Bacterial Infections and Mycoses Commons^™

Prevention And Reduction Of Catheter-Associated Urinary Tract Infection, Lea F. Garin

Master's Projects and Capstones

Abstract

Problem: Fifteen to twenty-five percent of hospitalized patients receive indwelling urinary catheters (IUCs) during their hospital stay and are at high risk for catheter-associated urinary tract infections, according to the Centers for Disease Control and Prevention (CDC, 2015).

Context: A CAUTI Prevention program was implemented in a community hospital surgical unit to address concerns of high rates of CAUTI.

Interventions: Staff training/education, pre-CAUTI and post-CAUTI prevention survey, hand hygiene, bundle care audit, and staff competency for indwelling urinary catheter insertion were implemented to prevent and reduce CAUTI cases in the surgical unit.

Measures: The Standardized Infection Ratio …

Pediatric Streptococcal Pharyngitis Testing And Treatment Practices, Amanda Welch

Dissertations

Objective: The purpose of this pilot quality improvement study was to implement SmartPhrases and assess its impact on adherence to the Infectious Disease Society of America (IDSA) guideline for Group A Streptococcus (GAS) pharyngitis testing and treatment in pediatric patients ages 1-16 years old. The aim was to use SmartPhrases to improve adherence with the IDSA guideline by 30% for GAS pharyngitis swabbing and 10% for appropriate antibiotic prescribing in three months.

Methods: A retrospective data analysis approach was used, in reviewing SmartPhrases data from the electronic health records (EHR) in a metropolitan Urgent Care. This data were collected from …

Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho

Master's Projects and Capstones

The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …

Nursing Perspectives And Opinions On Early Or Delayed Sepsis Treatment: A Mixed Methods Approach, Pamela L. Harris

Theses and Dissertations (ETD)

Purpose. Each year at least 1.7 million adults in America develop sepsis. Sepsis can lead to life threatening organ dysfunction, severe hypotension, and death when severe sepsis or septic shock is involved. Sepsis is responsible for 50% of acute kidney injury (AKI), which is the most common form of organ dysfunction seen in critical care. Sepsis associated AKI results in loss of, or decreased renal function, is associated with adverse long-term outcomes, and carries a higher mortality rate than non-septic AKI, sepsis without AKI, or septic shock without AKI. Surviving sepsis guidelines suggests a 1-hour window from the time of …

Implementation And Evaluation Of A Syphilis Screening Tool To Increase Patient Testing For Syphilis Among Adults 18 Years And Older In A Rural Primary Care Clinic, Valeria S. Wiggins

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) are an increasing epidemic in the United States (U.S.) that need immediate interventions to reverse the effects of syphilis on the sexual health of adults in rural populations. Many are unaware of the growing rate of syphilis and the overall impact it causes nationally. When syphilis is detected early, it can be easily treated and cured. Rural primary care providers are ideal candidates for implementing education, screening, testing, and treatment.

Purpose: The Doctor of Nursing Practice (DNP) project aims to increase the frequency of screening patients in rural primary care clinics for high-risk sexual behaviors. …

Creating A Guideline For Sti Testing In The Pediatric Population, Alexandria Molaro, Alexandra Evans, Alex Niebrugge

Doctor of Nursing Practice Projects

Sexually transmitted infection (STI) prevention, education, screening, and management in pediatric primary care settings are of importance due to the increasing number of cases yearly. Almost half of the 26 million new STIs that occurred in 2018 were among young people 15-24. An opportunity existed in a rural pediatric primary clinic, for improved adherence to Centers for Disease Control and Prevention (CDC) or American Academy of Pediatrics (AAP) recommendations to screen/test patients. An evidence-based project (EBP) was developed to address this concern. Project objectives included: developing STI screening guidelines for pre-teen to young adults, developing a screening algorithm, providing alternative …

Improving Disinfectant Cap Use On Central Lines In The Icu To Reduce Patient Risk For Clabsi: A Quality Improvement Project, Tali Cherim

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are the most common type of preventable healthcare-associated bloodstream infection, and may increase length of stay (LOS), facility treatment costs, and patient mortality rates. Intensive Care Unit (ICU) patients are especially vulnerable to CLABSI due to their critical health conditions and other comorbid factors. A literature review provided evidence supporting the use of alcohol-impregnated disinfectant caps, such as SwabCap®, on central line (CL) ports to significantly reduce patients’ risk for CLABSI. This quality improvement project took place within an adult ICU of a Level II trauma facility in New England, where the Infection Prevention …

Reducing Catheter-Associated Urinary Tract Infection Project, Beatriz Agado

Student Scholarly Projects

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) are prevalent and responsible for an estimated 13,000 deaths annually in the United States. Reported cases of CAUTIs remain disproportionately high at a rehabilitation center located in South Texas.

