July Core Intervention Assignment (for the BSI QIA)

Slides:



Advertisements
Similar presentations
Catheter-Associated Bloodstream Infections
Advertisements

Intermountain ESRD – Network 15 Karen Strott, RN Linda Pleiman, RN !
TRAINING INFORMATION FOR QIA FACILITIES CDC can assist with PPM facility training!
The State of CKD, ESRD and Mortality in the First Year on Dialysis: Are We Doing Enough? Allan J. Collins, MD, FACP Professor of Medicine University of.
Strategies for Improving Adequacy Decreasing the Risk of Premature Death Educate Your Dialysis Team Review Proper Procedure for Drawing Lab Samples - Lab.
Hospital Acquired Infections & Quality Improvement Texas Rural Health Forum Conference, Austin, Texas November 10, 2010 Terri Conner, Vice President, TCQPS.
Collaborative to Reduce Healthcare Associated Infections
Venous Stenosis Associated with Tunneled Dialysis Catheter Placement and Exchange ASDIN Coding University 1.
Patient has a tunneled hemodialysis catheter in her left internal jugular vein and has had multiple episodes of catheter dysfunction due to formation of.
Prevention of Nosocomial Infections
Central Lines: All you ever wanted to know Allison Ballantine, MD Assistant Professor of Pediatrics Medical Director, Integrated Care Service Director.
The Dialysis Patient Access Kidney Transplantation Anne Lally, MD Surgical Director of Kidney Transplantation Hartford Hospital.
Hemodialysis Catheter Infection Reduction Kathleen Maloney, RN State University of New York Institute of Technology Department of Nursing Introduction.
Catheter Related Blood Stream Infection Presented by: Mrs. Lima Aboul Hosn Dubai Hospital- UAE.
Catheter Related Blood Stream Infection Presented by: Mrs. Lima Aboul Hosn Dubai Hospital- UAE.
Tunneled Catheter Removal & Exchange ASDIN Coding University 1.
July 2009 Feasibility and Efficacy of Optimal Peritoneal Dialysis Catheter Placement Using a Laparoscopic Technique Introduction or Purpose Peritoneal.
Epidemiology of Hospital Acquired Infections By Alena Bosconi, Candice Smith, Dusica Goralewski SUNY Delhi Biol , Infection and Disease Dr. Marsha.
Jean‑Jacques Parienti, M.D., Ph.D., Nicolas Mongardon, M.D.,
“ Change of Urinary Tract Infection Prevalence at a Skilled Nursing Care (SNF) Facility or Long Term Care Facility (LTCF): Lessons Learned Michael Liu.
 Central line-associated bloodstream infections (CLABSI) are a significant national problem resulting in morbidity and mortality.  According to the CDC.
IM R4 박미나 Management of infected Central venous catheters used for hemodialysis.
Antimicrobial Stewardship
Florida Hospital Association
Uncompromised Handling with Tri-layer Sealing Properties
MRSA Regina Livshits RN MSN NYU Langone Medical Center
George M. Foulard, William I. Douglas MD
Infectious complications of the hemodialysis access
F.H. Bender, J. Bernardini, B. Piraino  Kidney International 
Believed discrimination occurred because of their:
MRSA: Implications in Sports Medicine
Preventing Patient Falls
Implant Associated Infections & Sterilization Methods
Dr Asmaa fathy abdellah hassan
CIC Study Questions September 23, 2016.
Inpatient Quality Coding It’s Not Just About What you Get Paid
HAI August 30, 2017.
HAI January 24, 2018.
Pediatric Central Venous Catheters In Patients Less Than Two Years Of Age: Do Complication Rates Differ Between Tunneled IJ, Tunneled Femoral, and PICCs?
Core Interventions Rollout Part 2
Hi, My name is Paige Nielsen
Preventing Medication Errors and Omissions
Central Line Education: Focus on CLABSI 2009
90 Day Catheter Reduction
SIRS Systemic Inflammatory Response Syndrome
HAI Sept. 25, 2017.
Report Back Track 6: Population Health Track
Steve J. Schwab, Gerald Beathard  Kidney International 
Surgical treatment of hemodialysis-related central venous stenosis or occlusion: Another option to maintain vascular access  Javier Eduardo Ferrari Ayarragaray,
Vascular Access: Core Curriculum 2008
A. Simon, U. Bode, K. Beutel  Clinical Microbiology and Infection 
Meeting Objectives Build skills among care team members that will improve teamwork, communication, and create a patient safety culture in your unit Hear.
weeks since the CCU’s last central line BSI !!!!
Vascular Access: Core Curriculum 2008
MRSA=Methicillin resistant Staphylococcus aureus
Renal replacement therapy
Infectious complications of the hemodialysis access
F.H. Bender, J. Bernardini, B. Piraino  Kidney International 
Mortality, Hospitalization, and Technique Failure in Daily Home Hemodialysis and Matched Peritoneal Dialysis Patients: A Matched Cohort Study  Eric D.
National Center for Emerging and Zoonotic Infectious Diseases
Daniel L. Landry, DO, FASN  Advances in Chronic Kidney Disease 
Rise and subsequent decline of community-associated methicillin resistant Staphylococcus aureus ST30-IVc in Copenhagen, Denmark through an effective search.
Current Concepts in Hemodialysis Vascular Access Infections
weeks since the CCU’s last central line BSI !!!!
Volume 67, Issue 6, Pages (June 2005)
CIC Prep Questions Education and Research
Multidrug-Resistant Organisms Within the Dialysis Population: A Potentially Preventable Perfect Storm  David P. Calfee, MD, MS  American Journal of Kidney.
Volume 61, Issue 1, Pages (January 2002)
Management of Gram-Positive Coccal Bacteremia and Hemodialysis
Ivan D. Maya, Michael Allon  Kidney International 
Presentation transcript:

