5700 EBP PROJECT: Cross-Contamination on high touch surface areas INCREASING CONSISTENCY OF EQUIPMENT CLEANING BETWEEN PATIENTS IN THE PEDIATRIC ICU Team Members: E. Kast RN,BSN,CNPT,CCRN M. Galindo RN,BSN C. Dwyer RN,bsn S. Elhazin Cna M. Wilson MS,NP,CNS,CCRn-k P. Radovich PHd,CNS,FCCM

PROJECT PURPOSE 1. To increase consistency in unit room equipment cleaning. 2. To increase nursing staff knowledge of required equipment cleaning.

WHY DO IT? It was identified that there was confusion about who (housekeeper or RN) cleans what when we transfer/DC patients. Housekeeper: Cleans most of the room except medical equipment. RN: IV poles, pumps, monitor, cables, computers. What about thermometers, suction dials, End CO2 monitors???

PROJECT START Initial meeting with Dr. Radovich and Michele Wilson, 5700 CNS. Team members and monthly meetings selected. Used an evidence-based practice (EBP) approach by using Johns Hopkins EBP methodology (Dearhold & Dang, 2012). - Translational Science EBP team protocol and development of PICO question - Literature Review - Identification of tools and methods for a nurse-driven protocol - Assessment, Education, and Intervention Bundles with measured outcomes.

ASSESSMENT SURVEY https://www.surveymonkey.com/results/SM-PXKZCJPP/

INTERVENTION BUNDLE A cleaning checklist was created for staff to fill out once room was cleaned. Kept at the secretary’s desk to pass out with every transfer. Staff was educated using a power point presentation, hands-on at staff meetings, a video, and email. Audits were done by team members (also educated on how to mark and read results in a consistent manner)

PROJECT FINDINGS Several room items were marked (Ultraviolet marker) and tested after transfers. The majority of room items were NOT cleaned, if the attempt was made, it was smeared

SET A NEW ROUTINE Wipe the room items that housekeeping does not clean after EVERY transfer. Wipe the room nursing area and items before every shift, between use, and every discharge. Refer to LLUMC Policy G-36

Post Discharge/Transfer Cleaning Checklist Room number: Completed by: Date of Completion: Items to be Cleaned: *Mark with an X or N/A if indicated for each row* If item not cleaned, comment why?   Items Tested Cleaned Cardiac monitor frame Cardiac monitor boxes Cardiac monitor cables/end connectors Cardiac monitor alarm remote Rolling computer frame Rolling computer top Rolling computer keyboard Rolling computer lever Rolling computer scanner Rolling computer mouse and mouse pad End tidal monitor dial End tidal monitor frame Thermometer body Thermometer cord Thermometer charging station Room white board frame Suction wall mounts/dial IV pumps/station IV pole Stentofon Intercom Telephone Nurse Server DISCARD: Oxygen connector (Christmas tree)  Other equipment (please list):

RESULTS

RESULTS Initial hesitation with limited time. Follow up audits showed a marked improvement from only 23% of items cleaned before education to 81% of items cleaned after education! EBP abstract submitted to the American Association of Critical Care Nurses, accepted to display poster at the National Teaching Institute in Boston, 2018. Audits still happening in the unit, 88% compliance.

THANK YOU!