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two paragraphs and two references no more than 5 years including doi. No

two paragraphs and two references no more than 5 years including doi. No plagirism. 

The practice problem I chose is Central Line-Associated Blood Stream Infections (CLABSIs) in Pediatric Patients in the Home Care Setting. In my department, we have a small pediatric population. The majority of pediatric patients have central lines for parenteral nutrition therapy. These patients represent a small portion of our patients with Central Venous Access Devices (CVADs); however, they represent over 90% of the CLABSIs in our department.

           I performed a literature search with the Chamberlain Librarian's assistance, who helped me focus my search for peer-reviewed articles representing CLABSIs in the home's pediatric population. This literature review revealed several articles related to the topic. I chose the articles to review for research location, known authors on the subject matter, the journal in which it was published, the subject matter itself, and did it relate to the desired topic. I also looked for the level of research. I reviewed the abstracts and looked for a methods section. I compared the methods and again looked for validity toward the topic. 

           I found two compelling articles written relatively close together addressing what I was looking for. One article was very clearly a Quality Improvement project done that was identified by a large children's hospital that was seeing an increase of Community-Acquired CLABSI's (CA-CLABSI's) once the patient was discharged to a home health agency. The other article I believe to be a retrospective quantitative research design based on six years of data collection from chart audits. I am choosing to focus on the second article. The article was written by four physicians from the University Children's Hospital in Zurich, Switzerland, between 2009 and 2015. The four physician's contributed equally to the study and are infectious diseases and epidemiology specialists. 

           The intended audience of the article includes medical providers who care for acutely and chronically ill children, who prescribe treatments and order the intended central lines for these treatments, such as IV antibiotics and total parenteral nutrition. In addition, the nurses who care for the central lines on a routine ongoing basis. The unintended focus specifically called out Pediatric Gastroenterologists because their research found that children with gastroenterology type diagnoses were at a significantly increased rate of CA-CLABSI's. The seven-year study was published in January 2020.

            This article has 40 references and citations. There are no footnotes or bibliographies noted in the article. The majority of the 40 references cited were credible because the journals they were published in were credible. This article is a primary source paper, as the researchers themselves completed the study. The authors clearly defined the inclusion and exclusion criteria. While synthesizing the evidence, the authors discovered that one patient population had a higher rate of infections, which was an unexpected finding. The authors were physicians and scholars who work in the fields of study they were discussing. The article referenced the Center for Disease Control (CDC) and the National Healthcare Safety Network (NHSN) specific to bloodstream infections and patient safety. However, some of the articles referenced or cited are outdated for today's literature, going back to 2000. However, the study referenced began in 2009, so at the time was not outdated.

           One of the ways I choose to share evidence at my workplace is to share the article with the team via email and then ask them to discuss the article at our next staff meeting. If I am planning to use it as part of a competency, it becomes pre-learning and preparation for the competency and questions regarding the information is embedded throughout for knowledge assessment. Lastly, we have daily safety huddles where I can share information with a larger group. 

Paioni, P., Kuhn, S., Stassle, Y., Burkardt, S., & Berger, C. (2020). Risk factors for central line-associated bloodstream infections in children with tunneled central venous catheters. American Journal of Infection Control, 48(1), 33-39. https://doi.10.1016/j.ajic.2019.06.027

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