A Quality Improvement Project to Decrease CLABSIs in Non-ICU Settings.
Background and Objectives: Central line–associated bloodstream infections (CLABSIs) are a common, preventable healthcare–associated infection. In our 3-hospital health system, CLABSI rates in non-intensive care unit (ICU) settings were above the internal target rate of zero. A robust quality improve...
| Publicado en: | Quality Management in Health Care Vol. 32; no. 3; pp. 189 - 197 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul-Sep2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164442279&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 164442279 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10638628 0O9 jtl: Quality Management in Health Care issn: 10638628 maglogo: N pubinfo: dt: Jul-Sep2023 vid: 32 iid: 3 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 164442279 164442279 164442279 10.1097/QMH.0000000000000375 164442279 ppf: 189 ppct: 8 formats: tig: atl: A Quality Improvement Project to Decrease CLABSIs in Non-ICU Settings. aug: au: Engel, Jill Meyer, Britt M. McNeil, Gloria Alston Hicks, Tammi Bhandari, Kalpana Hatch, Daniel Granger, Bradi B. Reynolds, Staci S. affil: Duke University Health System, Durham, North Carolina (Drs Engel and Granger) sug: subj: Quality Improvement Methods Infection Control Methods Catheter-Related Bloodstream Infections Prevention and Control Cross Infection Prevention and Control Intensive Care Units Human Descriptive Statistics Chlorhexidine Pretest-Posttest Design Infection Control Teaching Methods Health Personnel Education Leadership Medical Practice, Evidence-Based ab: Background and Objectives: Central line–associated bloodstream infections (CLABSIs) are a common, preventable healthcare–associated infection. In our 3-hospital health system, CLABSI rates in non-intensive care unit (ICU) settings were above the internal target rate of zero. A robust quality improvement (QI) project to reduce non-ICU CLABSIs was undertaken by a team of Doctor of Nursing Practice (DNP)-prepared nurse leaders enrolled in a post-DNP Quality Implementation Scholars program and 2 QI experts. Based on a review of the literature and local root cause analyses, the QI team implemented the evidence-based practice of using 2% chlorhexidine gluconate (CHG) cloths for daily bathing for non-ICU patients with a central line. Methods: A pre-post-design was used for this QI study. CHG bathing was implemented using multifaceted educational strategies that included an e-learning module, printed educational materials, educational outreach, engagement of unit-based CLABSI champions, and an electronic reminder in the electronic health record. Generalized linear mixed-effects models were used to assess the change in CLABSI rates before and after implementation of CHG bathing. CLABSI rates were also tracked using statistical process control (SPC) charts to monitor stability over time. CHG bathing documentation compliance was audited as a process measure. These audit data were provided to unit-based leadership (nurse managers and clinical team leaders) on a monthly basis. A Qualtrics survey was also disseminated to nursing leadership to evaluate their satisfaction with the CHG bathing implementation processes. Results: Thirty-four non-ICU settings participated in the QI study, including general medical/surgical units and specialty areas (oncology, neurosciences, cardiac, orthopedic, and pediatrics). While the change in CLABSI rates after the intervention was not statistically significant (b = −0.35, P =.15), there was a clinically significant CLABSI rate reduction of 22.8%. Monitoring the SPC charts demonstrated that CLABSI rates remained stable after the intervention at all 3 hospitals as well as the health system. CHG bathing documentation compliance increased system-wide from 77% (January 2020) to 94% (February 2021). Overall, nurse leaders were satisfied with the CHG bathing implementation process. Conclusions: To sustain this practice change in non-ICU settings, booster sessions will be completed at least on an annual basis. This study provides further support for using CHG cloths for daily patient bathing in the non-ICU setting. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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