Prevention of Health Care Associated Infections Yvonne Jackson, BSN, RN, CCRN Nursing-sensitive indicators Catheter associated urinary tract infection (CAUTI) Central line associated blood stream infection (CLABSI) Hospital National Patient Safety Goals Prevent infection The Joint Commission (TJC), 2009

CAUTI- Overview Use of catheters Practice recommendations and guidelines Performance initiatives Nursing and catheter usage Conway, & Larson, 2012 Drekonja, Kuskowski, & Johnson, 2010 Patrizzi, Fasmacjt, & Manno 2009

CAUTI- Information and Data Catheter related infections Strategies to reduce infections Research needed Bruminhent, Keegan, Lakhani, Roberts, & Passalacqua, 2010 Conway, & Larson, 2012 Drekonja, Kuskowski, & Johnson, 2010

CLABSI- Overview Use of central lines Sources of infection Centers for Disease Control and Prevention (CDC) recommendations Nurses positioned to influence reduction in CLABSIs Dumont, & Nesselrodt, 2012 Stone, et al., 2014

CLABSI- Information and Data Mortality Cost Results Dumont, & Nesselrodt, 2012 Guerin, Wagner, Rains, & Bessesen, 2010 Marra, et al., 2010 Wright, et al., 2013

Prevent Infection- Overview Cultural change to one of patient safety Interventions Bundles of care (Dumont, & Nesselrodt, 2012). Braun, et al., 2013 Dumont, & Nesselrodt, 2012 Ehrenkranz, Macintyre, Hebert, Schneider & Hennekens, 2010 Stone, et al., 2014 The Joint Commission, 2015 Vandijck, Cleemput, Hellings, & Vogelaers, 2013

Prevent Infection- Data Hospital acquired infection (HAI) Costs Financial Human Ehrenkranz , et al., 2010 Fakih, Heavens, Ratcliffe, & Hendrich, 2013 Vandijck, Cleemput, Hellings, & Vogelaers, 2013

References Braun, B., Harris, A., D., Richards, C., L., Belton, B., M., Dembry, L., M., Morton, D., J., & Xiao, Y. (2013). Does health care role and experience influence perception of safety culture related to preventing infections? American Journal of Infection Control, 41(7), 638-641. doi: 10.1016/j.ajic.2012.09.006 Bruminhent, J., Keegan, M., Lakhani, A., Roberts, I., & Passalacqua, J. (2010). Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections in a community teaching hospital. American Journal of Infection Control, 38(9), 689-693. doi: 10.1016/j.ajic.20100.05.028 Conway, L., J., & Larson, E., L. (2012). Guidelines to prevent catheter-associated urinary tract infection: 1980 to 2010. Heart & Lung, 41(3), 271-283. Doi: 10.1016/j.hrtlng.2011.08.001 Drekonja, D., M., Kuskowski, M., A., & Johnson, J., R. (2010). Internet survey of foley catheter practices and knowledge among Minnesota nurses. American Journal of Infection Control, 38(1), 31-37. doi: 10.1016/j.ajic.2009.05.005 Dumont, C., & Nesselrodt, D. (2012). Preventing central line-associated bloodstream infections CLABSI. Nursing, 42(6), 41-46. doi: 10.1097/01.NURSE.0000414623.31647.f5 Ehrenkranz, N., J., Macintyre, A., T., Hebert, P., R., Schneider, w., R., & Hennekens, C., H. (2010). Control of health care-associated infections (HAI): Winning both the battles and the war. Journal General Internal Medicine, 26(3), 340-342. doi: 10.1007/s11606-010-1521-8 Fakih, M., G., Heavens, M., Ratcliffe, C., J., & Hendrich, A. (2013). First step to reducing infection risk as a system: Evaluation of infection prevention processes for 71 hospitals. American Journal of Infection Control, 41(11), 950-954. doi: 10.1016/j.ajic.2013.04.019

References Guerin, K., Wagner, J., Rains, K., & Bessesen, M. (2010). Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle. American Journal of Infection Control, 38(6), 430-433. doi: 10.1016/j.ajic.2010.03.007 Marra, A., R., Cal, R., G., C., Durao, M., S., Correa, L., Reis, Guastelli, L., R., Moura, D., F., Edmond, M., B., & Pavao dos Santos, O., F. (2010). Impact of a program to prevent central line-associated bloodstream infections in the zero tolerance era. American Journal of Infection Control, 38(6), 434-439. doi: 10.1016/j.ajic.2009.11.012 Patrizzi, K., Fasnacht, A., & Manno, M. (2009). A collaborative, nurse-driven initiative to reduce hospital-acquired urinary tract infections. Journal of Emergency Nursing, 35(6), 536-539. doi: 10.1016/j.jen.2009.04.017 Stone, P,. W., Pogorqelska-Maziarz, M., Herzig, C., T., A., Weiner, L., M., Furuya, Y., Dick, A., & Larson, E. (2014). State of infection prevention in US hospitals enrolled in the national health and safety network. American Journal of Infection Control, 42(2), 94-99. doi: 10.1016/j.ajic.2013.10.003 The Joint Commission (TJC). (2009). Implementation guide for the NQF endorsed nursing-sensitive care measure set. Retrieved from http://www.jointcommission.org/assets/1/6/NSC%20Manual.pdf The Joint Commission. (2015). Hospital national patient safety goals. Retrieved from http://www.jointcommission.org/assets/1/6/2015_HAP_NPSG_ER.pdf Vandijck, D., Cleemput, I., Hellings, J., & Vogelaers, D. (2013). Infection prevention and control strategies in the era of limited resources and quality improvement: A perspective paper. Australian Critical Care, 26(4), 154-157. doi: 10.1016/j.aucc.2013.07.005 Wright, M., O., Tropp, J., Schora, D., M., Dillon-Grant, M., Peterson, K., Boehm, S., Robicsek, A., & Peterson, L., R. (2013). Continuous passive disinfection of catheter hubs prevents contamination and bloodstream infection. American Journal of Infection Control, 41(1), 33-38. doi: 10.1016/j.ajic.2012.05.030