Journal Entry 2
This week you complete and submit your first journal entry. Your journal draws from evidence concepts and/or theories you have examined in this program especially those related to your specialization. What have you observed during your Practicum Experience that you would like to analyze through your journal writing?
To prepare:
Reflect on your Practicum Experiences in Weeks 47.
Think about the evidence concepts and/or theories (evidence) learned throughout this program and your specialization.
Analyze a problem issue or situation that you have observed during your Practicum Experience. (There was an unplanned downtime of the electronic health system (EHR) which lasted an hour).
Using a minimum of three peer-reviewed sources of evidence consider what you have observed within the context of your specialty using appropriate concepts principles and theories. Give special attention to observed events that vary from the scholarly literature. (See attached pdf of the peer-reviewed articles)
Determine how the problem situation or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory concepts and principles detailed in the evidence. (Read attached pdf articles)
Given the various evidence-based approaches that can be used in handling the observed problem situation or issue think about a plan for approaching the matter differently. (Read attached pdf articles)
To complete:
Write a 250- to 300-word journal entry in APA format and at least 3 references (identified as Journal Entry 1) in which you do the following:
1) Describe a problem issue or situation that you have observed during your Practicum Experience (no more than a half page). (Central Line-Associated Bloodstream Infections [CLABSI]).
2) Using no fewer than three peer-reviewed sources of evidence (SEE ATTACHED PDF) analyze what you have observed within the context of your specialty using appropriate concepts principles and theories. Give special attention to observed events that vary from scholarly literature. (there was 5 CLABSI incidence at my practicum site during the month of April. All 5 cases were due to the fact that all positive blood cultures were drawn from the central line. In 4/5 cases only peripheral blood cultures were ordered but the nurses decided to draw from the central line instead therefore creating infections in the central line).
3) Explain how the problem situation or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory concepts and principles detailed in the evidence. (The CLABSI team held a meeting with the nursing informatics department to come up with a solution)
4) Given the various evidence-based approaches that can be used in handling the problem situation or issue formulate a plan for approaching the matter differently. (See attached plan)
(A CLABSI meeting was held after the incidence as the result it was decided that in order to prevent CLABSI staff should:1) Label all tubing with date and time and initials 2) document all tubing and cap changes 3) properly identify and document central line lumens 4) only draw blood cultures from central line if suspecting that the line is infected (septic) with doctors order only. 5) Backflush secondary tubing instead of connecting a new set. Additionally and most importantly the nursing informatics team developed additional documentation in the electronic health record system to ensure that the above numbered steps are being followed
Required Readings
Theodoro D. Olsen M. A. Warren D. K. McMullen K. M. Asaro P. Henderson A. & … Fraser V. (2015). Emergency Department Central Line-associated Bloodstream Infections (CLABSI) Incidence in the Era of Prevention Practices. Academic Emergency Medicine: Official Journal of The Society For Academic Emergency Medicine 22(9) 1048-1055. doi:10.1111/acem.12744
VESELY R. (2017). PREDICTIVE ANALYTICS: IU Health knows the patient in Room 103 is at high-risk for CLABSI. WOULD YOU?. H&HN: Hospitals & Health Networks 91(2) 20-25.
Valencia C. Hammami N. Agodi A. Lepape A. Herrejon E. P. Blot S. & … Lambert M. (2016). Poor adherence to guidelines for preventing central line-associated bloodstream infections (CLABSI): results of a worldwide survey. Antimicrobial Resistance And Infection Control 549.

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