PICOT: This evidence-based project answered the following question: In rehabilitation patients, what is the effect of a nurse-driven protocol (NDP) CAUTI bundle on the number of indwelling urinary catheter-related infections, compared to the current practice, over a 12-week time period?

Evidence: Twenty high-quality studies that met the inclusion and exclusion criteria recommended using an NDP CAUTI bundle, education, and champions to …

Sepsis Pathophysiology, Samantha Kingsley

Nursing Student Class Projects (Formerly MSN)

Sepsis is one of the most common diagnoses in medical intensive care units (MICUs) worldwide. Sepsis is a medical emergency where prompt intervention is vital to promoting positive patient outcomes. Septic shock develops when sepsis has progressed to the point of persistent hypotension despite appropriate fluid resuscitation. It is important to recognize the early signs of sepsis and intervene to prevent further progression. As the understanding of the pathophysiology has developed further over the years, the treatments and outcomes associated with sepsis have also improved. However, prompt recognition and intervention have always been at the forefront of management and should …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Probiotics And The Prevention Of Clostridioides Difficile: A Review Of Existing Systematic Reviews, Andrea L. Onstad

All Graduate Theses, Dissertations, and Other Capstone Projects

Clostridioides difficile is the leading cause of infectious diarrhea (Vernaya et al., 2017). Probiotics have been proposed to provide a protective benefit against Clostridioides difficile infection (CDI). The objective of this literature review was to examine the research evidence pertaining to the use of probiotics for the prevention of CDI in individuals receiving antibiotic therapy. A systematic literature review of studies published between 2015 and 2019 was performed. Five databases were searched, which yielded 10 systematic reviews that met strict inclusion criteria. Overall, the majority of evidence indicated that probiotics versus no treatment, placebo, or usual care have the potential …

Mortality Influenced By Sepsis Bundle Compliance And Initial Lactic Acid In Severe Sepsis And Septic Shock, Evelyn George

DNP Scholarly Projects

Sepsis, a life-threatening infection killing 270,000 yearly, is a concern to health care providers, policy makers, and patients due to its high volume and increasing cost. Patients older than 64 years have a higher occurrence of sepsis and greater mortality risk. The Surviving Sepsis Guidelines (SSG) recommends the use of the three-hour bundle that standardizes care to decrease cost, morbidity, and mortality. The three-hour bundle includes two treatments, intravenous fluids and antibiotics, and two tests, blood cultures and lactic acid level. One bundle element, lactic acid level, is associated with higher mortality rates, although only a few studies exist. The …

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

Gram-Negative Bacteria And Sepsis, Christine D. Ridge

Nursing Student Class Projects (Formerly MSN)

Today’s medical world encompasses an environment in which gram-negative bacteria that once were defeated with common antibiotics, have now become resistant. Gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter, and Acinetobacter are pathogens that are an emerging threat causing sepsis due to multidrug-resistance (Pop-Vicas & Opal, 2014, p.189). The multidrug-resistance mechanisms of gram-negative bacteria coupled with a patient population commonly seen in hospital settings, that consist of immunocompromised adults due to advancing age, comorbidities (e.g. AIDS, history of transplants, diabetes, and chemotherapy), and immunotherapies, create an environment for advanced infection or sepsis to take place.

Complications of multidrug-resistant gram-negative bacteria …

The Effects Of Implementing Best Practice On Clostridium Difficile Infection Treatment, Melissa A. Craig

Evidence-Based Practice Project Reports

For many years the number of Clostridium difficile infections (CDI) has steadily risen. This common cause of antibiotic-associated diarrhea can have variable clinical presentations ranging from mild diarrhea to severe cases complicated by the development of pseudomembranous colitis, electrolyte abnormalities, dehydration, sepsis, and even death. The resistant nature of the spores produced by the bacteria and the emergence of hypervirulent strains have made treatment challenging. Previous studies have demonstrated clinician non-adherence to CDI clinical treatment guidelines may result in poor patient outcomes. This evidence-based practice project was implemented at a 311 bed academic medical center in the Midwest. The project …

