Quality and Patient Safety Annual Report 2017 Quality & Safety Annual Report 2017 | Page 29

INFECTION PREVENTION Infection prevention efforts continue to focus on HAI prevention. Reducing the incidence of Central Line-Associated Bloodstream Infections (CLABSI): The revised Vascular Access Standard was fully implemented hospital- wide, and all providers were educated regarding the revisions. Infection Prevention partnered with clinical experts to assess bedside central venous line (CVL) care and maintenance practices. Results of the assessment were reviewed with Nursing. In addition, Infection Prevention and Nursing collaborated with resource utilization to refine CVL care supplies. Infection Prevention and Nursing also conducted rounds on patients with a CVL to assess care and maintenance. Details of all CLABSI events were immediately reported to the health care team, and reviews of each case were conducted using a standardized review process. Results from case reviews were shared monthly with Nursing. To maintain focus on CLABSI prevention strategies, Infection Prevention reported CLABSI data daily in bed huddles and weekly in a summary report. CLABSI data were reported and reviewed monthly at the Health System Infection Prevention Committee and at the Nursing Quality Council Infection Prevention Subgroup. There were 94 CLABSI events for FY17, which met our goal of fewer than 100 CLABSI events for the fiscal year. Reducing the incidence of Methicillin-Resistant Staphylococcus Aureus (MRSA): Efforts to reduce CLABSI also resulted in a decrease in MRSA bloodstream LabID events. There were 40 such events during FY17, a decrease from 64 events during FY16, which met our goal of fewer than 50 events for the fiscal year. Reducing the incidence of Catheter-Associated Urinary Tract Infections (CAUTI): Regarding catheter-associated urinary tract infections (CAUTI), details of newly identified CAUTI events were immediately reported to the health care team. An assessment of urinary catheter insertion and maintenance was conducted on CMS-reportable locations. Results were reported to Nursing. In addition, Infection Prevention and Nursing conducted rounds on patients with a urinary catheter to assess care and maintenance. To maintain focus on CAUTI prevention strategies, Infection Prevention reported CAUTI data weekly in a summary report. CAUTI data was reported and reviewed monthly by the Health System Infection Prevention Committee and the Nursing Quality Council Infection Prevention Subgroup. The infection prevention team implemented electronic surveillance through Cerner IC Solutions in January 2017. Use of this tool consolidated all of the information needed for health care-associated infection (HAI) surveillance into one source, enabling the infection prevention specialists to be more efficient in their work. However, there were 64 CAUTI events during FY17, so the goal of fewer than 60 events was not met. Reducing the incidence of C. difficile: Prevention of hospital-onset clostridium difficile infection (CDI) also was a focus of the infection prevention team during FY17. Interventions included alerts that go out to the providers when CDI lab testing was ordered if the patient was prescribed a laxative in the prior 48 hours. Details of newly identified CDI events were shared with the health care team, including a review of event details with emphasis on key components of the CDI prevention bundle (laxative administration, fever, white blood count, diarrhea, and CDI treatment). CDI data is reported and reviewed quarterly at the Health System Infection Prevention Committee and at the Nursing Quality Council Infection Prevention Subgroup. Although the goal of fewer than 150 CDI events was not met in FY17, the total of 153 CDI events was significantly lower than the 200+ events that occurred in FY16. Interventions to prevent HAI planned by the infection prevention team during the coming year include: • Enhanced rounding to assess care and maintenance of central venous lines and urinary catheters • Reinforcement of the urinary retention and nurse-driven urinary catheter removal protocols, in order to decrease urinary catheter days • Rounding to assess compliance with environmental infection prevention best practices • Continued analysis and feedback of HAI event details to the health care team www.uabmedicine.org 27