Interventions Showcase

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Interventions Showcase
Member Successes in 100K Lives Initiatives

• quality safety trust

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Prevention of Central Line Infections

• FirstHealth Moore Regional Hospital
• Pinehurst, North Carolina
• Jayne Lee, BSN, MPH, CIC
• Administrative Director, Clinical Performance
• Project started January 2005

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Prevention of Central Line Infections

• Central Line Team Clinical Performance (Quality
  and Infection Control), Critical Care Staff,
  Physicians on the Critical Care Committee,
  Materials Management Staff
• Initial Goal Determine our current status on
  the central line bundle and implement changes as
  identified

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Prevention of Central Line Infections

• Did not collect Central Line Infections using the
  CDC NNIS definitions denominator
• Started collecting central line days for the
  denominator which also encouraged the staff to
  review the need for lines each day
• Collect bloodstream infections on central line
  patients in the critical care units review all
  positive blood cultures and review patient
  records
• Did not use operator maximal barrier precautions
  physicians were resistant to gown, masks, and
  head covers for central line insertion these
  barriers not readily available when ready to
  insert the lines

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Prevention of Central Line Infections

• Chlorhexidine Skin Antiseptic changed in all
  the catheter insertion and care kits
• Education required on the product
• 4. Hand Hygiene handwashing facilities and
  alcohol handrinse are readily available.
  Throughout the hospital patients and staff are
  reminded that hand hygiene is important each
  patient room has a sign at or near the door that
  states To help prevent the spread of germs,
  health care providers disinfect their hands after
  each contact with patient or patients
  environment.

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Prevention of Central Line Infections

• Implementation of this bundle is costly
• Chlorhexidine is more expensive than betadine
• Maximal Barrier precautions needed to be in the
  central line insertion tray extra cost of 20
  per tray
• New products are coming out on the market daily
• Materials Management Staff is vital to be
  involved in this team and initiative

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Prevention of Central Line Infections

• The cost savings is in Infection Prevention and
  Saving Lives
• Cost per bloodstream infection is estimated to be
  between 3,700 and 29,000
• Our current Infection Rate is at the CDC NNIS
  Benchmark of 3.2 infections/1000 central line
  days.
• Continuous improvement is needed - - -

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Prevention of Central Line Infections

• Target Hand Hygiene as it directly relates to
  central line care
• Add larger patient barrier and operator barriers
  to the insertion tray for central lines
• Implement checklist of steps to follow when
  inserting central lines
• Continue implementation of chlorhexidine
  including the OR

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Prevention of Central Line Infections

• Long Term Goal Prevent All Catheter Related
  Bloodstream Infections and thereby SAVE LIVES!