Community Acquired Pneumonia Project, Patricia Heaney

Doctor of Nursing Practice Projects

There is an increasing number of microorganisms that are becoming resistant to antimicrobial medications. This growing number of resistant organism poses a serious health threat, not only in this nation, but throughout the world. The Center for Disease Control and Prevention (CDC) estimates that there are greater than 2 million people who acquire serious infections that are resistant to one or more antimicrobial agents that were made to treat those organisms (CDC, 2013). Streptococcus pneumonia (S. pneumoniae or pneumococcus) is one such organism that has been identified by the CDC (2013) as becoming increasingly resistant to drugs that were once …

Difference In Knowledge Of Mrsa Regarding Sophomore And Senior Baccalaureate Nursing Students, Payton T. Lloyd, Daniel B. Whited, Lori N. Crimaldi

Williams Honors College, Honors Research Projects

Abstract

Background

The risk of infection by antibiotic resistant organisms is a common problem in hospital settings. Methicillin-resistant Staphylococcus Aureus (MRSA) is the most common type of resistant bacteria that can have serious consequences or even lead to death. Nurses' knowledge of how to prevent and treat this problem is essential for patient safety. The purpose of this study is to determine the differences in level of knowledge of MRSA in sophomore and senior level baccalaureate nursing students.

Methods

This descriptive, comparative study will examine differences in knowledge of MRSA between sophomore and senior baccalaureate nursing students and determine if …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Prevalence Of Sepsis In Pediatric Populations, Brittany Barnes

Nursing Student Class Projects (Formerly MSN)

Sepsis and more specifically septic shock in the pediatric population is a diagnosis that is full of complexities. There are instances where a neutropenic oncology patient observes a better outcome than a previously healthy patient who is suffering from the same pathogen related sepsis. Sepsis is the 10th leading cause of death according to the Center for Disease Control and Prevention, and each year between 20,000 and 42,000 children are diagnosed with severe sepsis (Riley & Wheeler, 2012). Even with significant advances in medical treatment, sepsis is still associated with high morbidity and mortality rates. A retrospective study of patient …

Identifying Acute Organ Dysfunction As A Marker Of Severe Sepsis, Daniell Mcsweeney

Nursing Student Class Projects (Formerly MSN)

The current definition of sepsis is suspected or documented infection plus at least one systemic manifestation of infection. Severe sepsis has been defined as sepsis plus evidence of organ dysfunction. Identifying acute organ dysfunction is a marker of severe sepsis. This topic was chosen after witnessing a number a patients fall into septic shock before severe sepsis was diagnosed and treatment initiated. Diagnosis of severe sepsis is important for specific protocol to be implemented in a timely fashion. The current differentiation between sepsis and severe sepsis is evidence of organ dysfunction. There are many examples of organ dysfunction that are …

Lyme Disease: A Tick’S Risky Bite, Jana Keller

Nursing Student Class Projects (Formerly MSN)

Lyme Disease is a bacterial infection transmitted primarily by the deer tick and is commonly seen in the United States. It is an infectious disease caused by the bacterium Borrelia burgdorferi, which is a spirochete (Pearson, 2014). Lyme disease’s prevalence is confirmed by the Centers for Disease Control and Preventions whom estimates that 30,000 people per year are diagnosed with Lyme disease in the Unites States (Moore, 2015). It is imperative that primary health care workers (such as Nurse Practitioners) are familiar with this disease and the early signs and symptoms. If early signs and symptoms go unnoticed or misdiagnosed …

Lyme Disease, Jared Hostetler

Nursing Student Class Projects (Formerly MSN)

Lyme disease is the most common vector borne illness found in the United States. Each year 30,000 people are diagnosed with the disease, with many more cases going unreported (Centers for Disease Control and Prevention, 2015). The vector responsible for spreading the disease is the deer tick. The infection itself is caused by the spirochete Borrelia burgdorferi. This bacteria is transmitted through the saliva from the bite of a deer tick. Diagnosis can be challenging due to the fact that multiple systems of the body can be affected with different severities. Early diagnosis and treatment is critical in the prevention …

The Importance Of Evaluation And Management Of Sepsis, Severe Sepsis, And Septic Shock, Katherine Herda

Nursing Student Class Projects (Formerly MSN)

