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Transcript of NACHRI CLA-BSI
Pediatric Hematology/Oncology/BMT Fellow
Children's Hospital Colorado Process Improvement is:
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
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:
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:
- 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
of analysis RESULTS
Conclusion Shot out to
St. Luke's!!! Courtney Daniels
Kelly Maloney CCBD CVC STEERING COMMITTEE P D S A EVALUATION OF STAFF