simple is effective · hywel dda local health board peripheral vascular cannula and short term...
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![Page 1: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/1.jpg)
Hywel DdaLocal Health Board
Peripheral Vascular Cannula and Short Term Urinary Catheter
Insertion and Maintenance Bundles
September 2011 – ‘Simple is Effective’
Presenter: Tracey Nicholas
PLUS
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Hywel DdaLocal Health Board
Baseline Data Prevalence Survey 2010 Hywel
Dda Health Board
Total Number Hospital Acquired
Peripheral Line 52 5
Catheter 22 2
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Hywel DdaLocal Health Board
2. ChloraPrep 0.67ml Sepp Implemented 2010 √3. Peripheral Vascular Cannula
Insertion Bundle revised roll out
August/Sept 2011
Hand hygiene PPE
Skin Prep Dressing
(Chloraprep)
Signature ……………………..
√ Prescription Chart sticker
Hand hygiene PPE
Aseptic Technique Clean urethral meatus
Sterile closed drainage system
Documentation
Signature …………………………….
4. Short Term Urinary Catheter Roll
out August/Septemeber 2011 √
DEVICES/PROCEDURES Total Number
Peripheral Line 52
Catheter 22
Defined Types of HAI
SSI
15%
Resp Tract
15%
GI Tract
12%
Pneumonia
12%
Bone & Joint
8%
Blood Stream
8%
UTI
4% Skin & Soft
Tissue
22%
Systemic
infection
4%
1. Baseline August
2010 √
OUTCOME = MRSA Bacteraemias April 2010-March 2011 Prescription Chart sticker
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Hywel DdaLocal Health Board
Sticker DevelopmentPeripheral Vascular Catheter Insertion Bundle Date ..../..../.... Day 1 Time ......................
Hospital ............................ Ward ............................
Reason for Insertion (Please cross all that apply)
IV Fluids Antibiotics Blood Transfusion Pain
Control
Other (Please
state)
..............................
Insertion Technique yes no ye
s
no
Hand Hygiene Sterile Gloves
Informed Patient consent Dressing Applied – clear,
semi-permeable dressing
Skin Preparation – 2% Chlorhexidine in
70% Alcohol
Cannula Flushed
Allow to dry for 30 secs Number of attempts
Cannula Size Batch No Cannula Site
Print Name ............................ Signature...................................... Designation.....................
![Page 5: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/5.jpg)
Hywel DdaLocal Health Board
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Hywel DdaLocal Health Board
`
Reorder Form Number; WTA152 (pack 50)
Peripheral Intravenous Cannula Care Plan and Maintenance Bundle
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Hywel DdaLocal Health Board
Short Term Urinary Catheter Care Plan and Maintenance Bundle
![Page 8: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/8.jpg)
Hywel DdaLocal Health Board
Roll out Programme‘Start Small and Roll Out!’
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Hywel DdaLocal Health Board
SPREAD &
SUTAINABILITY
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Hywel DdaLocal Health Board
![Page 11: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/11.jpg)
Hywel DdaLocal Health Board
![Page 12: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/12.jpg)
Hywel DdaLocal Health Board
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Hywel DdaLocal Health Board
Compliance
• Required to fit into 1000 lives plus requirements
• Report Locally & Nationally
• Compare practice between wards
• Fit with Nursing Metrics/Dashboard
• Be aware of where we need to improve
• Collect data
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Hywel DdaLocal Health Board
Compliance Audit:
• Took methodology used for Hand Hygiene Compliance
• Developed Tool x2
• Pilot Results/Sampling 10 each ward each month
Audit Process
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Hywel DdaLocal Health Board
Excel Template
• Automatically Calculates compliance
• Summarises results per hospital
• Summarises Results of LHB
• Data formatted so that it is cut and pasted into PowerPoint Template
• Example graph overleaf.
• Process takes very little time
![Page 16: Simple is Effective · Hywel Dda Local Health Board Peripheral Vascular Cannula and Short Term Urinary Catheter Insertion and Maintenance Bundles September 2011 –‘Simple is Effective’](https://reader034.vdocument.in/reader034/viewer/2022050210/5f5ca24e4df3594eac00864a/html5/thumbnails/16.jpg)
Hywel DdaLocal Health Board
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Hywel DdaLocal Health Board
Hand Hygiene Compliance Rates – Staff Type
94%
87%
100%
53%
78%
71%
86%
100%
78%
0%
95%
75%
100%
94%
85%
92%
83%
60% 60%
NA
100%
0%
25%
50%
75%
100%
Manager/
Sister
Nurses Student
Nurses
CNS/NNP/
Bed Mngr
Consultants Senior Dr Junior Dr HCA AHP Ancillary Other
PPH WWGH
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Hywel DdaLocal Health Board
Type of Decontamination Missed
14
6
7
8
3
8
0
5
10
15
Before Patient
Contact
Before a clean
Aseptic Proceedure
After Body Fluid
Exposure
After Pt Contact After Contact
Patient Immediate
Surroundings
PPH WWGH
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Hywel DdaLocal Health Board
Title
9 Criteria identical to Care Bundle. Reply Yes, NO, NA
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Hywel DdaLocal Health Board
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Hywel DdaLocal Health Board
• Currently piloting Catheter and IV Data Collection Tools
• Automate the Audit process
• Fit for all reporting purposes
• Compare compliance rates
• Feedback Good and Bad Practice
Excel Templates in Draft
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Hywel DdaLocal Health Board
• 3 Wards Audited
• Good Compliance Rates
• Excel Data Collection Tool still needs tweaking to be as effective as Hand Hygiene
• Has highlighted areas of the bundle that require further input
Pilot Results
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Hywel DdaLocal Health Board
13%
75% 75% 75% 75% 75% 75%
0%
25%
50%
75%
100%S
ticker
Pre
sent
Care
Bundle
s
Com
ple
ted
Hand H
ygein
e
Indic
ation f
or
Use
VIP
Score
Less
than 2
Dre
ssin
g D
ry &
Inta
ct
Access P
ort
Dis
sin
fecte
d a
nd
Allo
wed t
o D
ry
Pilot Results
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Hywel DdaLocal Health Board
Just the Tip of the Iceberg! Part 1
Clostridium difficileMRSA/MSSA
Elective Orthopaedic
SSICaesaran Section SSI
Breast SSICVL/VAP Bundles
CABSI - Peripheral Lines
SSI :
• Vascular
•Gynaecology
• Urology
• ENT
•Ophthalmology
CAUTI- LDP
Other Multi Resistant Germs:
• VRE
• GRE
• MDR TB
• ESBL s E.Coli Klebsiella
• Acinetobcater
• Candida
•Serratia
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Hywel DdaLocal Health Board
Just the Tip of the Iceberg! Part 2
Clostridium difficileMRSA/MSSA
Caesaran Section SSICVL/VAP BundlesElective Orthopaedic SSI
Breast SSI
CABSI -
SSI :
Vascular
Gynaecology
Urology
ENT
Ophthalmolog
y
Other Multi Resistant Germs:
• VRE
• GRE
• MDR TB
• ESBL s E.Coli Klebsiella
• Acinetobcater
• Candida
•Serratia
Peripheral Lines CAUTI
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Hywel DdaLocal Health Board
Thankyou
Any Questions?