Ashley Dobuzinsky, BSN, RN, CCRN Lynn Orser, MSN, RN, CCRN, PCCN St. Vincent’s Medical Center

Discuss:  Development of the ICU Exit Checklist  Implementation process  Outcomes

 To address increasing incidence of HAI among hospitalized patients through the utilization of an ICU Exit checklist  To decrease utilization of central venous catheters (CVC) and indwelling catheters  Improve communication among the healthcare team

 Setting  30-bed mixed surgical/medical ICU, inclusive of 6 bed PCU  Closed unit-Intensivist led model  Pre-implementation data  Collected over a 30-day period from August September 2012 on patients transfers from the ICU/PCU. Monitoring for the presence of CVC or indwelling catheters at time of transfer.

 Of the 84 patients tracked, 23 patients (27%) were transferred with a CVC in place  42 patients (50%) were transferred with an indwelling catheter in place

 Engaging the multidisciplinary team  Expanding goals of checklist to include:  Narrowing antibiotic coverage  Evaluation of proton pump inhibitor therapy for discontinuation  Notification of accepting physician at time of transfer  Staff education

 ICU Indwelling Catheter Utilization  37% reduction in utilization from Sept 2012-Nov 2013  No ICU CAUTIs Aug 2013-Oct 2013  ICU CVC  14.5% reduction in patient transfers with CVC in place  One reported CLABSI over 12 month period

 ICU process improvement project  Primary goal to decrease HAI by reducing the utilization of CVC and indwelling catheters  Involved a multidisciplinary team approach  Observations included overall decline in utilization of CVC and indwelling catheters