Adhesive Transparent Chlorohexidine Gluconate Tegaderm™ Gel Dressing for Central Venous Catheter

Adhesive Transparent Chlorohexidine Gluconate TegadermTM Gel Dressing for Central Venous Catheter by Peter Kimiti Mwangi MS, Walden University, 2016 BS, Jacksonville State University, 2012 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2019 Abstract Central-line-associated bloodstream infections (CLABSIs) occur during the insertion or change of the dressing of the central venous catheter (CVC) and are reportable healthcare-associated infections at the state and the national level. The purpose of this systematic review of the literature was to evaluate and synthesize available evidence to establish the effectiveness of using an adhesive transparent chlorohexidine gluconate (CHG) TegadermTM gel dressing for CVC in the prevention of CLABSIs. The logic model was used as a framework to guide the review of the literature to establish how an intervention that is not currently practiced can contribute to CVC prevention of infection. The practice question focused on gathering evidence to support the effects of CHG TegadermTM gel central-line dressing compared with the Biopatch® dressing. A total of 373 articles were retrieved and 16 met the inclusion for review and were graded according to the Melnyk and Fineout-Overholt hierarchy level of evidence and evidence synthesis broken down into the reduction of CLABSI, the cost-effectiveness and ease of use of the CHG TegadermTM gel. Findings from the systematic review supported the use of CHG gel dressing as a CLABSI preventative measure. The findings from the project support positive social change by reducing CLABSI and associated illnesses and saving the increased cost, mortality, and morbidity associated with CLABSIs.Central-line-associated bloodstream infections (CLABSIs) occur during the insertion or change of the dressing of the central venous catheter (CVC) and are reportable healthcare-associated infections at the state and the national level. The purpose of this systematic review of the literature was to evaluate and synthesize available evidence to establish the effectiveness of using an adhesive transparent chlorohexidine gluconate (CHG) TegadermTM gel dressing for CVC in the prevention of CLABSIs. The logic model was used as a framework to guide the review of the literature to establish how an intervention that is not currently practiced can contribute to CVC prevention of infection. The practice question focused on gathering evidence to support the effects of CHG TegadermTM gel central-line dressing compared with the Biopatch® dressing. A total of 373 articles were retrieved and 16 met the inclusion for review and were graded according to the Melnyk and Fineout-Overholt hierarchy level of evidence and evidence synthesis broken down into the reduction of CLABSI, the cost-effectiveness and ease of use of the CHG TegadermTM gel. Findings from the systematic review supported the use of CHG gel dressing as a CLABSI preventative measure. The findings from the project support positive social change by reducing CLABSI and associated illnesses and saving the increased cost, mortality, and morbidity associated with CLABSIs. Adhesive Transparent Chlorohexidine Gluconate TegadermTM Gel Dressing for Central Venous Catheter by Peter Kimiti Mwangi MS, Walden University, 2016 BS, Jacksonville State University, 2012 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2019 Dedication My dedication to God for his continued strength despite some challenges, unshakable faith, courage and perseverance in the process of my Doctor of Nursing practice journey. Allegiances to my late dad who could have been proud to see me achieving my dream goals of becoming a scholar and a doctor in the nursing practice. I am thankful to my loving mum who never cease to pray and her generous support. Also, to my life partner who has been a shoulder to cry on, encourager, and always pushed me hard to continue striving and my siblings, nephews and nieces who view me as a role model to emulate. Finally, to my preceptor, Dr. Sharina, Arceneaux, DNP, RN-BC, NEABC. Sharina, I cannot pay you for everything you have done to make my dreams come true and may God bless you mightily. Acknowledgments I want to thank Dr. Francisca Farrar, my committee chair, for your kind and continuous support and prompt feedback throughout the process of the DNP project. You have been a pillar, supporter, and encourager and always there when needed to see me succeed. I don’t know what I can pay you with, but may God bless you abundantly and enlarge your territories and continue with that kind spirit of helping students achieve their life and professional dreams. To Dr. Rosaline Olade and Dr. Eileen Fowles who not only been part of the DNP committee and reviewer respectively, but I have learned from your feedback, and everything you have done towards my doctoral journey has not been in vain. To you both, you are highly appreciated for accepting to be part of my team in my doctoral journey. Thank you to my preceptor, Dr. Sharina Arceneaux who has been my mentor and my encourager as well. Sharina, you set the bar high as a young successful black woman to get your doctoral degree at a youthful age, and I have followed your footsteps. Thank you for your time, sacrifice and commitment. Thank you to my partner, my mother, siblings, nephews, nieces, cousins, friends, and colleagues for their continued words of encouragement and unwavering support and prayers. I could not have achieved this terminal degree without your support. Lastly, I dedicate this project to my mother and my late father who sacrificed their lives and luxury to see us through and who instilled the values of discipline, hard work, perseverance, determination and emphasized the importance of remaining humble regardless of the social status.