Central Line Bloodstream Infection Reduction CHI Health Lakeside

Central Line Bloodstream Infection Reduction CHI Health Lakeside Omaha, Nebraska

Process of Identifying Need • A dramatic increase in CLABSI's was evident • Where was the problem? • Audits performed • CLABSI Taskforce formed • Literature reviewed • Point prevalence studies conducted

Process Improvement Methods • Staff RN's (Clinical Practice Coordinator, 3 Nursing Supervisors, Infection Prevention specialist, Operations Director, Emergency Department educator) formed CLABSI taskforce • Employed 'Safety First' expectations of – Having a questioning attitude – Paying attention to detail – Stopping and Resolving • Audits performed every shift, became very detail oriented • 2 RN central line visualization upon patient arrival/transfer to unit • Education and communication with Radiology and ER to ensure patients received same message

Process Improvements Cont. . • Educational pamphlet developed for patients explaining CLABSI and when to access central lines. • Changed process of central line use to 'asking to access'. • Educated staff via mandatory skills day. – Staff was required to return demonstrate proper technique • Implemented 'phone buddies' • Changed verbiage of CHG bathing to 'treatments', mandated RN's to perform this task to reinforce 'treatment' • Partnered with lab to use peripheral blood draws • Met with Hospital Administration and Infection Prevention Specialists to confirm plans • Algorithm developed to assist staff in deciding when to use a central line/access a port • Streamlined audit process

Results • Patients and staff embraced the changes • Hospital wide Lakeside has gone over 90 days without a CLABSI, and over 200 days without a CAUTI. • Oncology is below the NDNQI national CLABSI mean for the first time in 2 years

Lessons Learned • • Staff buy in is essential Explain the 'why' to staff and patients Education is the key to prevention Vigilance is necessary