cauti content call 6 - community hospital may …...microsoft powerpoint - cauti content call 6 -...

1

1

2

C U S P / C A U T I C o n t e n t C a l l # 2 - T h e S c i e n c e o f S a f e t yM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S e a n B e r e n h o l t z0 3 / 2 2 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 3 - C a r e a n d R e m o v a l I n t e r v e n t i o nM o d e r a t o r – S a m W a t s o n ; S p e a k e r – M o h a m a d F a k i h0 4 / 0 5 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 4 - D a t a C o l l e c t i o nM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S a m W a t s o n0 4 / 1 9 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 5 - T h e V i e w f r o m t h e B e d s i d eM o d e r a t o r – S a m W a t s o n ; S p e a k e r – R u s s O l m s t e d0 5 / 0 3 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .C U S P / C A U T I C o n t e n t C a l l # 6 - I m p l e m e n t a t i o n i n a C o m m u n i t y H o s p i t a lM o d e r a t o r – S a m W a t s o n ; S p e a k e r – M a r y J o S k i b a0 5 / 1 7 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .

C U S P / C A U T I C o n t e n t C a l l # 1 – C U S PM o d e r a t o r – S a m W a t s o n ; S p e a k e r – S e a n B e r e n h o l t z0 3 / 0 7 / 1 1 2 E T / 1 C T / 1 2 M T / 1 1 P T A t t e n d e e : ( 8 6 6 ) 2 5 6 - 9 2 9 5 6 0 M i n .

2

M a r y J o S k i b a R N B S NP r o j e c t M a n a g e r Q I / R e s e a r c hJ a n u a r y 2 0 1 13

M e d S u r g ( 2 U n i t s )I C U ( 8 B e d )W o m e n ’ s H e a l t hI n p a t i e n t R e h a bI n p a t i e n t P s y c hN o n - P r o f i tS o l e C o m m u n i t y P r o v i d e r 4

3

5

P l a n , P l a n , P l a n …t h e n P l a n s o m e m o r e … 6

4

7• E s t a b l i s h C A U T I T e a m M e m b e r s

•I n v o l v e f r o n t l i n e s t a f f• H a v e a p h y s i c i a n c h a m p i o n•

I n c l u d e c h a r g e n u r s e s•

I n c l u d e s t a f f d e v e l o p m e n t• D e t e r m i n e t h e s c o p e o f y o u r i n i t i a l p r o j e c t• P o l i c y - U r i n a r y C a t h e t e r i z a t i o n•

R e v i e w / R e v i s e• U s e p o l i c y i n t o o l k i t• D o n ’ t r e - c r e a t e t h e w h e e l• C o n s o l i d a t e i n t o o n e p o l i c y i f p o s s i b l e

•A u t o m a t i c C a t h e t e r S t o p P o l i c y8

5

KEYSTONE HAI(Hospital Associated Infections)

“Bladder “Bladder “Bladder “Bladder Bundle Project”Bundle Project”Bundle Project”Bundle Project”

Preventing Catheter Preventing Catheter Preventing Catheter Preventing Catheter

Associated Urinary Associated Urinary Associated Urinary Associated Urinary

Tract InfectionsTract InfectionsTract InfectionsTract Infections

A Focus

9

1 0

6

• D a t a c o l l e c t o r s• D a t a f o r m s –A d d q u a l i f i e r s s p e c i f i c t o y o u rh o s p i t a l• A s s u r e u n d e r s t a n d i n go f p r o j e c t r e q u i r e m e n t s• 5 d a y s w e e k= M o n t h r u F r i ( n o t W / E )• D a t a e n t r y w e b - b a s e dp r o g r a m 1 2

7

• U s e c a l e n d a r o r G a n t t c h a r t t o p l o t a c t i v i t i e s• C h e c k v a c a t i o n s c h e d u l e s o f k e y s t a f f• W a t c h o u t f o r m a j o r h o l i d a y sBe FlexibleBe Flexible

1 3

• W h o w i l l b e t r a i n e d• W h o w i l l t r a i n• H o w w i l l w e t r a i n• W h e n w i l l w e t r a i n• H o w w i l l w e d o m a k e - u p s• H o w m u c h o n g o i n g t r a i n i n go r r e - t r a i n i n g n e e d e d•

W h o w i l l t r a i n•

H o w w i l l w e t r a i n•

W h e n w i l l w e t r a i n1 4

8

• C A U T I F a c e t o F a c e I n s e r v i c e• A l l N u r s i n g / A i d e s• G u i d e l i n e F o r P r e v e n t i o n o f C A U T I• P h y s i c i a n C M E• D e p t M e e t i n g s1 5

• D o n ’ t R e - c r e a t e T h e W h e e l• U s e O t h e r H o s p i t a l s P o w e r P o i n t S l i d e s• U p d a t e / R e v i s e t o F i tJ e r r i ’ s S t o r yN o r t h C a r o l i n a P r e v e n t C A U T I T o o l k i th t t p : / / w w w . n c q u a l i t y c e n t e r . o r g / r e s o u r c e s . l a s s o

1 6

9

1 7

1 8

10

• T r a v e l i n g M a n n e q u i n• 1 0 0 % A i d e s a n d a l l n u r s e f r e q u e n t i n s e r t e r s( E D , O R , W H U , I P R e h a b , I C U )• R e a d P o l i c y• T a k e Q u i z• P e r f o r m P r o c e d u r e• I n s t a n t R e m e d i a t i o n a n d R e p e a t D e m o n s t r a t i o n1 9• 1 6 7 C o m p e t e n c i e s• A v g 1 5 m i n / s t a f f m e m b e r• 4 1 A i d e s , 1 2 6 N u r s e s