Sepsis is a life-threatening and complicated host response to the presence of infection that is affecting millions of individuals around the world each year (Dellinger et al., 2013, p. 583). According to Gray et al. (2013), sepsis is not only one of the primary causes of hospital admission but it is also a leading cause of morbidity and mortality worldwide (p. 397). Severe sepsis and septic shock are the more advanced and detrimental stages of sepsis, which are starting to increase in incidence and are killing one in four (and sometimes more) individuals infected (Dellinger et al., 2013, p. 583). …

Clostridium Difficile, Kristen Johnson

Nursing Student Class Projects (Formerly MSN)

Clostridium difficile (CD) is an infectious disease that has a direct impact on our healthcare resources. “Clostridium difficile, an anaerobic, spore forming, toxin-forming, gram-positive bacillus, has become the leading cause of health care—associated infectious diarrhea (Walters & Zuckerbraun, 2014, p. 329).” I chose this topic because CD is a hypervirulent organism that is not only affecting hospitalized patients but is now emerging as a community acquired infection. Healthcare treatments and costs are on the rise due to persistent and recurrent CD infections. Understanding the pathogenesis, risk factors, diagnostic testing, and management strategies are important in reducing the spread of CD …

Tuberculosis, Lindsay Mackey

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis and mostly affects the lungs and sometimes other organs such as the kidneys, spine, and brain (Center for Disease Control and Prevention, 2015). In 2013, the CDC (2015) estimated that approximately 9 million people were infected with Mycobacterium tuberculosis worldwide and approximately 1.5 million deaths were a result of TB. Tuberculosis is an airborne infection which can be spread through the air from an infected individuals cough, sneeze, or speech. Individuals infected with TB can either have latent or active stage. Latent TB is when an individual becomes infected …

The Pathophysiology Of Sepsis, Rachel Hamilton

Nursing Student Class Projects (Formerly MSN)

Sepsis is still a leading cause of hospital admissions and often leads to death if not identified early and treated properly (Pilcher, Cooper & Bellomo, 2015). In the US there are approximately 200,000 deaths annually due to sepsis (Puskarich, Illich, & Jones, 2014). It is important for advance practice nurses to recognize risk factors for sepsis. By understanding the pathophysiology of sepsis nurse practitioners will be able to recognize early signs and symptoms of this inflammatory disease process and implement early medical management. Early medical treatment in septic patients is crucial to increase patient survival rates.

Sepsis & Emergency Management, Sharon Herndon

Nursing Student Class Projects (Formerly MSN)

Sepsis is a potentially life-threatening complication of an infection and a leading cause of death in the United States (Cawcutt & Peters, 2014). Sepsis is a systemic inflammatory response syndrome (SIRS) to invading microorganisms. Sagy, Al-Qaquu, and Kim (2013) define sepsis in three categories. “Sepsis” would be defined as the presence of infection along with other general systemic signs and symptoms. “Severe Sepsis” would be defined as sepsis complicated by at least one organ dysfunction, and “Septic Shock” would be defined as severe sepsis with acute circulatory failure that may be characterized by persistent arterial hypotension unexplained by other causes. …

Necrotizing Fasciitis, Holly Herron

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis also known as necrotizing soft tissue infections (NSTIs) is a rare life-threatening infection that involves the skin and soft tissue. A rapid and accurate diagnosis of NSTIs must be identified by healthcare providers to diminish morbidity and mortality. NSTIs are characterized by progressive necrosis of subcutaneous tissue and fascia involving large areas of tissue (Lin, Chang, Lai, Lin, & Chen, 2013). Hippocrates (500 BC) described necrotizing fasciitis as “diffuse erysipelas caused by trivial accidents [where] flesh, sinews, and bones fell away in large quantities, [leading to] death in many cases” (Lancerotto, Tocco, Salmaso, Vindigni & Bassetto, 2012). In …

Necrotizing Fasciitis: The “Flesh Eating” Disease, John Neukam

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis, often referred to as the “flesh-eating disease”, is a rare bacterial infection with an extremely high mortality rate with symptoms that begin subtle but can quickly ravish the human body.1 While the prevalence of this disease is relatively low, evidence of this disease can be traced back as far as the 5th century BC where it was initially described by Hippocrates.2 It wasn’t until 1952 however that Dr. Bob Wilson termed the disease “necrotizing fasciitis”.3 The rapid progression of this disease and the acute deterioration it causes in a patient is extremely intriguing. This “flesh-eating disease” can present …