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CLAB In The Mainland

CLAB In The Mainland. Overview. Christchurch ICU Where were we? Where are we now? Where are we going?. The Challenge. South Island 56% New Zealand 23% population 5 DHBs Culture Christchurch Single ICU All subspecialties except paeds cardiac and burns Population 550,000.

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CLAB In The Mainland

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  1. CLAB In The Mainland

  2. Overview • Christchurch ICU • Where were we? • Where are we now? • Where are we going?

  3. The Challenge • South Island • 56% New Zealand • 23% population • 5 DHBs • Culture • Christchurch • Single ICU • All subspecialties except paeds cardiac and burns • Population 550,000

  4. Christchurch ICU • Size of unit • Staffed 16 ICU bed equivalents • 120 nurses, 8 SMO and 18 registrars • 2.9 beds/100,000 (4.8 NZ average) • Interventions • 65% ventilation rate • Mean length of stay 3.5 days • Outcomes • Mortality 12% • Low SMR

  5. CLAB Consideration • History • Insertion process established 2009 • Patients • 1250 admissions PA (70% CVC) • 350 cardiac patients • 120 LTM patients • Process • Antibiotic impregnated lines for high risk • PICC service for LTM lines • Observation • Average 300 line days per month

  6. Quality Healthcare in Christchurch

  7. Historic Chch CLAB Data

  8. CLAB Results • Structure • Team – Dr, nurses, educator, data, IPC + guest • Regular meetings • Goals • Simple -Awareness/Education • Process • Compliance – insertion/maintenance/cultures • Alliance and complement DHB processes • Robust data

  9. Outcome • CLAB rate 0/1000 line days • 352 CLAB free days • 10 CLAB avoided • 1-5 lives saved • Up to $500,000 saved • Endorsement CEO • Role out to NICU

  10. Problems • Education • Data burden • E-database • Global IT issues • Compliance • Insertion – 80-100% (10/week) • Maintenance- 60-70% (150 episodes/week) • Blood culture- recent reduction in compliance

  11. Key Success • CLAB rate • QI profile • MDT

  12. Future • Maintain high profile • Formalise competencies • Compliance improvement • Blood culture simplicity • Sustainability beyond April 2013

  13. Key Objectives • Reduce the rate of CLAB in New Zealand ICUs towards zero (<1 per 1000 line days by 31 March 2013) • Share evidence based practices and provide leadership, coordination and data management that will lead to sustainable improvement and better patient safety outcomes • Establish a robust national measurement approach for CLAB • Spread the methodology to at least one other area

  14. The Region

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