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CLABSI with K-Cards
3
CLABSI Observations
Cheri Cole-Jenkins, RN, QOM
CBDI Clinic
CVC Team Members
CBDI
The team
The team
Hannah Reed, RNIII
Shawna Langworthy, RN
Clinical Director
Amy Hendrix, RN Clinical Manager
Megan Ewald,
RN II CVC Chair
Reenie Giesken, RNII
Kristy Feld
RN, Educator
Aubrie Schroer, RNII
Kelly Vu / RN
Tiffany Holt, RNII
Cheri Cole-Jenkins, RN
Quality Outcomes Manager
16 CLABSIs in FY 2016
~400 kids with CVC
When did the CLABSIs occur?
When did the CLABSIs occur?
July 2016 x1 skin
Jan 2017 Skin x2
Aug 2016 x2 Gut x2
Feb 2017
Env x1, Skin x 1, Gut x1, ENT x 1
Sept 2016 Enviromental x1
March 2017 0
April 2017 0
Oct 2016 Gut x2
May 2017 0
Nov 2016 Skin x1
June 2017 Gut x1
Dec 2016 Skin x2
What were the BUGS?
What were the BUGS?
6 gut bugs
(E. coli, enterbacter, Kelb Pneumo Strep Pneumo)
5 Skin bugs
(staph aureus, MRSA, moraxella)
4 Environmental bugs
( Pseudomonas, acinetobacter, paenibacillus)
1 ENT
(rothia mucilaginosa)
Observations
We need to improve our CLABSI Observation process
Barriers for observations
Barriers for observations
Staffing Issues
Lack of clarity of responsibility for completing
No timely feedback
Name / Job title
Experiences with Observations
Experiences with Observations
Learnings limited
Learnings not available to staff in real time
Name / Job title
K-Cards
Let's try something new
PICU K-Card Rounding
PICU K-Card Rounding
Column description
Column 1--- Perfect care map. If your loved one was in the bed, what key things should happen to prevent a hospital acquired condition
Column 2---The specific project or hospital acquired condition we are trying to improve
Columns 3-9--- Date of the week and the number of green or orange K-Cards each day. This should be updated by each person who performs a k-card
Column 10---The days since the last event occurred
Column 11---This will be updated weekly by each team lead, sharing the areas of focus for us to improve. We will need you to make these better. Please use the post-its to provide us ideas!!!
Notes on PICU K-Card Board
- updated each time someone performs a K-card coaching and observation moment!
Green
= the system is performing as it should.
All communication and prevention standards were followed.
Orange
= an opportunity for improvement was identified during the K-Card observation and coaching.
The top one- three opportunities will be listed on the white board.
K-card concerns
Where to put it?
Daily update?
Roll out?