Florida State University Nurse E Portfolio Capstone
Professional E-Portfolio Students will use critical self-reflection, promote life-long learning, identify individual learning goals and progress. Students will synthesize class content and application of EBP to promote current and future practice and scholarship. The Eportfolio is a means to document significant accomplishments in this course and students may build upon the portfolio to apply to graduate school or jobs. Students may use free sites to build their e-portfolios such as: • •
Weebly Google Sites Portfolios Must include (but not limited to): • • • • • • • • • • • Picture (s) Nursing Philosophy 3-5 Professional Goals Written Reflection on how 4440 course outcomes were met Any changes in Nurse’s Professional Role Development throughout this course Major assignment from the course with a short summary identifying the learning value of each assignment and/or rationale for the inclusion of it into the portfolio.
This can include (but not limited to): contract, implementation plan, Evaluation/Decision to Adopt Change, examples of products related to the EBP Change project. Resume Students may include any other examples from other courses that would be helpful when applying to graduate school or for a job.
These can include (but not limited to) major papers and major projects. Any honors achieved while in the RN-BSN program. How your BSN goals were met (these were identified in Week 1) with examples How your BSN Education has affected your Nursing Practice Course outcomes • • • • •
Integrate quality improvement, safety, and ethics into an evidence-based practice project. Plan collaborative leadership activities among the interprofessional team. Engage in activities that promote the importance of professional nursing roles in creating change in healthcare environments. Evaluate outcomes of an evidence-based practice project. Disseminate evidence-based practice project results. CHANGE PROJECT CONTRACT Student Name: Anna Driver Project Topic or Title: Blood Culture Contamination
1.Include a brief description of the change that you will implement and evaluate this semester. My change project will involve blood culture contamination. The hospital spent millions of dollars on contaminated cultures. The change project I am proposing is something we will be implementing in our unit. The first change is phlebotomy is no longer allowed to collect blood cultures.
We will have a blood culture team of RNs on our unit who are to collect the cultures, this team will include all the nurses who are PIV ultrasound trained and a few others. We will have blood culture kits with all the necessary materials needed to collect a set of blood cultures. II. IV. V. VI. IX.
2. List at least 5 important course and program concepts and state how they will be incorporated into the change. Florida State University Nurse E Portfolio Capstone (Consult course outcomes, BSN Essentials, and QSEN competencies) Basic Organizational and Systems Leadership for Quality Care and Patient Safety Information Management and Application of Patient Care Technology Healthcare Policy, Finance, and Regulatory Environments Interprofessional Communication and Collaboration for Improving Patient Health Outcomes Baccalaureate Generalist Nursing Practice
3. Discuss the direct or indirect link to patient-centered care or safety.
4. Discuss how this proposed change aligns with the ANA Code of Ethics (please list all the provision(s) and how your project relates to each). Having uncontaminated blood cultures will
positively affect patient care by ensuring that patients are correctly diagnosed and properly treated. Contaminated specimens cause increased time spent by the lab, which takes their time away from conducting other lab examinations. Having contaminated specimens can lead to improper use of antibiotics, increase hospital stay time and nosocomial infections, increase risk of a thrombotic event related to prolonged indwelling catheters for IV antibiotic treatments, and increase cost for the patients.
This will also save the patient money by not having to run multiple lab tests since 1 set (anaerobic and aerobic) culture test costs $3,000 or more depending on the facility and providers order a minimum of 2 sets.
5. List 5 peer-reviewed healthcare-related articles to support the project. The articles must be quantitative or qualitative research articles. The research articles must be less than 5 years old and nursing focused.Please use APA format or you will receive a 0. 6. How do each of these 5 articles relate to your project? Be specific as to the method, findings, and how to incorporate each into the project.
This should be in paragraph form and 1-2 paragraphs per article. 1. Bae, M., In Kim, H., Park, J. H., Ryu, B.-H., Chang, J., Sung, H., Jung, J., Kim, M. J., Kim, S.-H., Lee, S.O., Choi, S.-H., Kim,
Y. S., Woo, J. H., Kim, M.-N., & Chong, Y. P. (2018).
Improvement of blood culture contamination rate, blood volume, and true positive rate after introducing a dedicated phlebotomy team. European Journal of Clinical Microbiology & Infectious Diseases, 38(2), 325– 330. https://doi.org/10.1007/s10096-018-3430-4 This study identified the cost effectiveness and the reduction of contamination rates by implementing the use of dedicated phlebotomy teams that had been certified for blood culture collection. In this study, there were no changes made in the method used for blood collection, antiseptic
measures, or blood culture bottles. For my project, the unit will be selecting nurses to be part of our blood culture team that will be responsible for the collection of all blood cultures. 2. Doern,
G. V., Carroll, K. C., Diekema, D. J., Garey, K. W., Rupp, M. E., Weinstein, M. P., & Sexton, D. J. (2019). Practical Guidance for Clinical Microbiology Laboratories: A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem. Clinical Microbiology Reviews, 33(1). https://doi.org/10.1128/cmr.00009-19 This article is a comprehensive discussion of blood culture contamination. By using quantitative data, the authors discuss the problems and consequences associated with false positive blood cultures related to contamination.
The authors identify practices that lead to increased contamination rates; Using these findings, a practice change will be implemented for the collection of blood cultures. This article identifies that poor technique of the individual collecting the blood sample is a major factor in increased contamination rates.
The authors also identify that a double needle transfer technique, sterile gloves and hand hygiene, and blood culture kits have all been associated with decreased contamination rates. The changes that will be made to current practice are providing blood culture kits that provide sterile gloves, individual use hand hygiene products, and a chlorhexidine skin antiseptic.
The current practice of using a transfer device (i.e., double needle transfers) to inoculate culture bottles will remain. 3. Moeller, D. (2017). Eliminating Blood Culture False Positives: Harnessing the Power of Nursing Shared Governance. Journal of Emergency Nursing, 43(2), 126–132. doi: 10.1016/j.jen.2016.07.001.
In this study, the researchers identify the importance of education and procedure. In this study, the implemented changes included educating staff on proper technique and procedure for specimen collection.One change that was made was to change gloves between skin preparation and actual draw. This is identified as an important step because the changing of gloves removes the surface contaminants from the hospital workers initial set of gloves. In my change project, I will be implementing the practice of preparing the skin, then donning a pair of sterile gloves. 4.
McLeod, C. G. (2020). Reducing Blood Culture Contamination in the Emergency Department. Journal of Nursing Care Quality, 35(3), 245–251. doi: 10.1097/NCQ.0000000000000441.
