CAUTI Content Call 6 - Community Hospital May …...Microsoft PowerPoint - CAUTI Content Call 6 - Community Hospital May 2011(Final).ppt [Compatibility Mode] Author RZB15925 Created

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1

2

C U S P / C A U T I C o n t e n t C a l l # 2 - T h e S c i e n c e o f S a f e t yM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S e a n B e r e n h o l t z0 3 / 2 2 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 3 - C a r e a n d R e m o v a l I n t e r v e n t i o nM o d e r a t o r – S a m W a t s o n ; S p e a k e r – M o h a m a d F a k i h0 4 / 0 5 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 4 - D a t a C o l l e c t i o nM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S a m W a t s o n0 4 / 1 9 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 5 - T h e V i e w f r o m t h e B e d s i d eM o d e r a t o r – S a m W a t s o n ; S p e a k e r – R u s s O l m s t e d0 5 / 0 3 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 6 - I m p l e m e n t a t i o n i n a C o m m u n i t y H o s p i t a lM o d e r a t o r – S a m W a t s o n ; S p e a k e r – M a r y J o S k i b a0 5 / 1 7 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .

C U S P / C A U T I C o n t e n t C a l l # 1 – C U S PM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S e a n B e r e n h o l t z0 3 / 0 7 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .

2

M a r y J o S k i b a R N B S NP r o j e c t M a n a g e r Q I / R e s e a r c hJ a n u a r y 2 0 1 13

M e d S u r g ( 2 U n i t s )I C U ( 8 B e d )W o m e n ’ s H e a l t hI n p a t i e n t R e h a bI n p a t i e n t P s y c hN o n - P r o f i tS o l e C o m m u n i t y P r o v i d e r 4

3

5

P l a n , P l a n , P l a n …t h e n P l a n s o m e m o r e … 6

4

7• E s t a b l i s h C A U T I T e a m M e m b e r s

•I n v o l v e f r o n t l i n e s t a f f• H a v e a p h y s i c i a n c h a m p i o n•

I n c l u d e c h a r g e n u r s e s•

I n c l u d e s t a f f d e v e l o p m e n t• D e t e r m i n e t h e s c o p e o f y o u r i n i t i a l p r o j e c t• P o l i c y - U r i n a r y C a t h e t e r i z a t i o n•

R e v i e w / R e v i s e• U s e p o l i c y i n t o o l k i t• D o n ’ t r e - c r e a t e t h e w h e e l• C o n s o l i d a t e i n t o o n e p o l i c y i f p o s s i b l e

•A u t o m a t i c C a t h e t e r S t o p P o l i c y8

5

KEYSTONE HAI(Hospital Associated Infections)

“Bladder “Bladder “Bladder “Bladder Bundle Project”Bundle Project”Bundle Project”Bundle Project”

Preventing Catheter Preventing Catheter Preventing Catheter Preventing Catheter

Associated Urinary Associated Urinary Associated Urinary Associated Urinary

Tract InfectionsTract InfectionsTract InfectionsTract Infections

A Focus

9

1 0

6

• D a t a c o l l e c t o r s• D a t a f o r m s –A d d q u a l i f i e r s s p e c i f i c t o y o u rh o s p i t a l• A s s u r e u n d e r s t a n d i n go f p r o j e c t r e q u i r e m e n t s• 5 d a y s w e e k= M o n t h r u F r i ( n o t W / E )• D a t a e n t r y w e b - b a s e dp r o g r a m 1 2

7

• U s e c a l e n d a r o r G a n t t c h a r t t o p l o t a c t i v i t i e s• C h e c k v a c a t i o n s c h e d u l e s o f k e y s t a f f• W a t c h o u t f o r m a j o r h o l i d a y sBe FlexibleBe Flexible

1 3

• W h o w i l l b e t r a i n e d• W h o w i l l t r a i n• H o w w i l l w e t r a i n• W h e n w i l l w e t r a i n• H o w w i l l w e d o m a k e - u p s• H o w m u c h o n g o i n g t r a i n i n go r r e - t r a i n i n g n e e d e d•

W h o w i l l t r a i n•

H o w w i l l w e t r a i n•

W h e n w i l l w e t r a i n1 4

8

• C A U T I F a c e t o F a c e I n s e r v i c e• A l l N u r s i n g / A i d e s• G u i d e l i n e F o r P r e v e n t i o n o f C A U T I• P h y s i c i a n C M E• D e p t M e e t i n g s1 5

• D o n ’ t R e - c r e a t e T h e W h e e l• U s e O t h e r H o s p i t a l s P o w e r P o i n t S l i d e s• U p d a t e / R e v i s e t o F i tJ e r r i ’ s S t o r yN o r t h C a r o l i n a P r e v e n t C A U T I T o o l k i th t t p : / / w w w . n c q u a l i t y c e n t e r . o r g / r e s o u r c e s . l a s s o

1 6

9

1 7

1 8

10

• T r a v e l i n g M a n n e q u i n• 1 0 0 % A i d e s a n d a l l n u r s e f r e q u e n t i n s e r t e r s( E D , O R , W H U , I P R e h a b , I C U )• R e a d P o l i c y• T a k e Q u i z• P e r f o r m P r o c e d u r e• I n s t a n t R e m e d i a t i o n a n d R e p e a t D e m o n s t r a t i o n1 9• 1 6 7 C o m p e t e n c i e s• A v g 1 5 m i n / s t a f f m e m b e r• 4 1 A i d e s , 1 2 6 N u r s e s