2 0

11

I m p r o p e r C l e a n i n g 2 6I m p r o p e r G l o v i n g 2 4C o n t a m i n a t e d f i e l d 4 5D i d n ’ t k n o w n e e d l e l e s sc a t h p o r t f o r s p e c i m e n s 3 02 1I m p r o v e m e n t P l a n• R e q u i r e F i e l d C o m p e t e n c y a l l A i d e s w i t h i n2 m o n t h s - s u p e r v i s e d b y R N ’ s• N e w l y h i r e d A i d e s t r a i n e d b y R N ’ s• Y e a r l y A i d e h a n d s o n d e m o n s t r a t i o n o f c o m p e t e n c y2 2

12

• C a t h s f l a g g e d w i t h d a t e o f i n s e r t i o n• S e c u r e d t o l e g s• S p e c i m e n c o l l e c t i o n f o r c u l t u r eD o n ’ t u s e f i r s t u r i n e d r a i n e d f r o m c a t h e t e r- E D p a t i e n t s – p r i o r t o c o l l e c t i o n , c h a n g e c a t h e t e ru n l e s s k n o w n c h a n g e w i t h i n 7 d a y s- I n p a t i e n t s … I f c a t h e t e r i n f o r 7 d a y s m u s t c h a n g ep r i o r t o s p e c i m e n c o l l e c t i o n• P e r i n e a l h y g i e n e p r i o r t o c a t h s• “ J o h n D o o r ” e d u c a t i o n a l p o s t e r s2 3Catheters Per Patient

0%

5%

10%

15%

20%

25%

30%

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 82 4

13

0

4

8

12

16

20

24

28

Pre

Int 1

Int 2

Post 1

@Unit Rate

@Vendor Rate1 / 1 / 2 0 0 8 - 4 / 3 0 / 2 0 0 8A R M C K e y s t o n e C e n t e r f o r P a t i e n t S a f e t y a n d Q u a l i t yC o m p a r a t i v e D a t aU n i t sD a t a P o i n t N u m D e n P r e v e l a n c e R a t e R e p o r t i n g N u m D e n P r e v e l a n c e R a t eP r e 5 6 2 3 3 2 4 . 0 3 2 9 7 7 5 3 , 9 1 2 1 9 . 8 1I n t 1 5 4 2 3 9 2 2 . 5 9 2 6 6 9 7 3 , 4 0 0 2 0 . 5 0I n t 2 2 7 1 6 9 1 5 . 9 8 2 7 6 5 0 3 , 7 0 9 1 7 . 5 2P o s t 1 3 4 1 8 7 1 8 . 1 8 2 6 5 6 9 3 , 2 6 2 1 7 . 4 41 7 1 8 2 8 2 0 . 6 5 2 , 6 9 1 1 4 , 2 8 3 1 8 . 8 4

1/1/08 –4/30/08

ARMC

Michigan

2 5A R M C M o n t h l y U r i n a r y C a t h R e l a t e d U T I ’ s

200646 CAUTI’sAvg 3.8 mo




2 6

14

A R M C M o n t h l y U r i n a r y C a t h R e l a t e d U T I ’ s2006





2 7• Cath competency plan not followed

• Focus was on hospital EMR implementation

• Daily cath patrol not consistent

• Prevalence rates up

0

10

20

30

40

50

60No Indicated Reason for Catheter

2 8

15

• A n n u a l c o m p e t e n c y a i d e a n d E D / O R n u r s e s• C o m p e t e n c y i m b e d d e d i n o r i e n t a t i o n / a n n u a l s k i l l se v a l u a t i o n• A g e n d a i t e m e v e r y l e a d e r s h i p / s t a f f m t g• C h a r g e n u r s e s d o d a i l y C a t h P a t r o l - M e d S u r g• M e t r i c r e p o r t s m o n t h l y t o s t a f f a n d p h y s i c i a n s• C a t h n e c e s s i t y b u i l t i n t o E M R d o c u m e n t a t i o n• D e c r e a s e s i z e s t a n d a r d c a t h f r o m # 1 6 t o # 1 42 9Outcomes

ARMC Monthly Urinary Cath Related UTI’s

ARMC Monthly Urinary Cath Related UTI's

-4

-2

0

2

4

6

8

10

Jan-

06

Mar

-06

May

-06

Jul-0

6

Sep

-06

Nov

-06

Jan-

07

Mar

-07

May

-07

Jul-0

7

Sep

-07

Nov

-07

Jan-

08

Mar

-08

May

-08

Jul-0

8

Sep

-08

Nov

-08

Jan-

09

Mar

-09

May

-09

Jul-0

9

Sep

-09

Nov

-09

Jan-

10

Mar

-10

May

-10

Jul-1

0

Sep

-10

Nov

-10

Jan-

11

Mar

-11

May

-11

ZERO!!

3 0

16

B e v i g i l a n t … P l a n f o r a n d c a r r y o u t f o l l o w - u pi n t e r v e n t i o n sD o n ’ t w o r r y a l o n e …“ C o u r a g e i s b e i n g s c a r e d t o d e a t h ,b u t s a d d l i n g u p a n y w a y ” ( J o h n W a y n e )m j s k i b a @ a g h . o r g3 1

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