July Core Intervention Assignment (for the BSI QIA) #6 Catheter Reduction

6. Catheter Reduction Incorporate efforts (e.g., through patient education, vascular access coordinator) to reduce catheters by identifying and addressing barriers to permanent vascular access placement and catheter removal.

Catheter Facts In 2010, more than 380,000 patients in the United States relied on hemodialysis for treatment of their end-stage kidney disease. About 8 in 10 of these patients start treatment with a central line. CDC estimates 37,000 central line-associated bloodstream infections may have occurred in U.S. hemodialysis patients in 2008. A dialysis patient is more than 100 times more likely to get a bloodstream infection from a common resistant bacteria, methicillin-resistant Staphylococcus aureus, than other people. Source: CDC

Questions to Review How many patients have catheters in your facility? Does each catheter patient have an access placement plan? Have these access placement plans been followed through for each patient? Does any of the data need updating? Identify barriers for patients that have not or refuse to follow up for access placement evaluations. How many access infections has your facility had since January 2018? How many of those access infections were catheter related?

How to View Your Access Related Bloodstream Infections in NHSN

Tunneled Catheters Early recognition is important to prevent: Potential complications are: Early recognition is important to prevent: Malfunction due to mechanical causes like Poor placement technique Retraction with or without exposure of the cuff Cracked hub or broken clamps Thrombosis/Fibrin sheath formation Infection Exit site Tunnel infection Central vein stenosis Loss of the vascular site if the catheter falls out Inadequate dialysis clearance Bacteremia- and sepsis-related morbidity and mortality Source: Atlas of Dialysis Vascular Access | Tushar J. Vachharajani, MD, FASN, FACP

The next few slides depict common problems associated with tunneled catheters…

Fibrin Sheath Source: Atlas of Dialysis Vascular Access | Tushar J. Vachharajani, MD, FASN, FACP

Intraluminal Thrombus Source: Atlas of Dialysis Vascular Access | Tushar J. Vachharajani, MD, FASN, FACP

Exposed Cuff Source: Atlas of Dialysis Vascular Access | Tushar J. Vachharajani, MD, FASN, FACP

Tunnel Infection Source: Atlas of Dialysis Vascular Access | Tushar J. Vachharajani, MD, FASN, FACP

Suggestions to Reduce Catheters Dedicated, persistent team Vascular Access Manager Communication Education All Staff Patients