2 0

11

I m p r o p e r C l e a n i n g 2 6I m p r o p e r G l o v i n g 2 4C o n t a m i n a t e d f i e l d 4 5D i d n ’ t k n o w n e e d l e l e s sc a t h p o r t f o r s p e c i m e n s 3 02 1I m p r o v e m e n t P l a n• R e q u i r e F i e l d C o m p e t e n c y a l l A i d e s w i t h i n2 m o n t h s - s u p e r v i s e d b y R N ’ s• N e w l y h i r e d A i d e s t r a i n e d b y R N ’ s• Y e a r l y A i d e h a n d s o n d e m o n s t r a t i o n o f c o m p e t e n c y2 2

12

• C a t h s f l a g g e d w i t h d a t e o f i n s e r t i o n• S e c u r e d t o l e g s• S p e c i m e n c o l l e c t i o n f o r c u l t u r eD o n ’ t u s e f i r s t u r i n e d r a i n e d f r o m c a t h e t e r- E D p a t i e n t s – p r i o r t o c o l l e c t i o n , c h a n g e c a t h e t e ru n l e s s k n o w n c h a n g e w i t h i n 7 d a y s- I n p a t i e n t s … I f c a t h e t e r i n f o r 7 d a y s m u s t c h a n g ep r i o r t o s p e c i m e n c o l l e c t i o n• P e r i n e a l h y g i e n e p r i o r t o c a t h s• “ J o h n D o o r ” e d u c a t i o n a l p o s t e r s2 3Catheters Per Patient

0%

5%

10%

15%

20%

25%

30%

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 82 4

13

0

4

8

12

16

20

24

28

Pre

Int 1

Int 2

Post 1

@Unit Rate

@Vendor Rate1 / 1 / 2 0 0 8 - 4 / 3 0 / 2 0 0 8A R M C K e y s t o n e C e n t e r f o r P a t i e n t S a f e t y a n d Q u a l i t yC o m p a r a t i v e D a t aU n i t sD a t a P o i n t N u m D e n P r e v e l a n c e R a t e R e p o r t i n g N u m D e n P r e v e l a n c e R a t eP r e 5 6 2 3 3 2 4 . 0 3 2 9 7 7 5 3 , 9 1 2 1 9 . 8 1I n t 1 5 4 2 3 9 2 2 . 5 9 2 6 6 9 7 3 , 4 0 0 2 0 . 5 0I n t 2 2 7 1 6 9 1 5 . 9 8 2 7 6 5 0 3 , 7 0 9 1 7 . 5 2P o s t 1 3 4 1 8 7 1 8 . 1 8 2 6 5 6 9 3 , 2 6 2 1 7 . 4 41 7 1 8 2 8 2 0 . 6 5 2 , 6 9 1 1 4 , 2 8 3 1 8 . 8 4

1/1/08 –4/30/08

ARMC

Michigan

2 5A R M C M o n t h l y U r i n a r y C a t h R e l a t e d U T I ’ s

200646 CAUTI’sAvg 3.8 mo




2 6

14

A R M C M o n t h l y U r i n a r y C a t h R e l a t e d U T I ’ s2006





2 7• Cath competency plan not followed

• Focus was on hospital EMR implementation

• Daily cath patrol not consistent

• Prevalence rates up

0

10

20

30

40

50

60No Indicated Reason for Catheter

2 8

15

• A n n u a l c o m p e t e n c y a i d e a n d E D / O R n u r s e s• C o m p e t e n c y i m b e d d e d i n o r i e n t a t i o n / a n n u a l s k i l l se v a l u a t i o n• A g e n d a i t e m e v e r y l e a d e r s h i p / s t a f f m t g• C h a r g e n u r s e s d o d a i l y C a t h P a t r o l - M e d S u r g• M e t r i c r e p o r t s m o n t h l y t o s t a f f a n d p h y s i c i a n s• C a t h n e c e s s i t y b u i l t i n t o E M R d o c u m e n t a t i o n• D e c r e a s e s i z e s t a n d a r d c a t h f r o m # 1 6 t o # 1 42 9Outcomes

ARMC Monthly Urinary Cath Related UTI’s

ARMC Monthly Urinary Cath Related UTI's

-4

-2

0

2

4

6

8

10

Jan-

06

Mar

-06

May

-06

Jul-0

6

Sep

-06

Nov

-06

Jan-

07

Mar

-07

May

-07

Jul-0

7

Sep

-07

Nov

-07

Jan-

08

Mar

-08

May

-08

Jul-0

8

Sep

-08

Nov

-08

Jan-

09

Mar

-09

May

-09

Jul-0

9

Sep

-09

Nov

-09

Jan-

10

Mar

-10

May

-10

Jul-1

0

Sep

-10

Nov

-10

Jan-

11

Mar

-11

May

-11

ZERO!!

3 0

16

B e v i g i l a n t … P l a n f o r a n d c a r r y o u t f o l l o w - u pi n t e r v e n t i o n sD o n ’ t w o r r y a l o n e …“ C o u r a g e i s b e i n g s c a r e d t o d e a t h ,b u t s a d d l i n g u p a n y w a y ” ( J o h n W a y n e )m j s k i b a @ a g h . o r g3 1

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CAUTI Content Call 6 - Community Hospital May …...Microsoft PowerPoint - CAUTI Content Call 6 - Community Hospital May 2011(Final).ppt [Compatibility Mode] Author RZB15925 Created