I need someone who is good at APA tables and statistical analysis. The information is already in the attachment. The tables and charts must be in APA format
Chapter 4: Data Analysis and Results
This chapter will review the collected data, evaluate methods used to analyze the data, and appraise the findings of the study. The purpose of this quantitative project was to determine the degree of relationship between the independent variale of nurses participation in an evidence-based CLABSI prevention using CHG bathing and the dependent variables of lowering CLABSI rates in patients with CVCs in a healthcare facility in Texas. The quantitative research methodology was selected as a means to review the collected data, evaluate and analyze the data and to appraise the findings of the quality improvement project. The purpose of the project is to explore the problem of CLABSIs and examine available measures to prevent, control, reduce incidences, and to implement a quality improvement project set forth by this investigator to decrease CLABSIs. More importantly, the project seeks to contribute to the field of evidence-based practices in nursing by showing the role of the nurse in helping to reduce HAIs, such as CLABSIs, in the adult critical care setting. In particular, the present project proposes nurse training on the CUSP toolkit and additional CLABSI maintenance, including CHG bathing as an intervention to prevent CLABSI. Central line Venous Catheters (CVCs) are commonly used for inpatients hospitalized in acute care Intensive Care Units (ICU) to administer blood products, intravenous fluids, parenteral nutrition, and other types of medications, such as antibiotics. The use of catheters is, however, linked to the risk of developing a hospital-acquired infection (HAI), known as Central-line Associated Bloodstream Infection (CLABSI) mainly caused by microorganisms found on the external surface of the patients skin, improper hand hygiene, or in the fluid pathway post-catheter insertion. Notably, CVCs have been cited as the most frequent and costliest causes of bloodstream infections (Haddadin & Regunath., 2019). CLABSI prevention is one of seven requirements by the Joint Commission for hospitals to accredited nursing care centers and listed as a National Patient Safety Goal (NPSG) NPSG.07.04.01 (Yokoe et al., 2018).
Evidence-based practices, including CHG bathing, adequate hand hygiene, and clear de-escalation protocols for central lines that are no longer medically necessary, were utilized. The Comprehensive Unit-based Safety Program (CUSP) is a program designed to teach and enhance patient safety awareness as well as the quality of nursing care (Basinger, 2015). The project will implement CUSP, which is comprised of five basic steps. The CUSP process starts with providing education on the CUSP Central-line maintenance bundle that includes chlorohexidine gluconate (CHG) bathing, followed by the identification of weaknesses and risks in patient safety, then the partnering of a senior executive of the critical care unit, learning from the flaws, and the execution of communication and teamwork tools (Basinger, 2015). The core CUSP toolkit (appendix B) gives clinical teams the training resources and tools to apply the CUSP CHG bathing intervention for this project to prevent CLABSIs.
The present project will consist of audit tools on awareness and compliance, like the AHRQ CUSP CLABSI Central Line Maintenance Audit Form and CUSP toolkit (appendix B) in which proper maintenance of CLABSI is ensured (Baldassarre, Finkelston, Decker, Lewis, & Niesley, 2015). A CUSP CLABSI maintenance audit tool (Appendix B) was used on the nurses providing care on those patients with CVCs were used within the adult ICU at Texas hospital, to help in determining the CLASBI maintenance bundle compliance. The results of the project were analyzed using the necessary statistical methods to help in establishing the conclusion of the results. The Texas hospitals nursing data portal was used to gather statistical data that will determine if CHG use has helped reach the benchmark goal of SIR = 75th percentile and the Goal Process Measures or KPIs = 90% compliance compared to other hospitals in the division. Currently, in the last quarter of 2019, the benchmark of the 75th percentile has been achieving post quality improvements that include the addition of CHG bathing. CUSP CLABSI maintenance audit tool (Appendix B) (Heale & Twycross, 2015). Statistical significance was calculated at a p-value of < .05 and a 95% confidence interval. The Centers for Disease Control and Preventions (CDCs) National Healthcare Safety Network (NHSN) developed and used standardized infection ratios (SIRs) to measure healthcare-associated infection (HAI) incidence (Soe, Gould, Pollock, & Edwards, 2015).
