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HAI Project- CAUTI

HAI Project- CAUTI. Thank you for joining OFMQ and other stakeholders in the state in efforts to reduce Healthcare Associated Infections. By the end of today’s conference, attendees will be able to : . Discuss the goals of the HAI project Describe the methods that will be used in the projects

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HAI Project- CAUTI

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  1. HAI Project- CAUTI

  2. Thank you for joining OFMQ and other stakeholders in the state in efforts to reduce Healthcare Associated Infections.

  3. By the end of today’s conference, attendees will be able to: • Discuss the goals of the HAI project • Describe the methods that will be used in the projects • Identify stakeholders in work to improve health care in Oklahoma • Recall appropriate use of indwelling urinary catheters and how to use guidelines

  4. Goals of OFMQ- HAI Project • Reduce preventable harm to patients • Reduce inappropriate use of urinary catheters • Reduce infections related to use of urinary catheters • Reduce hospital acquired CDI • Increase antibiotic stewardship in hospitals • Reduce Surgical Site Infections

  5. Oklahoma Partners • Oklahoma Hospital Association LaWanna Halstead • Oklahoma State Dept of Health • Vonnie Meritt • Volunteer Hospitals of America OK/Arkansas Donna McNutt

  6. Using the WebEx tools • We want your questions • to the whole group or • just to the presenters- • Polling throughout the presentation with real time feedback • you may ask a question or make a comment at any time

  7. Reducing Healthcare Associated Infections • Interactive work • All teach, all learn format • WebEx functions

  8. Readiness • How many staffed beds are in your hospital? • CAH or 25-50 • 51-100 • 101-200 • 201-300 • More than 300 • In what Unit do you plan to do the CAUTI Project? • ICU-Medical • ICU-Other _______ • Non-ICU-Medical • Other: ________ • Is Clinical staff from the unit present today? • _____ YES • _____ NO • 4. Do you know the Unit’s catheter-associated Urinary tract infection rates? • _____ YES • _____ NO

  9. Readiness-Continued • 5. Do you have a protocol in place for Nurse-initiated Discontinuance of Urinary Indwelling Catheter? • _____ YES • _____ NO • 6. What is the average nurse-to-patient ratio on this unit? • Don’t know • 1:1—1:2 • 1:3--- 1:4 • 1:5—1:6 • 1:7 or greater _____ • 7. Are catheter-associated urinary tract infection rates regularly reported to hospital senior executives? • _____ YES • _____ NO • 8. What is your top reason for joining the Learning and Action Network? _________

  10. Readiness Continued • Is someone at your facility a member of Association of Preventionists in Infection Control (APIC)? • 10. What is the major barrier to reducing CAUTI or reducing the use of catheters in your hospital? • 11. What is the major barrier to reporting CAUTI to NHSN?

  11. Aligned with National Priorities OFMQ improvement initiatives support the: • National Quality Strategy • Safer care • Coordinated care • Person- and family-centered care • Preventive care • Community health • Making care more affordable

  12. Aligned with National Priorities • Partnership for Patients • The OFMQ initiative supports your commitment • Keep patients from getting injured or sicker • Help patients heal without complication • Improving Care Transitions

  13. Join the Partnership for Patients • The Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly. • http://www.healthcare.gov/compare/partnership-for-patients/join/index.html

  14. Hospital Commitment • Make achieving the goals of harm reduction and improved care transitions to reduce readmissions a priority of Board of Directors, senior leaders, clinicians, and staff;  • Support clinicians and staff working for and with us and engage patients and families in order to make care safer, improve communication, and increase coordination by implementing proven systems and processes; and • Learn from and share with others our experiences with making care safer and more coordinated

  15. Reduce Health Care-Associated Infections (HAIs) and Healthcare-Acquired Conditions by 40 % • CLABSI, CAUTI, C. difficile, SSIs --- utilizing • Technical Assistance • Learning and Action Networks • Care Reinvention through Information and Innovation Spread (CRISP)

  16. Moving Toward Different Models

  17. What’s in it for providers? • Brings evidence-based best practices to the bedside with the flexibility to respond to local needs • You can work with peers and quality leaders in rapid-cycle projects for collaborative learning and action that accelerates health care quality improvement • A ready resource for taking action on your commitment to the Partnership for Patients and preparing for Value Based Purchasing

  18. What’s in it for patients? • Keeping patients from getting injured or sicker • Helping patients heal without complication.

  19. Proven Interventions for Improving Care • Reducing Catheter Associated Infections • Comprehensive Unit-based Safety Program (CUSP) methodology • http://www.hret.org/quality/projects/stop-uti.shtml

  20. Principles of Safe Design • Standardize • Eliminate steps if possible • Create independent checks • Learn when things go wrong • What happened • Why • What did you do to reduce risk • How do you know it worked

  21. CUSP • Assemble a hospital team • Collect and submit data • Attend a state kick off meeting • Team Check up Tool • Content Calls- Science of Safety • Informal Coaching Calls

  22. CAUTI Fundamentals • Most common healthcare-associated infection (~ 40%) • Many urinary catheters used inappropriately 1 • Prevention guidelines: • HICPAC www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf • SHEA/IDSA: Infect Control Hosp Epid 2008;29:S41-S50 • Nurse-Led multidisciplinary rounds to reduce unnecessary urinary catheters 2 • Urinary catheter reminders and stop-orders decrease infection rates 3 • Saint S, et al. Am J Med 2000 • 2 Fakih MG, et al. Infec Control Hosp Epi 2008 • 3Meddings J et al. Clin Infect Dis 2010

  23. CUSP- Teamwork Tools • Daily Goals • AM briefing • Shadowing • Culture-Team check up • TeamSTEPPS

  24. CUSP METHODOLOGY • Educate; the science of safety • Identify defects • Assign executives to champion the work • Learn from defects • Implement team work and communication tools • Goal: Reduce mean catheter-associated urinary tract infection (CAUTI) rates in participating clinical units by 25% over two years

  25. Questions? • ewallis@ofmq.com This material was prepared by Oklahoma Foundation for medical Quality, the Medicare Quality Improvement Organization for Oklahoma, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10C8ICPC-1357-OK-1111

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