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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. - PowerPoint PPT Presentation
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CLAB In The Mainland
Overview
Christchurch ICU
Where were we?
Where are we now?
Where are we going?
The ChallengeSouth Island56% New Zealand23% population5 DHBsCulture
ChristchurchSingle ICUAll subspecialties except paeds cardiac and burnsPopulation 550,000
Christchurch ICUSize of unitStaffed 16 ICU bed equivalents120 nurses, 8 SMO and 18 registrars2.9 beds/100,000 (4.8 NZ average)
Interventions65% ventilation rateMean length of stay 3.5 days
OutcomesMortality 12%Low SMR
CLAB ConsiderationHistoryInsertion process established 2009
Patients1250 admissions PA (70% CVC)350 cardiac patients120 LTM patients
ProcessAntibiotic impregnated lines for high riskPICC service for LTM lines
ObservationAverage 300 line days per month
Quality Healthcare in Christchurch
Historic Chch CLAB Data
CLAB ResultsStructureTeam Dr, nurses, educator, data, IPC + guestRegular meetingsGoalsSimple -Awareness/EducationProcessCompliance insertion/maintenance/culturesAlliance and complement DHB processesRobust data
OutcomeCLAB rate 0/1000 line days352 CLAB free days10 CLAB avoided1-5 lives savedUp to $500,000 savedEndorsement CEORole out to NICU
ProblemsEducationData burdenE-databaseGlobal IT issuesComplianceInsertion 80-100% (10/week)Maintenance- 60-70% (150 episodes/week)Blood culture- recent reduction in compliance
Key Success
CLAB rate
QI profile
MDT
Future
Maintain high profileFormalise competenciesCompliance improvementBlood culture simplicitySustainability beyond April 2013
The Region
CityPopulationDHBChristchurch380,900CDHBDunedin117,700SDHHNelson60,800NMDHBInvercargill49,200SDHBBlenheim30,300NMDHBTimaru27,700SCDHBAshburton17,950CDHBOamaru13,000SDHBQueenstown10,442SDHBGreymouth10,100WCDHB
A presentation that outlines the unique characteristics of the Central Regional units, patient population, volumes, acuity and an outline of the practices that support the CLAB rate results in the region
*PatientsGeneral medicineGeneral surgeryCardiothoracic NeurosurgerySpinal injuriesPaediatrics
*Is there a problem?Regression of the meanNo local problem
Is there a solution?Bundle approach Scarce resource diversion
*6.6 to 0.9 in middlemore
Nationally 3.32/1000 line days*At risk lines
*200 000 not in these centres*