CAUTI / CLABSI NURSING EDUCATION I-APIC 123 March 25, 2015 Presenters: Carolyn Leader, RN, BSN, CIC and Anita Brewer, MT(ASCP) CIC

Why the Need For Education Practice drift across our organization involving multiple disciplines; Physicians, RNs, CNAs, Laboratory EMR complex for both physicians and nursing Rates higher than our goal

Educational Goals Develop criteria for catheter usage Improve catheter insertion technique Improve catheter care and maintenance Improve specimen collection technique Improve timely catheter removal Improve central and peripheral IV line care and maintenance

Preparation and Planning Two work groups formed Nursing, Infection Prevention, Education Group Goals: Restore and review best practice Develop mandatory education plan for all RNs and CNAs Projected 700 colleagues would attend Discuss culturing process with laboratory Physician Group Hospitalist champions, Infectious Disease physician, Infection Prevention Specialists. Education for physicians Heighten awareness of indications for urine cultures Develop algorithm for physician guidance on culturing

Preparation and Planning – cont. Saint Alphonsus Foundation Opportunity Grant Secured grant for manikins and supplies for hands-on practice Nursing Leadership Support SBAR created to summarize need for hands-on education Approval granted for 2 hours mandatory nursing education for all SARMC RNs and Support Associates [CNAs]

Outline of two hour Education Collaboration with Nursing Education, ED and Nursing Council Introduction with discussion about culture of safety for our patients that includes reduction of suffering: “to do no harm” SARMC patient stories highlighting issues we identified with CAUTI and CLABSI care presented by by Senior Leadership

Outline of two hour Education cont. Four stations – 20 minutes each station Insertion / discontinuation of Foley catheters on male and female manikins using return demonstration Maintenance of Foley catheters Educated to best practice for urine specimen collection: Foley’s and clean catch CLABSI – Central and peripheral line care and maintenance including introduction of alcohol impregnated caps Learning assessed and summarized with Jeopardy game

Ongoing Monthly Audits Monitor CLABSI /CAUTI Data Foley bundle elements by RN unit champions Alcohol impregnated cap usage by RN unit champions Monitor CLABSI /CAUTI Data Hands-on demonstration for new nursing colleagues using manikins and return demonstration Annual e-learning Collaboration with our parent company to improve our EMR documentation

Lessons Learned Surgery did not fall under Nursing Leadership Necessitated special educational arrangements No formal plan for nursing staff who did not attend mandatory training Communication had to be brief and concise since we had so many points we wanted to discuss.

Remember: CAUTI is naughty!! QUESTIONS?? Remember: CAUTI is naughty!!