CLABSI Supplemental Call Series

1. CLABSI Supplemental Call Series Best Practices: How Successful Units Engaged Their Senior Executive Leaders October 18, 2011 Presenters: Jonathan Kling, BSN, BHA, RN, CCRN Scott Raynes, MA, MBA Joan Chatham, MSN, RN Melissa Allen, MS, RN

2. CLABSI Supplemental Call Series Jonathan Kling, BSN, BHA, RN, CCRNDirector, Critical CareNCH Healthcare SystemNaples, Florida

3. Initial Challenges & Solutions • Challenges • Buy-in from staff, physicians, and senior leadership • Inconsistent data collection and reviewing of data • Outdated, non-evidence-based policies and procedures • Solutions • Consistent audit process with weekly meetings with senior leadership, physicians, and staff • With consistent data and timely communication, the cost benefits of quality care were clearly observed • Revision of policies in line with evidence-based practice

4. Best Practices • Consistent application of insertion bundle always • Identification of appropriate site • Sterile technique, head-to-toe coverage • Everyone in room sterile or clean at all times • Sterile dressing and documentation of line • Continuous assessment of lines • Consistent line care and maintenance at all times -- “scrub the hub”

5. Lessons to Bring Back to Your Hospitals • Collaborative, multidisciplinary team approach is key • Mandatory staff education • Quality contracts • Policies must be in line with evidence-based practice • Clear direction set with senior leadership • Strong physician champion is vital to success • Invest in products with proven success • Consistently use evidence-based practice “bundles” on all insertions • Consistently re-educate and audit on daily basis

6. Final Thoughts • Keys to success • Clear vision and direction of strong senior leadership • Buy-in of physicians and staff • Cannot be done quickly or without the support of a large multidisciplinary team • Never say good is good enough; the challenge to be the best requires daily follow through and effort

7. CLABSI Supplemental Call Series Scott Raynes, MA, MBA, Chief Executive OfficerNorthCrest Medical CenterSpringfield, Tennessee Melissa Allen, MS, RNDirector, Infection ControlNorthCrest Medical CenterSpringfield, Tennessee Joan Chatham, MSN, RNDirector, QualityNorthCrest Medical CenterSpringfield, Tennessee

8. Initial Challenges & How they were Overcome • Initial CLABSI project started with IHI Save 100,000 Lives Project • A CLABSI bundle was established and has been in use since then • Initial challenges were physician buy-in and compliance • Results were reported quarterly to the Quality Review Committee, which includes senior administrators, physicians, and board members • This group provided the support necessary to get physicians involved; nurses were empowered to speak up and stop the process if the physician was not compliant

9. Best Practices • Leadership best practices • Keep senior leadership informed of progress and failures • Make success an organizational goal to keep everyone involved • Look constantly at your processes for opportunities for improvement • Monitor every insertion and share compliance results with staff • Clinical best practices • Have a central line kit that contains all necessary items • Have a checklist attached to the bundle to make it immediately available • Have a procedure cart with extra supplies immediately available in case an item in the kit is contaminated • Include consents and time outs on your checklist

10. Lessons to Bring Home to your Hospitals • Zero infections is achievable if everyone complies with the bundle • We have had no CLABSI in our CCU since July 2008 • If you make the process simple and convenient, you are more like to achieve compliance • Leadership support is essential

11. Final Thoughts • We teach this process to new graduate nurses during their orientation so they start out knowing the process • We are happy to share our checklist with anyone who is interested

12. CLABSI Supplemental Call Series Craig Becker, President and CEO Tennessee Hospital Association Nashville, TN

13. Tennessee Hospital Association Board Aim Vision: Healthier, Safer Tennessee Aim: Zero Preventable Harm Targets: - Zero infections within 3 years - Top quartile performance on public measures Priorities • Focus on achieving THA Board Aim of Zero Preventable Harm. • Position Tennessee as a leader on patient safety efforts and healthcare-acquired infection reduction strategies. • Accelerate Tennessee’s efforts by focusing on • Alignment among partner organizations • Leadership • Culture change • Accountability

14. Questions?