1. Never Declare Victory against CLABSI Patty Kampf BSN RN CRNI Valarie Goitiandia RN CCRN CRNI Susan Imhoff MSN RN Never Declare Victory against CLABSI Patty Kampf BSN RN CRNI Valarie Goitiandia RN CCRN CRNI Susan Imhoff MSN RN Abstract Objective Methods Results Using Organizational Values References Deshpande, K. S. (2003, July). Total parenteral nutrition and infections associated with use of central venous catheters [Guest Editorial]. American Journal Of Critical Care, 12(4), 326-327. Retrieved from ajcc.aacnjournals.org Halm, M., Hickson, T., Stein, D., Tanner, M., & VandeGraaf, S. (2011, July). Blood cultures and central catheters: Is the “easiest way” best practice? American Journal of Critical Care, 20(4), 335-338. http://dx.doi.org/10.4037/ajcc2011519 Health Care Improvement Foundation Delaware Valley Healthcare. (2006). Partnership for patient care: Failure mode and effects analysis central line catheter-related bloodstream infections: Insertion and maintenance practices. Retrieved from The Healthcare Improvement Foundation: http://www.hcifonline.org/ Holder, C., & Zellinger, M. (2012). Daily bathing with chlorhexidine in the icu to prevent central line-associated bloodstream infections. Critical Care Medicine, 40(11). Infusion nursing standards of practice [Supplemental material]. (2011, January/February). Journal of Infusion Nursing, 34(1S). Marsteller, J. A., Sexton, J. B., Hsu, Y., Hsiao, C., Holzmueller, C. G., Pronovost, P. J., & Thompson, D. A. (2012). A multicenter, phased, cluster-randomized controlled trial to reduce central line-associated bloodstream infections in intensive care units. Critical Care Medicine, 40(11), 1-7. http://dx.doi.org/10.1097/CCM.0b013e31825fd4d8 TargetBSI.com (Producer). (2011, May 31 and June 1). Show me the evidence - Should blood cultures be obtained through an intravascular catheter? [Webinar transcript]. Retrieved from http://TargetBSI.com/ Eliminate CLABSI at JFK Sustainable unit based ownership for CLABSI prevention Protect patients from harm associated with CLABSIs Avoid unnecessary hospital costs Improve the hospital’s position on Value Based Purchasing and Hospital Acquired Conditions Add Image Established an organizational Goal to eliminate CLABSIs house wide Evidence based practices Adapted practices locally Data driven assessments and action Simulation Peer Checking and Peer Coaching Comprehensive Unit Based Safety Program approach Blood Culture Draw Video Blood Culture Draw Video Sustained downward trend in CLABSI occurrences Sustained downward trend in CLABSI occurrences Decrease in CLABSIs house wide 2012 - 31 CLABSIs 2013 - 11 CLABSIs Decrease in critical care CLABSIs Cost avoidance from 2012 – 2013 Intervention and Reslts Gra Intervention and Reslts Gra Logo At JFK we say Never to Declare Victory against CLABSIs. We are exhibiting our highest level of skill to decrease CLABSI rates from insertion of appropriate line to discharge and beyond. Cost of care ($30,000 per occurrence) Mortality associated with CLABSI* (18%) Increase Length of Stay Public reporting impacts the hospital’s reputation Evidence based best practices Cost avoidance $690,000 (23 CLABSI) Public reporting (Consumer reports, NPR, Hospital Compare, Leapfrog) Business Best Patient and family education Promoting a welcoming environment while mentoring new RN’s and coaching staff at the bedside led to increased engagement, knowledge retention, and quality care. Human Touch Brainstorming led to innovative ways of improving quality of care Tool developed for assessing, measuring, and evaluating care and maintenance Being receptive to the staff nurses’ feedback led to advancing the delivery of care at JFK. Visionary Spirit While providing the knowledge and passion for central line nursing care the PICC Team was able to encourage “doing the right thing” for our patients Best Self This past year led to a 75% reduction of CLABSIs We are exhibiting our highest level of skill to decrease CLABSI rates from insertion of appropriate line to discharge At JFK we say Never to Declare Victory against CLABSIs. Perfect Performance

3. HTTPS://WWW.DROPBOX.COM/S/0Q0BDS6JKR7F5CI/BLOOD%20CULTURE%20VIDEO.MPG Blood Culture Draw Technique