Presentation1

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Presentation1

  1. 1. What is a bundle? • A bundle is a structured way of improving processes of care and patient outcomes. • It is a small straightforward set of practices - generally three to five - that, when performed collectively, reliably and continuously, have been proven to improve patient outcomes.
  2. 2. Who can use the bundles? • Anyone in the clinical setting with the agreement of the clinical team and Quality Improvement Leads can use the bundles.
  3. 3. Impact of the 4 bundles Impact on patient Impact on leadership Impact on staff Impact on system Impact on statistics
  4. 4. CATHETER ASSOCIATED URINARY TRACT INFECTION(CAUTI)
  5. 5. Evidence-based Risk Factors for CAUTI
  6. 6. Pathogenesis of CAUTI • Source of microorganisms may be endogenous (meatal, rectal, or vaginal colonization) or exogenous, usually via contaminated hands of healthcare personnel during catheter insertion or manipulation of the collecting system
  7. 7. CAUTI PREVENTION BUNDLE Meatal hygiene Urine bag emptied Assess the need of catheterization
  8. 8. Surgical Site Infection (SSI)
  9. 9. Epidemiology: Important Modifiable Risk Factors • Antimicrobial prophylaxis Inappropriate choice (procedure specific) • Improper timing (pre-incision dose) • Inadequate dose based on body mass index, procedures >3h, or increased blood loss • Skin or site preparation ineffective Removal of hair with razors • Colorectal procedures Inadequate bowel prep/antibiotics • Improper intraoperative temperature regulation
  10. 10. Pathogenesis Pathogen Sources • Endogenous – Patient skin flora – mucous membranes – GI tract • Seeding from a distant focus of infection • Exogenous – Surgical Personnel (surgeon and team) Soiled attire – Breaks in aseptic technique – Inadequate hand hygiene • physical environment and ventilation • Tools, equipment, materials brought to the operative field
  11. 11. SSI PREVENTION BUNDLE Administration of antibiotic
  12. 12. CENTRAL VENOUS CATHETER ASSOCIATED BLOODSTREAM INFECTION
  13. 13. Modifiable Risk Factors
  14. 14. Pathogenesis More Common Mechanisms 1. Pathogen migration along external surface - more common early (< 7days) 2. Hub contamination with intraluminal colonization -more common >10 days Less Common Mechanisms 1. Hematogenous seeding from another source 2. Contaminated infusates
  15. 15. CENTRAL VENOUS CATHETER CARE BUNDLE
  16. 16. PERIPHERAL VENOUS CATHETER ASSOCIATED INFECTION
  17. 17. MODIFIABLE RISK FACTORS • Insertion circumstances • Skill of inserter • Insertion site • Skin antisepsis • Catheter lumens • Duration of catheter care • Barrier precautions
  18. 18. Pathogenesis: PVC infection More Common Mechanisms 1. Pathogen migration along external surface 2. Hub contamination with intraluminal colonization Less Common Mechanisms 1. Hematogenous seeding from another source 2. Contaminated infusates
  19. 19. PVC CARE BUNDLE Necessity of line
  20. 20. VENTILATOR ASSOCIATED PNEUMONIA
  21. 21. Risk factors of ventilator associated pneumonia
  22. 22. Pathogenesis • Colonization of respiratory and digestive tracts • Micro aspiration of secretions of the upper and the lower parts of the airway
  23. 23. Ventilator associated pneumonia care bundle asepsis
  24. 24. Thank you

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