A Process Improvement Approach to the Elimination of Central Line Associated Bloodstream Infections Donna Matocha  BSN, RN...
Financial Disclosures <ul><li>No financial disclosures to report </li></ul>
Background <ul><li>The Institute for Healthcare Improvement’s Central Line Bundle was implemented in our intensive care un...
Practice Audit Outcomes <ul><li>Inconsistent practice was noted </li></ul><ul><li>Dressing labels were absent </li></ul><u...
Action Items <ul><li>Literature review </li></ul><ul><li>Policies and protocols revised </li></ul><ul><li>Product assessme...
Changes Implemented <ul><li>Aseptic technique training initiated </li></ul><ul><li>Layered kits were designed with improve...
Results <ul><li>Central line associated infections per 1000 catheter line days: </li></ul><ul><li>July 2007-June 2008:  1....
Conclusions <ul><li>Practice protocols must be followed at all times </li></ul><ul><li>Layered kit design increases asepti...
Implications <ul><li>Collaboration & Commitment are important </li></ul><ul><li>Improve Outcomes </li></ul><ul><li>Reduce ...
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AVA 25th Annual Scientific Meeting, October 3 – 6, 2011

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AVA 25th Annual Scientific Meeting, October 3 – 6, 2011

  1. 1. A Process Improvement Approach to the Elimination of Central Line Associated Bloodstream Infections Donna Matocha BSN, RN, CNRN Rush-Copley Medical Center Aurora, Illinois
  2. 2. Financial Disclosures <ul><li>No financial disclosures to report </li></ul>
  3. 3. Background <ul><li>The Institute for Healthcare Improvement’s Central Line Bundle was implemented in our intensive care unit at Rush-Copley Medical Center </li></ul><ul><li>Goal of zero not obtained </li></ul><ul><li>Quality collaborative established in 2008 </li></ul><ul><li>IV Therapy Coordinator/Nurse Educator and Infection Control </li></ul>
  4. 4. Practice Audit Outcomes <ul><li>Inconsistent practice was noted </li></ul><ul><li>Dressing labels were absent </li></ul><ul><li>Multiple dressing changes were necessary due to poor dressing adhesive </li></ul><ul><li>CHG impregnated patch was placed upside down 75% of the time </li></ul><ul><li>Improper training for negative pressure valve caused clotted lines </li></ul><ul><li>Breaks in aseptic technique identified </li></ul>
  5. 5. Action Items <ul><li>Literature review </li></ul><ul><li>Policies and protocols revised </li></ul><ul><li>Product assessment </li></ul><ul><li>Education with audits & reinforcement </li></ul><ul><li>Collaboration with Intervention Radiology, Shared Governance & Discharge Planning </li></ul>
  6. 6. Changes Implemented <ul><li>Aseptic technique training initiated </li></ul><ul><li>Layered kits were designed with improved transparent dressing. </li></ul><ul><li>3.15% Chlorhexidine gluconate/70% isopropyl alcohol solution implemented for skin prep and dressing changes (2009) </li></ul><ul><li>Chlorhexidine impregnated patch placed during line placement </li></ul><ul><li>Negative pressure ports re-established </li></ul>
  7. 7. Results <ul><li>Central line associated infections per 1000 catheter line days: </li></ul><ul><li>July 2007-June 2008: 1.27 infections </li></ul><ul><li>July 2008-June 2009: 0.51 infections </li></ul><ul><li>July 2009-June 2010: 0.45 infections </li></ul><ul><li>July 2010-June 2011: 0.00 (no infections) </li></ul>
  8. 8. Conclusions <ul><li>Practice protocols must be followed at all times </li></ul><ul><li>Layered kit design increases aseptic technique compliance </li></ul><ul><li>Efficacious products play an important part in getting to zero </li></ul><ul><li>Process changes can be important parts of the puzzle. </li></ul>
  9. 9. Implications <ul><li>Collaboration & Commitment are important </li></ul><ul><li>Improve Outcomes </li></ul><ul><li>Reduce Costs </li></ul><ul><li>Achieve Zero Central Line Associated Bloodstream Infections </li></ul>

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