patient safety & quality
By J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , BC-MSLcert™ , NCEE , NREMT , MSL-BC , DICO-C , TR-C , CPPS , CPHQ , CPXP , FACDONA , FAAPM , FNAP , FSHEA , FIDSA
The Journey to Zero CLABSI and CAUTI Infections : Is It Possible ?
Millions of indwelling central venous and urinary catheters are inserted in both acute care and non-acute care healthcare settings annually across the globe . While in many instances , these devices play serve as a critical medical treatment delivery tool , there are unfortunately scenarios where these catheters are not medically necessary and can result in patient harm and associated mortality and morbidity . A new resource guide was released in April by the Agency for Healthcare Research and Quality ( AHRQ ) directly targeting core interventions to reduce the incidence of catheter-associated urinary tract infection ( CAUTI ) and central line-associated bloodstream infections ( CLABSI ). CAUTIs account for 75 percent of all healthcare-associated urinary tract infections . CLABSIs significantly increase the risk of death .
There are some important questions that must be asked by the healthcare team to ensure that all possible preventable risks are mitigated :
●Understanding the Science of Safety ●Identifying Defects ●Engage the Senior Executive ●Learn from Defects ●Implement Teamwork and Communication
The new recommendations from AHRQ are broken into two tiers , both of which are equally important . Tier 1 is focused on standardizing products , procedures , and bedside processes and Tier 2 which is focused on enhanced practices . Together , these interventions provide healthcare providers and facilities with the most sustained approach to infection control to reduce CAUTIs and CLABSIs .
A new resource guide was released in April by the Agency for Healthcare Research and Quality ( AHRQ ) directly targeting core interventions to reduce the incidence of catheter-associated urinary tract infection ( CAUTI ) and central lineassociated bloodstream infections ( CLABSI ).”
Part of reducing preventable CLABSI and CAUTI infections is frequent , unit-based rounding . Some of the best practices for catheter rounds include :
●Identify key practices to observe or check during planned rounds and specific goal ( s ) of rounds . This will vary over time as barriers or needs are identified and may vary by ICU .
●Identify nurse experts to round and a nurse champion to lead the rounds .
●Observe insertions , if the opportunity to observe an insertion occurs . ●Develop or adapt a rounding checklist to record findings . ●Provide direct , constructive feedback to staff during rounds to educate , compliment , seek information , etc . per goals of rounds , and as opportunities arise .
●Aggregate findings from rounds and provide feedback to the ICU and individuals as appropriate .
Tier 1 Interventions
Tier 1 interventions are technically focused , evidence-based actions that should occur with every patient , every time .
Tier 2 Interventions
Tier 2 interventions are team-based strategies that extend beyond the bedside and can enhance the Tier 1 interventions .
The interventions in Tier 1 will aid in driving the consistent application of evidence-based practices .
Tier 1 interventions are technically focused , evidence-based actions that should occur with every patient , every time .