Central Line Bloodstream Infection Reduction CHI Health Lakeside Omaha, Nebraska

Process of Identifying Need A dramatic increase in CLABSI's was evident Where was the problem? Audits performed CLABSI Taskforce formed  Literature reviewed Point prevalence studies conducted 

Process Improvement Methods Staff RN's (Clinical Practice Coordinator, 3 Nursing Supervisors, Infection Prevention specialist, Operations Director, Emergency Department educator) formed CLABSI taskforce  Employed 'Safety First' expectations of  Having a questioning attitude Paying attention to detail  Stopping and Resolving  Audits performed every shift, became very detail oriented 2 RN central line visualization upon patient arrival/transfer to unit   Education and communication with Radiology and ER to ensure patients received same message 

Process Improvements Cont.. Educational pamphlet developed for patients explaining CLABSI and when to access central lines. Changed process of central line use to 'asking to access'.  Educated staff via mandatory skills day. Staff was required to return demonstrate proper technique Implemented 'phone buddies' Changed verbiage of CHG bathing to 'treatments', mandated RN's to perform this task to reinforce 'treatment'  Partnered with lab to use peripheral blood draws Met with Hospital Administration and Infection Prevention Specialists to confirm plans  Algorithm developed to assist staff in deciding when to use a central line/access a port  Streamlined audit process 

Results Patients and staff embraced the changes Hospital wide Lakeside has gone over 90 days without a CLABSI, and over 200 days without a CAUTI.  Oncology is below the NDNQI national CLABSI mean for the first time in 2 years

Lessons Learned Staff buy in is essential Explain the 'why' to staff and patients  Education is the key to prevention  Vigilance is necessary