Purpose

1. An Examination and Analysis of Central Line Associated Bloodstream Infections within Mease Countryside CCU and Morton Plant CSU Jenny Paxton, USF Student RN  Teresa Rivera, USF Student RN Purpose Results Methods • To examine and evaluate the incidents of CLABSIs in Mease Countryside Critical Care Unit (CCU) and Morton Plant Cardiac Surgical Unit (CSU) • To compare the microsystem statistics to the national average • To evaluate the effectiveness of current practice and protocols aimed at reducing CLABSIs • Microsystem statistics received from the BayCare Health System Database (unable to obtain) • National statistics derived from The Joint Commission (JCAHO) • The use of cause and effect analysis (Fishbone diagram) Background Process Improvement • Mease Countryside Hospital and Morton Plant Hospital are both acute care facilities apart of the BayCare Health System located in Pinellas County, Florida. • Mease Countryside CCU is a 14bed unit that serves the critical care needs of its patients with underlying cardiac complications. • Morton Plant CSU is a 21 bed unit that focuses on the immediate recovery of the post-operative, open heart surgery patient. • All patients admitted to CCU or CSU have received one or more types of central lines to assist in patient care. • With direct access provided by central lines, the risk for infection is present in every case which is why the examination of associated practices is of high importance. • CLABSIs can increase patient acuity, length of hospital stay, and hospital expenditures related to a lack of reimbursement • Implementation of more frequent education (bi-annual vs. annual) and creation of an annual skills test focused on sterile technique and the care of central lines. • More intensive CCIP curriculum to include longer didactic and clinical orientation times. • Creation of a critical care nursing pool positions to alleviate staffing issues. • Availability of additional training for patient care technicians to assist RNs in the critical care setting. • Continual use current evidenced based practice. • National CLABSI Statistics • Statistics pertaining specifically to Mease Countryside CCU and Morton Plant CSU were unavailable to us • An estimated 250,000 CLABSI cases are reported annually • 80,000 of reported cases occur in ICUs • Thousands of deaths can be attributed to CLABSIs, but an exact number is unknown because of frequent co-morbidities • The associated costs per CLABSI incidence averages $16,550 but can cost as much as $36,441 • In 2002, The International Nosocomial Infection Control Consortium (INICC) began improving adherence to infection prevention and control measures, resulting in an incidence reduction of 54% and a mortality reduction by 58% (The Joint Commission, 2012) Limitations / Lessons Learned • Available funding • Availability of staff • Willingness of staff to participate in additional training opportunities and educational requirements Improvement Tools/Methods • The implementation of Critical Care Internship Programs (CCIPs) • The requirement of previous medical surgical or telemetry experience as an RN • Lower and more controlled nurse to patient ratio • Stricter protocols for central line care including sterile technique, the use of blue caps, and frequent dressing changes and assessments. • Annual education requirements relating to infection prevention and management of central lines. References • BayCare Health System. (2013). Central Line Associated • Bloodstream Infections [Data File]. Retrieved from • http://baycare.org/body.cfm?xyzpdqabc=0&id=673& action=detail&reportid=455 • The Joint Commission. (2012). Preventing central line- • associated bloodstream infections: A global • challenge, a global perspective. Oak Brook, IL.: Joint • Commission Resources. (BayCare Health Systems, 2013) Team Members • Jackson Tillquist, BSN, RN (CCU) • Patty Mullan-Waldrop, BSN, RN (CSU)