Presentation on theme: "Central Line Blood Stream Infections"— Presentation transcript:
1 Central Line Blood Stream Infections Houston Medical CenterTomeko Fuller, RN, BSNClinical Resource Manager
2 Points of Discussion Goals Objectives History Problem Methodology ImplementationNew ProcessOutcome
3 Goals Ultimate Goal - Zero Central Line Blood Stream Infections Goal for 2012 – To have 25% reduction in Blood Stream Infections at Houston Medical Center.
4 ObjectivesTo create a cost effective process to reduce Blood stream infections utilizing resources available with our Central Line Dressing changes.
5 ProblemDuring 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 nurseNo consistencyRecommendation was made to decrease the number of staff members responsible for dressing changes.
6 MethodologyA 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 ImplementationDiscussed 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 changesDefinined a way to accurately capture supply charges.
8 New ProcessROUTINE 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 flushCentral line = Central line dressing tray, 1 end cap for each lumen, saline flushPort= Huber needle, Central line dressing tray, 1 end cap, saline flushIVT 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 Trial Phase 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, 2012Total of 9 dressings changed2 Main = 4 (1 port, 3 PICCs)3 Main = 3 (1 port, 1 PICC and 1 Central line-double lumen)4 M= 02 N= 05NW= 2 (2 PICCs)No problems reported.Remember we will restock from YOUR supplies
10 Trial Phase 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, 2012Total of 14 dressings changed2 Main = 7 (1 triple lumen central line, 3 PICCs, 3ports)3 Main = 2 (1 port, 1 PICC)4 M= 02 N= 2 (1port, 1 PICC)5NW= 3 (2 PICCs, 1 port)No problem reported
11 OutcomesPer our Infection Prevention & Control Department we have NOT had any reportable Central Line Blood Stream Infections since July 1, 2012