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Houston Medical Center Tomeko Fuller, RN, BSN Clinical Resource Manager.

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Presentation on theme: "Houston Medical Center Tomeko Fuller, RN, BSN Clinical Resource Manager."— Presentation transcript:

1 Houston Medical Center Tomeko Fuller, RN, BSN Clinical Resource Manager

2  Goals  Objectives  History  Problem  Methodology  Implementation  New Process  Outcome

3  Ultimate Goal - Zero Central Line Blood Stream Infections  Goal for 2012 – To have 25% reduction in Blood Stream Infections at Houston Medical Center.

4  To create a cost effective process to reduce Blood stream infections utilizing resources available with our Central Line Dressing changes.

5  During rounds it was noted that Central Line dressings were not being changed per our policy. Some dressing were not changed correctly or in the time frame set.  No accountability for who was responsible for the dressing change. Day or Nightshift nurse  No consistency  Recommendation was made to decrease the number of staff members responsible for dressing changes.

6  A new process was discussed with the Infection Prevention & Control Manager, Director of Nursing and IV Therapy Manager to utilize IV Therapy nurses.  Implementing a cost-effective process.  A process focused on ensuring efficient use of time by all staff.

7  Discussed process with the Med/Surg, ICU and IV Therapy Nurse Managers and Clinical Coordinators in a meeting.  Arranged a Trial Period June 6 -27, 2012.  Discussed With IV therapy nurses the process and expectations.  Educated IV Therapy nurses on the documentation in Meditech.  Contacted IT department to give nurse permission to access patient information.  Arranged for supply availability to complete dressing changes  Definined a way to accurately capture supply charges.

8  ROUTINE central line dressings will be changed on WEDNESDAY by IVT nurse.  The ANM or charge nurse for each Med/Surg area will FAX a list of the patients that have a central line to IV Therapy on Tuesday evening or early (before 0800) Wednesday morning.  Supplies for the dressing change will be brought from IV Therapy and restocked on the Nursing unit.  PICC = PICC dressing tray, biopatch, 1 end cap for each lumen, saline flush  Central line = Central line dressing tray, 1 end cap for each lumen, saline flush  Port= Huber needle, Central line dressing tray, 1 end cap, saline flush  IVT nurse will change the dressing, communicate with the primary nurse and/or charge nurse and document the procedure in the patient’s record.  The IVT Manager will keep the Med/Surg Managers and Infection Prevention & Control Manager informed of findings each week during the trial

9  June 6, 2012  A total of 13 dressings changed  2 Main= 5 (2 PICC, 1 IJ, 1 femoral line, 1 Port)  3 Main = 3 (2 ports, 1 PICC)  4 Main = 1(sutured PICC)  2 N= 2(1 PICC and 1 IJ)  5 NW= 2(1 port, 1 PICC)  The IVT nurses reported that it went very well, all the staff was appreciative and helped with making sure supply charges were completed appropriately.  Remember…IVT will bring supplies to the room with them and restock from your supply room. This insures that the patient gets charged appropriately and that no supplies are wasted.  June 13, 2012  Total of 9 dressings changed  2 Main = 4 (1 port, 3 PICCs)  3 Main = 3 (1 port, 1 PICC and 1 Central line-double lumen)  4 M= 0  2 N= 0  5NW= 2 (2 PICCs)  No problems reported.  Remember we will restock from YOUR supplies

10  June 20, 2012  Total of 21 dressings changed  2 Main = 8 (1Trauma cath, 7 PICCs)  3 Main = 7 (2 ports, 5 PICCs)  4 M= 2(1 port, 1 PICC)  2 N= 1 (port)  5NW= 3 (2 PICCs, 1 port)  No problems reported.  June 27, 2012  Total of 14 dressings changed  2 Main = 7 (1 triple lumen central line, 3 PICCs, 3ports)  3 Main = 2 (1 port, 1 PICC)  4 M= 0  2 N= 2 (1port, 1 PICC)  5NW= 3 (2 PICCs, 1 port)  No problem reported

11  Per our Infection Prevention & Control Department we have NOT had any reportable Central Line Blood Stream Infections since July 1, 2012

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13 Baseline CLABSI data: 47% Reduction House wide; 50% Reduction ICU 2008-2011  2008: 15 cases house wide, 6 ICU cases  2009: 13 cases house wide, 3 ICU cases  2010: 10 cases house wide, 2 ICU cases  2011: 8 cases house wide, 3 ICU cases  2012: (YTD) 5 cases house wide, 1 ICU case

14 Team Members  Melinda Hartley, DNP, RN, NE-BC, VP Patient Care Services/CNO  Laura Gentry, RN, BSN, Director of Nursing  Tomeko Fuller, RN, BSN, Clinical Resource Manager  Barbara Adkins, RN, Nurse Manager Cardiac/ Telemetry Services  Tim Bennett Infection Prevention & Control Manager  Karen Bowen Infection Prevention & Control Assistant Team Members


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