The Infection rate is calculated using the overall percentage of infection by dividing the number of new cases by the average census and multiplying by 100. For more specific rates, the number will be provided by dividing the number of new cases by the total resident days and multiply by 1000, which gives you the number of infections per 1000 resident days (Liu et al., 2016). Standardized Infection Ratio (SRI) is expressed as a ratio and is the comparison of the actual number of HAIs to the predicted number of HAIs in a healthcare organization. This value is based upon data reported to National Healthcare Safety Network (NHSN) during a specified time period. The Hospital Corporation of Americas (HCA) goal is 75th percentile. A SIR can only be calculated if there is at least one predicted infection
Goal: SIR = 75th percentile
To assist in determining if patient outcomes could be improved using simulation
activities, a rural healthcare facility in Southeast Texas, was chosen to conduct the project. The methodology used for this project was quantitative. A quantitative methodology was chosen to provide absolute value to the rate of incidence or occurrence of adverse events to support measurement of the difference between pre- and post-simulation intervention. A quasi-experimental design was used as participants were not randomly selected. This approach suited the request of the institution to include nurses working in the ED.
Using comparative analysis, the CUSP CLABSI Central Line Maintenance Audit Form (appendix B) shows > 90 percent compliance, the data met the key performance indicators (KPIs) for a decrease in CLABSI and its compliance with evidence based standars has brought down CLABSI infection rates. The Goal Process Measures or KPIs (key performance indicators) = 90% compliance. The bullet graph (Table 1) at the top right corner of Nursing Data Portal trending screens, outlines how to read and interpret progress on performance milestones. The purpose of this chapter is to summarize the collected data, how it was analyzed, and then to present the results.
Table 1
Table 1 shows the Hospital KPI performance graph on CHG bathing from the organizations Nursing Data Portal. The table shows the prior month and current month percentage labeled 0% to 100%. Moving from left to right, the graph shows the organization’s divisional average at 50% and next the HCA corporate average of 70%. Aspiration goals for CHG bathing are set for the 75th percentile with higher aspirational goals set at 100% or in the 90th percentile.
Table 2[A1]
In the present project, a CVC maintenance bundle checklist (Appendix D) was used to observe nurses in the adult ICUs of an acute Texas hospital. The observation will involve the Central Line Audit Form (Appendix B) comparing nurse’s compliance regarding CVC maintenance and any significant definite statistical decrease in the reported standardize infection rates and was done for one month (Table 3). In 2019 in the first two quarters, the facility has already reported 20 HAIs, according to the Centers for Disease Control and Preventions (CDCs) National Healthcare Safety Network (NHSN) (Painter, 2018). From May to September (five-month trend) the Texas hospital was at 96% overall performance, and the division in which it belongs, the Gulf Coast Division, was at 97% with the goal of overall performance being 98% of all HCA hospitals (Table 2). [A2] The next five-month trend from August to November, the Texas hospital was at 95% overall performance, and the division in which it belongs, the Gulf Coast Division, was at 89% with the goal of overall performance being 98% of all HCA hospitals (Table 2). CLABSI infection and prevention are a factor in the overall performance both at the local, division and national levels. Other size hospitals in Texas have an average of 15 CLABSI per year (Liu et al., 2016). The present project will apply the quantitative approach, which was used in data collection and analysis. The present project will consist of audit tools on awareness and compliance, like the AHRQ CUSP CLABSI Central Line Maintenance Audit Form and CUSP toolkit (appendix B) in which maintenance of CLABSI is ensured (Baldassarre, Finkelston, Decker, Lewis, & Niesley, 2015). A CUSP CLABSI Central Line Maintenance Audit Form (appendix B) on the nurses providing care on those patients with CVCs was used within the adult ICU at Texas hospital, to help in determining CLASBI maintenance CHG bathing compliance. The results of