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NACHRI CLA-BSI

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by

Taizo Nakano

on 23 October 2012

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Transcript of NACHRI CLA-BSI

PUBLICATION OBJECTIVES Developing a Hospital-Wide CLABSI Curriculum with QI Methodology Taizo Nakano, MD
Pediatric Hematology/Oncology/BMT Fellow
Children's Hospital Colorado Process Improvement is:

Multidisciplinary
Evidence based science
Here to stay

Patients and Families ASSUME safety

Standardization does NOT eliminate medical autonomy Quality Safety Process Improvement
(QPSI) Facts Increase degree of belief
Document expectations
Build a common understanding
Evaluate costs and side-effects
Explore theories and predictions
Test ideas under different conditions
Learn and adapt WHY PDSA? TOOLS The BUNDLE ROADMAP (cc) photo by theaucitron on Flickr (cc) photo by theaucitron on Flickr 2) INTRO 1) TITLE Instituting a Hospital-Wide CVC Care Bundle:
A Single Hospital Quality Improvement Project to Prevent CLABSI 1) TITLE 2) Introduction BACKGROUND KNOWLEDGE No standardized CVC education for Families, Nursing, Physicians

Multiple departments, Multiple bundles, Multiple satellites, Multiple states

Limited PUBLISHED evidenced based justification for practices

Oscillating motivation, Limited time, Limited funding LOCAL PROBLEMS Develop a standardized CVC educational curriculum for:

Patient/Families
Nursing/Staff/Physicians
Home Care and Satellite Practices

Institute the standardized CVC curriculum hospital-wide

Decrease CLABSI rate in the CCBD and hospital-wide

Improve patient/family CVC knowledge and satisfaction INTENDED IMPROVEMENT Interdisciplinary Educational Curriculum 3) Methods http://www.squire-statement.org A checklist of 19 items to consider when writing articles on QI

Writing is part of quality & safety work

A method to standardize QI reporting and a means to disseminate good practice

Helpful in the planning & execution of improvement projects http://qualitysafety.bmj.com (Standards for Quality Improvement Reporting Excellence) SQUIREs Criteria Central Venous Catheter Class Offered weekly

Hands-on bundle education

Instruction & Evaluation

Ensure families have resources & supplies 1) To demonstrate the PDSA model for quality improvement and the SQUIRES criteria for project design and publication.


2) To illustrate the educational components required to develop a CLABSI curriculum.


3) To address the challenge of hospital-wide and outpatient expansion of CLABSI curriculum. Maintenance Bundle Audits PLAN DO STUDY ACT CAP CHANGE DRESSING CHANGE DRESSING GENERAL CARE TUBING CHANGE SPREADING THE BUNDLE OUTSIDE THE HOSPITAL - Discharge Order Sets

- Variability in types of patients

- Patients with infrequent visits

- Re-Education of long-term patients/families SPREADING THE BUNDLE HOSPITAL WIDE - Steering Committee:
Department representatives
Department presentations

- Champions

- Central CVC Team model Vs. Departmental Teams EVALUATING PATIENTS & FAMILIES - Survey of satisfaction

- Questionnaire of bundle knowledge

- Carried out at discharge, Repeated as outpatient
at three months into therapy TITLE
&
ABSTRACT INTRODUCTION

Background

Problems

Intended
Improvement METHODS

of Intervention

of study

of analysis RESULTS

Outcomes

Benefits

Harms DISCUSSION

Limitations

Interpretation

Conclusion Shot out to
St. Luke's!!! Courtney Daniels
Nancy Tena
Flori Legette
Susan Dolan
Anthony Yost
Tracy Duncan
Michael Rannie
Karen Walton
Taizo Nakano
Joanne Hilden
Kelly Maloney CCBD CVC STEERING COMMITTEE P D S A EVALUATION OF STAFF
Full transcript