ELLIS MEDICINE CLABSI REDUCTION IN THE ICU Eve Bankert, MT Director of Infection Prevention Kathleen Aidala, RN CCRN ICU Nursing Quality & Education Specialist

11 Background Sustained high CLABSI rates: Approx 50% of ICU patients have CVCs Hospital wide focus on “Culture of Safety” Identified opportunities for improvement Targeted initiatives vs. looking at discrete events Ownership of problem and process Need for a multidisciplinary approach Need for standardization

Initiatives CLABSI Task Force Dressing Change Observations ICU Unit Based Council ICU Huddles RN/IP Collaborative Rounds Curos CHG Bathing New Hand Hygiene Campaign 2

CLABSI TASK FORCE Created in 2007 CLABSI case reviews New product review IV team report 2013 transitioned to IP Task Force

ICU UNIT BASED COUNCIL Initiated in 2012 in response to increased infection rates Team leader is also ICU quality committee representative. Multidisciplinary team: ICU staff, NMs, physician, respiratory therapy, dietary & infection prevention. Meet once a month for an hour to review ICU infections Develop action plans to assist with decreasing infection rates

10 IV access ports have been associated with increased BSI rates Peel off hanging strip (hung on every IV pole) twist on over access port Physical barrier to contamination between line accesses. Inside green cap 70% isopropyl alcohol saturated sponge. Disinfects valve 3 minutes after application. Can be left on for up to 7 days if IV site not used

CHG BATHING 95% reduction in bacterial growth which decreased risk of hospital acquired infections. Although CHG can alter pH it is still maintained in the normal acidic range for skin flora. We still use basin for washing. Clean basin before and after use. Nothing is stored in wash basins.

HAND HYGIENE TASK FORCE Increase hand hygiene compliance Create a sense of accountability Engage key stakeholders/ departmental champions Embed hand hygiene in Ellis culture Identified as an organizational patient safety priority Multidisciplinary collaborative approach Education in what to say or do when someone is not in compliance

HIGH FIVE SAVES LIVES EDUCATIONAL MESSAGE HOW Give staff a friendly High Five as a reminder to do Hand Hygiene

ICU CLABSI RATES

Conclusions Culture of Safety must be our guiding force Collaborative efforts= favorable outcomes Sustainable practices a must for success Employ initiatives that align with nationally recognized standards Teamwork!