the project were analyzed using the necessary statistical methods to help in establishing the conclusion of the results. CUSP CLABSI maintenance audit tool (Appendix B) (Heale & Twycross, 2015). Statistical significance was calculated at a p-value of < .05 at 5.59 or 5% and a 95% confidence interval. The Centers for Disease Control and Preventions (CDCs) National Healthcare Safety [A3] Network (NHSN) developed and used standardized infection ratios (SIRs) to measure healthcare-associated infection (HAI) incidence (Soe, Gould, Pollock, & Edwards, 2015). The Infection rate calculation calculated using the overall percentage of infection by dividing the number of new cases by the average census and multiplying by 100. For more specific rates, divide the number of new cases by total resident days and multiply by [A4] 1000, which gives you the number of infections per 1000 resident days (Liu et al., 2016). Using comparative analysis, if the CUSP CLABSI Central Line Maintenance Audit Form (appendix B) shows 90 percent compliance, the data met the KPIs for a decrease in CLABSI. In the present project, a CVC maintenance bundle checklist (Appendix E) was used to observe nurses in the adult ICUs of an acute Texas hospital. The observation involved the Central Line Audit Form (Appendix B) comparing nurses' compliance regarding [A5] CVC maintenance and any significant definite statistical decrease in the reported standardize infection rates and was done for one month.
The following clinical question will guide this quantitative project:
Q: In adult patients with central line catheters, how does staff training on the CUSP CLABSIs maintenance CHG bathing to reduce the incidence of CLABSIs (Central Line-Associated Blood-stream Infections) compared to standard care over one month?
Standard care here is defined as procedural pause, aseptic techniques, hand hygiene, and optimal site selection, to protect the insertion site and to take maximal sterile precautions (Advani, Lee, Long, Schmitz, & Camins, 2018).
Criterion
Learner Score
(0, 1, 2, or 3)
Chairperson Score
(0, 1, 2, or 3)
Comments or Feedback
INTRODUCTION (TOTHE CHAPTER)
This section of Chapter 4 briefly restates the problem statement, the methodology, the clinical question(s) or phenomena, and offers a statement about what will be covered in this chapter.
1
Re-introduces the purpose of the practice project.
1
Briefly describes the project methodology and/or clinical question(s) tested.
1
Develop project methodology.
Provides an orienting statement about what will be covered in the chapter.
2
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
2
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document.
Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).
Descriptive Data
A CHG bath/treatment must be given each day (based off midnight census) for a patient in the adult ICU with a central line, hemodialysis catheter, PICC, midline, or accessed port, and the CHG bath must be documented as per the Texas hospitals policy. The Texas hospital utilizes Meditech 5.6.x Source System to documents daily CHG bathing (Appendix F). CHG bathing is tracked through the hospital's Nursing Data Portal, a division-wide analytics program. CHG bathing is tracked through the Texas hospital's Nursing Data Portal, a division-wide analytics program. This portal can track CHG compliance, date and time of bath, CVC placement, type of lumens, date and time of access, and any reason CHG bathing was not performed (Appendix E) on the CVC patient, both intervention and nonintervention groups were determined via the CUSP CLABSI Maintenance Audit form.
The CUSP CLABSI Maintenon Audit form asks the following questions: Was the need for a central line for this patient discussed on patient rounds? Was good hand hygiene used by all personnel involved in line care for this patient (i.e., handwashing with soap and water or with alcohol-based hand sanitizes. If the line was percutaneously placed, was this line placed in a recommended site? Was the dressing changed during this shift? Was Chloraprep or 2% chlorhexidine in 70% Isopropyl alcohol used for skin antisepsis? Were central line tubing and all additions (secondary tubing, etc.) changed during this shift? Was there blood return from each lumen? Was chlorhexidine impregnated BioPatch used? Was a chlorhexidine impregnated occlusive dressing used? Was an antibiotic coated catheter used at insertion? What will you change to improve line maintenance practices? (Appendix B and E).
