, Mika.
■24512▼aA Multi-Level Intervention Using Learning and Education (MILE) to Improve Chlorhexidine Gluconate Use and Reduce Central Line- Associated Bloodstream Infections
■260 ▼a[Sl]▼bThe University of North Carolina at Chapel Hill▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a65 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-11, Section: B.
■500 ▼aAdvisor: Coombs, Lorinda.
■5021 ▼aThesis (D.N.P.)--The University of North Carolina at Chapel Hill, 2025.
■520 ▼aProblem: Approximately 28,000 preventable deaths in the United States result from central line-associated bloodstream infections, contributing to over $2 billion in healthcare costs. These infections primarily develop from gram-positive organisms entering the bloodstream through central venous catheters. Current infectious disease guidelines recommend daily antiseptic chlorhexidine gluconate use to reduce infection rates in individuals requiring these catheters due to elevated morbidity and mortality risks.Purpose: At an academic Southeastern U.S. hospital on an adult inpatient Bone Marrow Transplant unit, central line-associated bloodstream infection rates (2.15/1,000 device days) were higher than the hospital-wide rate (1.28/1,000 device days). Overall documented chlorhexidine gluconate adherence on the Bone Marrow Transplant unit was lower than the hospital-wide chlorhexidine gluconate adherence rate at 53.54% compared to 63.31%. Given the increased risk in this vulnerable population, this project aimed to address the low chlorhexidine gluconate adherence and elevated central line-associated bloodstream infection rates.Methods: This 12-week quality improvement project implemented the chlorhexidine gluconate Multi-level Intervention using the Learning and Education (MILE) pilot program. The program identified barriers among nursing staff and provided staff and Bone Marrow Transplant patients with evidence-based training on chlorhexidine gluconate usage and documentation. Daily chart audits were conducted to monitor adherence.Results: Overall chlorhexidine gluconate adherence increased from 53.54% in the preintervention phase to 64.82% by the end of the implementation period. Zero central line-associated bloodstream infections were detected during the first eight weeks of the study period, while two infection events occurred during the final four weeks. Overall, the Bone Marrow Transplant unit lowered the infection rate to 0.66/1,000 device days compared to the baseline of 2.15/1,000 device days.Discussion and Further Considerations: Analysis suggests that implementing the MILE program improved chlorhexidine gluconate adherence and reduced overall central line-associated bloodstream infection rates on the Bone Marrow Transplant unit. Regarding the two infection events, a hospital shortage of IV fluids in late October 2024 due to Hurricane Helene resulted in temporary practice changes to conserve resources. This included less frequent IV changes to preserve fluids, suggesting an association between the impact of natural disasters and infection rates as planetary disasters can disrupt data collection.
■590 ▼aSchool code: 0153.
■650 4▼aNursing
■650 4▼aOncology
■650 4▼aCellular biology
■650 4▼aBiochemistry
■653 ▼aCentral venous catheters
■653 ▼aChlorhexidine gluconate
■653 ▼aStem cell transplant
■653 ▼aGram-positive organisms
■690 ▼a0569
■690 ▼a0992
■690 ▼a0379
■690 ▼a0487
■71020▼aThe University of North Carolina at Chapel Hill▼bNursing.
■7730 ▼tDissertations Abstracts International▼g86-11B.
■790 ▼a0153
■791 ▼aD.N.P.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17356887▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
