Critical Care Indicators Critical Care Indicators (CCI)(CCI)

MRSA, VRE, C-Diff and MDRO MRSA, VRE, C-Diff and MDRO NotificationNotification

Presented by: Presented by: Janice Lisee, RNC, BSNJanice Lisee, RNC, BSN Frederick Memorial Healthcare Frederick Memorial Healthcare SystemSystemSenior Systems AnalystSenior Systems Analyst Frederick, MarylandFrederick, Maryland

Previous ProcessPrevious Process

Reports from MicrobiologyReports from Microbiology Reports based on nurses Admit HXReports based on nurses Admit HX Relied on registration/bed Relied on registration/bed

management to contact nursing unitmanagement to contact nursing unit Used comment line on VIP screenUsed comment line on VIP screen

• Inconsistent wordingInconsistent wording• Used by more than one deptUsed by more than one dept• Does not inform nurses, doctors or Does not inform nurses, doctors or

departments who treatdepartments who treat

Goals For New ProcessesGoals For New Processes

Gather information at patient’s point Gather information at patient’s point of entryof entry

Notify staff as soon as possibleNotify staff as soon as possible Notify treating departmentsNotify treating departments Bring information forward to next Bring information forward to next

registration/admissionregistration/admission Keep access to ENTER information Keep access to ENTER information

limitedlimited

Points of EntryPoints of Entry

Emergency Room Emergency Room Same Day SurgerySame Day Surgery Direct AdmissionsDirect Admissions

ED RN – View and/or EnterED RN – View and/or Enter

Info Screen from F8Info Screen from F8

FCL1=%MIS.SCREEN.display.doc("NUREDAS.0000010","EDCCI_INFO")}

Pre-Admission and General Pre-Admission and General Nursing Staff on Admit HistoryNursing Staff on Admit History

Display ONLY

These go to Follow-Up Reports

CCIs Available in Reg RoutinesCCIs Available in Reg Routines

Not Seen In Transfer Routines

Information is seen in PCIInformation is seen in PCI(but not easily in Clinical Review) (but not easily in Clinical Review)

Information Shared on Reports & Information Shared on Reports & RequisitionsRequisitions

Daily Follow-Up Report for IC StaffDaily Follow-Up Report for IC Staff Same Day Surgery Standing OrdersSame Day Surgery Standing Orders Nursing Shift ReportsNursing Shift Reports 24 Hour Summary (SBAR)24 Hour Summary (SBAR) Admission Report (Admit Interventions)Admission Report (Admit Interventions) Radiology RequisitionRadiology Requisition Wound Center OE ConsultWound Center OE Consult Request for Bed (admit or transfer)Request for Bed (admit or transfer)

Infection Control Staff AccessInfection Control Staff Access

ImplementationImplementation

Started with MRSA and VREStarted with MRSA and VRE Added C-Diff and MDROAdded C-Diff and MDRO

• Edited 11 reportsEdited 11 reports• Edited Allergy FragmentEdited Allergy Fragment• Edited 16 screensEdited 16 screens

Post Live ReviewPost Live Review

Well received by staffWell received by staff IC pleased with reportsIC pleased with reports Need to “fix” Clinical ReviewNeed to “fix” Clinical Review Would like to flag MDs during POMWould like to flag MDs during POM

Knowledge Base ArticlesKnowledge Base Articles

410 (MRI)410 (MRI) 14568 (PCI)14568 (PCI) 17450 (MIC)17450 (MIC) 24652 (NUR)24652 (NUR) 31686 (PCI)31686 (PCI) 11816 (PCI)11816 (PCI)

Questions??Questions??