A CHG bath/treatment must be given each day for a patient in the ICU with a central line, hemodialysis catheter, PICC, midline, or accessed port, and the CHG bath must be documented in Meditech 5.6x. per the Texas hospitals policy. From the nursing data portal, this project the project investigator was able to gather statistical data that determined that CHG use has helped reach the goal of SIR = 75th percentile and the Goal Process Measures or KPIs of 90% compliance. Tallied scores (Table 4) were entered into SPSS Statistics program to give a percentage of CUSP CVC intervention and non-intervention groups with the number of new CLABSI patients in each group. This KPI was determined by a decrease in CLABSI rates. Occurrences of events constitute discrete data and are recorded in whole numbers and into various categories (Ali & Bhaskar, 2016). Entered in the SPSS program was the independent variable, which is all the nurses in the present project. This group was further divided into two variables an intervention group and a non-intervention group. The intervention group being nurses implementing CUSP CLABSI maintenance bundle CHG bathing and non-interventional group nurses who are attending patients without CHG bathing. All 60 comprised of 30 nurses in each group were coded in Camel case and number, for example, Nurs1 to maintain confidentiality. Dependent variables or numberof infections entered into the SPPS program the quantitative CUSP CLABSI maintenance CHG bathing intervention performed in the adult ICU at Texas hospital. Data entered will allow the investigator to create statistical graphs such as histogram, bar charts, Tukey box plots, line graphs, and scatterplots to give a visual representation of the collected data. The investigator expects that the CUSP intervention groups will have a level of statistical significance of lower CLABSI. CUSP Central line maintenance bundle compliance was measured with the CUSP CLABSI Central line Maintenance Audit Form (appendix B) with the reported standard infection ratio (SIR). The present project shows that the SIR will decrease with the addition of the CHG bathing, and using inferential statistics.
Calculation of the p-value and paired t-test was completed to compare the means of the sample groups (intervention and nonintervention) (Table 3). Statistical significance was calculated at a p-value of < .05 and a 95% confidence interval. Tallied compliance scores from the CUSP CVC audit form were entered SPSS Statistics program to give a percentage of CUSP CVC intervention and non-intervention groups with the number of new CLABSI patients in each group.
The information filled in the audit (Appendix B) were collected and coded to help in carrying out an unbiased de-identified analysis (See Table 4). The coded data were analyzed using the SPSS software to assist in getting the quantitative aspects of the data (Mihas, 2019). Calculation of standard deviation, p-value, and paired t-test was completed to compare the means of the sample groups. Statistical significance was calculated at a p-value of < .05 and a 95% confidence interval. Statistical tests are used to see if the difference between the number of actual infections, and the number of predicted infections are due to just chance alone. If it is doubtful that the difference is due to chance, then the difference is called statistically significant. If the SIR is less than 1, and the finding is statistically significant, then the facilitys performance is labeled Better than Expected. If the SIR is greater than 1, and the finding is statistically significant, then the facilitys performance is labeled Worse than Expected. If the SIR is not statistically significant, then the facility's SIR is "In the expected range" (Saman & Kavanagh, 2013). When the predicted number of infections is less than 1, then the numbers are too small to compare. Equally, the investigator used descriptive aspects of the data to assist in making meaning out of any complex scientific elements of the data. The analysis of the data is critical clinically in achieving the objective of the project and answering the clinical questions regarding CLABSI prevention and CHG maintenance (Saman & Kavanagh, 2013).
