1. Texas Regional Template: CLABSI Workgroup Organization: Texas Children’s Hospital

2. The Texas Regional Hospitals
Baylor Scott & White McLane Children’s Medical Center
Children’s Health, Children’s Medical Center
Children’s Memorial Hermann Hospital
Cook Children’s Medical Center
Covenant Children’s
Dell Children’s Medical Center of Central Texas
Driscoll Children’s Hospital
Medical City Children’s Hospital
Texas Children’s Hospital (Houston)
The Children’s Hospital of San Antonio

3. Insertion Bundle Elements
Hand Hygiene prior to insertion
Individuals actively participating wear mask, cap, sterile gown and gloves
Patient covered with head to toe drape
Sterile dressing applied after insertion
CHG prep unless contraindicated
Checklist completed by observer in real time

4. Maintenance Bundle Elements
Line necessity
Dressing clean, dry and intact
Dressing labeled and dated
Hand hygiene with all line entries
Clean gloves with all entries
15/15 scrub with all entries
15/15 scrub with each disconnection
Tubing labeled with date hung and day to change
Appropriate process followed for tubing and dressing change

5. CLABSI Data Collection Methods
Insertion – Collected by direct observation
Maintenance
Collected by direct observation
Collected Central Line Resource Nurse
450 observations /month

7. Improvement StrategiesCL
Resource RN
Operational Leadership
Central Line Champions
CLABSI HAC Team
System Education

8. Improvement Strategies
Educated over 2300 RN’s
Precursor to inception of CL champion program
Didactic instruction
Skills validation and check-off stations
Module and video technology as adjunct teaching tools
Policies and procedures review and revisions
Increased staff engagement, awareness, and comfort level

9. Improvement Strategies
Over 200 central line champions across the system
Serves as department level subject matter experts
Performs monthly direct observations
Assists in patient and staff educational efforts
Partners with UEC’s to validate and check-off skills
Attends monthly meetings
Serves as s succession planning strategy for the CLRN role

10. Improvement Strategies
Implemented in critical areas (NICU, HemeOnc, and BMT)
Dedicated unit resource
Performs high risk technical skills (declotting agents, pull lines)
Assists with central line maintenance tasks (cap changes, etc.)
Provides and develop comprehensive patient education
Assists with staff education and skills validation efforts
Serves as the catheter maintenance subject matter expert
Assists with policies and procedures revisions and review
Partners with CS and UEC’s with product selection and trials

11. CLABSI Rate

12. CLABSI Best Practice Recommendations
Consider conducting “hands on” skills validation
Observation, observation, observation
Ensure standardization of practice
Consider central line resource nurse role as a unit based subject matter expert

13. CLABSI Requests for Assistance
Elaine Whaley Director Quality & Safety
Katie Basta Assistant Director Quality & Safety

14. Questions?