Table 3
CHG Audit Dates
30-days pre- intervention
CHG Intervention
No CHG Intervention
No of Infection
with CHG Intervention
No of Infection
without CHG Intervention
SIR
Standard Infection Ratio
10/15-10/21
0
0
1
1
1
10/22-10/28
0
0
1
0
1
10/29-11/4
0
0
0
1
0
11/5-11/14
0
0
0
1
0
Mean
0
0
0.5
0.75
0.5
Standard Deviation
0
0
0
0.4
0
CHG Audit Dates
30-days poet-intervention
CHG Intervention
No CHG Intervention
No of Infection
with Intervention
No of Infection
without Intervention
SIR
Standard Infection Ratio
11/15 -11/21
42
18
0
1
1
11/22 11/28
47
13
0
1
1
11/29-12/06
51
9
0
0
< 1
12/07 12/15
58
2
0
0
< 1
Mean
51.6
10.5
0
0.5
-
Standard Deviation
6.7
5.9
0
0.5
-
CVC/ PICC Line Days - Current Census for Clear Lake (Campus: Clear Lake)
Date_______________
Nurse
De-identified
(Nurs1-Nurs60)
Location
ICU/NTICU/CCU
/CVICU
Patient
De-identified
(P1-P30)
Admit Date
Insertion Site
Location
Right/Left
Type
of Catheter
Start Date
CUSP
Audit
CHG Bath
(Y/N[A6] )
Nurs1
G.ICU
P1
-
ARM
RIGHT
CVC multi lumen double
-
Y
Nurs2
G.ICU
P2
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs3
G.ICU
P3
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs4
G.ICU
P4
-
ARM
RIGHT
Dialysis catheter triple
-
N
Nurs5
G.ICU
P5
-
ARM
LEFT
CVC multi lumen triple
-
N
Nurs6
G.ICU
P6
-
ARM
LEFT
CVC multi lumen triple
-
Y
Nurs7
G.ICU
P7
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs8
G.ICU
P8
-
ARM
LEFT
CVC multi lumen triple
-
N
Nurs9
G.ICU
P9
-
ARM
LEFT
Dialysis catheter triple
-
N
Nurs10
G.ICU
P10
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs11
G.ICU
P11
-
ARM
LEFT
Dialysis catheter triple
-
N
Nurs12
G.ICU
P12
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs13
G.ICU
P13
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs14
G.ICU
P14
-
ARM
RIGHT
CVC multi lumen double
-
Y
Nurs15
G.ICU
P15
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs16
G.ICU
P16
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs17
G.ICU
P17
-
ARM
RIGHT
Midline
-
Y
Nurs18
G.ICU
P18
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs19
G.ICU
P19
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs20
G.ICU
P20
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs21
G.ICU
P21
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs22
G.ICU
P22
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs23
G.ICU
P23
-
ARM
LEFT
CVC multi lumen double
-
Y
Nurs24
G.ICU
P24
-
ARM
RIGHT
Dialysis catheter triple
-
N
Nurs25
G.ICU
P25
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs26
G.ICU
P26
-
ARM
RIGHT
Midline
-
Y
Nurs27
G.ICU
P27
-
ARM
RIGHT
CVC multi lumen triple
-
N
Nurs28
G.ICU
P28
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs29
G.ICU
P29
-
ARM
LEFT
Dialysis catheter triple
-
N
Nurs30
G.ICU
P30
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs31
G.ICU
P31
-
ARM
LEFT
Dialysis catheter triple
-
N
Nurs32
G.ICU
P32
-
ARM
LEFT
CVC multi lumen triple
-
N
Nurs33
G.ICU
P33
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs34
G.ICU
P34
-
ARM
LEFT
CVC multi lumen double
-
Y
Nurs35
G.ICU
P35
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs36
G.ICU
P36
-
ARM
LEFT
CVC multi lumen triple
-
Y
Nurs37
G.ICU
P37
-
ARM
RIGHT
Midline
-
N
Nurs38
G.ICU
P38
-
ARM
CVC multi-lumen triple
-
N
Nurs39
G.ICU
P39
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs40
G.ICU
P40
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs41
G.ICU
P41
-
ARM
RIGHT
CVC multi lumen triple
-
N
Nurs42
G.ICU
P42
-
ARM
RIGHT
Dialysis catheter triple
-
N
Nurs43
G.ICU
P42
-
ARM
LEFT
CVC multi lumen double
-
N
Nurs44
G.ICU
P43
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs45
G.ICU
P44
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs46
G.ICU
P45
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs47
G.ICU
P46
-
ARM
LEFT
Dialysis catheter triple
-
N
Nurs48
G.ICU
P47
-
ARM
LEFT
CVC multi lumen triple
-
N
Nurs49
G.ICU
P48
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs50
G.ICU
P50
-
ARM
RIGHT
CVC multi lumen double
-
N
Nurs51
G.ICU
P51
-
ARM
LEFT
Dialysis catheter triple
-
Y
Nurs52
G.ICU
P52
-
ARM
RIGHT
CVC multi lumen triple
-
N
Nurs53
G.ICU
P53
-
ARM
LEFT
Midline
-
Y
Nurs54
G.ICU
P54
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs55
G.ICU
P55
-
ARM
RIGHT
Dialysis catheter triple
-
N
Nurs56
G.ICU
P56
-
ARM
RIGHT
Dialysis catheter triple
-
Y
Nurs57
G.ICU
P57
-
ARM
RIGHT
CVC multi lumen triple
-
Y
Nurs58
G.ICU
P58
-
ARM
RIGHT
Dialysis catheter triple
-
N
Nurs59
G.ICU
P59
-
ARM
RIGHT
CVC multi lumen double
-
Y
Nurs60
G.ICU
P60
-
ARM
LEFT
Dialysis catheter triple
-
N
Table 4
Criterion
Learner Score
(0, 1, 2, or 3)
Chairperson Score
(0, 1, 2, or 3)
Comments or Feedback
DESCRIPTIVE DATA
This section of Chapter 4 provides a narrative summary of the population or sample characteristics and demographics of the participants in the project. It establishes the number of subjects, gender, age, level (if appropriate), organization, or setting (if appropriate). The use of graphic organizers, such as tables, charts and graphs to provide further clarification and promote readability, is encouraged.
1
Provides a narrative summary of the population or sample characteristics and demographics.
1
Graphic organizers are used as appropriate to organize and present coded data, as well as descriptive data such as tables, histograms, graphs, and/or charts.
1
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
1
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document.
Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).
Data Analysis Procedures
A quantitative approach has been successfully used by McKim (2016) to identify barriers to compliance with evidence-based guidelines for central line management. The main objective of using this approach is to strengthen and/or expand conclusions, thereby contributing to existing knowledge. The approach helps to heighten knowledge and increase the validity of the results (Guetterman, Fetters & Creswell, 2015).
Reliability was addressed by ensuring that the instrument is consistent. The CUSP CLABSI Maintenance Central line audit was collected and coded to help in carrying out an unbiased analysis. The coded data were analyzed using the SPSS software to assist in obtaining the quality improvement aspects of the data (Mihas, 2019). Data were entered into the SPSS program were the independent variable, which is all the nurses in the present project. This group was further divided into two variables an intervention group and a non-intervention group. The intervention group being nurses implementing CUSP CLABSI maintenance bundle CHG bathing and non-interventional group nurses who are attending patients without CHG bathing. All 60 nurses 30 in each group were coded in Camel case and number, for example, Nurs1 to maintain confidentiality. Dependent variables or numberof infections entered into the SPPS program the quantitative CUSP CLABSI maintenance CHG bathing intervention performed in the adult ICU at Texas hospital.
The data entered will allow the investigator to create statistical graphs such as histogram, bar charts, Tukey box plots, line graphs, and scatterplots to give a visual representation of the collected data[A7] . The investigator expects that the CUSP intervention groups will have a level of statistical significance of lower CLABSI. CUSP Central line maintenance bundle compliance was measured with the Central line Maintenance Audit Form (appendix B) with the reported standard infection ratio (SIR). The present project shows that the SIR will decrease with the addition of the CHG bathing using inferential statistics.
A Calculation of P-value and paired t-test was completed to compare the means of the sample groups (intervention and nonintervention). Statistical [A8] significance was calculated at a p-value of < .05 at 5.59 or 5% and a 95% confidence interval. Tallied (Table 4) compliance scores from the audit form were entered via SPSS Statistics program to give a percentage of CUSP CVC intervention and non-intervention groups with the number of new CLABSI patients in each group (Heale & Twycross, 2015). SPSS has in-depth statistical capabilities, and the investigator can test Reliability Method Alpha using SPSS, meaning that the same data can be entered several times repeated and whatever the outcome will remain the same or consistent (Ozgur, Kleckner, & Li, 2015).
The quantitative design will involve CUSP central line audit form (Appendix B) for nurse compliance in the adult ICU hospitals for the application of the CUSP CVC maintenance CHG bathing. The quantitative approach has been successfully used by Ider et al. (2012) to identify compliance with evidence-based guidelines for central line management.
Criterion
Learner Score
(0, 1, 2, or 3)
Chairperson Score
(0, 1, 2, or 3)
Comments or Feedback
DATA ANALYSIS PROCEDURES
This section presents a description of the process that was used to analyze the data. If clinical question(s) guided the project, data analysis procedures can be framed relative to each clinical question. Data can also be organized by chronology of phenomena, by themes and patterns, or by other approaches as deemed appropriate according for a qualitative project.
1
Describes in detail the data analysis procedures.
1
Explains and justifies any differences in why the data analysis section does not match what was approved in Chapter 3 (if appropriate).
1
Provides validity and reliability of the data in statistical terms for quantitative methodology. Describes approaches used to ensure validity and reliability for qualitative projects.
1
Identifies sources of error and potential impact on the data.
1
For a quantitative project, justifies how the analysis aligns with the clinical question(s) and is appropriate for the DPI project design. For a qualitative project justifies how data and findings were organized by chronology of phenomena, by themes and patterns, or by other approaches as deemed appropriate.
1
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
2
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document.
Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).
Results
The focus was placed upon the adverse event of CLABSI infections and the CHG intervention. Table 5 demonstrates the frequency of CLABSI infection events for a year pre CHG intervention and was five occurrences up to this CLABSI [A9] prevention improvement project. The standard deviation (SD) of the sample for the occurrence of CLABSI after CHG intervention was calculated as the SD of 21.68, with a sample variance of 470. The SD of the sample of occurrences of CLABSI without the CHG intervention was calculated at 0.49 with a sample variance of 0.24. The frequency of CLABSI for the 12 months before the CHG intervention and the month post-intervention is displayed in Table 5. The most frequently occurring CLABSI events occurred pre CHG intervention in October 2018 with one reported, January 2019 with one reported, May 2019, with one reported, August 2019, with one reported, and October with one reported[A10] . The median frequency of occurrence for total reported adverse events was 1:6 or 0[A11] .16 events per month.
There was no identified trend for identifying a specific month marking an excessive frequency of CLABSI events. There is a higher frequency of CLABSI events noted on months when the CHG bathing intervention was not applied[A12] . This quality improvement project was implemented for one month from November to December 2019 with the CHG intervention and no reported CLABSI events occurred. The median frequency of occurrence was 1:2 or 0.5 per [A13] month.
Frequency of CLABSI Adverse Events [A14]
by Month from December 2018 to December 2019
Table 5
A paired comparison [A15] was performed of the four weeks immediately before intervention and the four weeks post-intervention. Table 3 demonstrates these values. [A16] The mean frequency of occurrence of adverse events pre-intervention was 0.25 with [A17] an SD of 0.5 in errors related to assessment while the mean frequency of events related to intervention was 0.5, and the SD was 0.58 for errors related to intervention. Post-performance of the simulation activity, there were no reported or recorded errors related to assessment or intervention resulting in a mean and SD of zero (o) for both categories[A18] .
The project may come with [A19] several limitations that would see the objectives of the project, not [A20] conclusively met. There is no way in which the project can control the responses from the nurses. T[A21] he analysis
