Together we can do this !

Key learnings

Hutt Valley“186 days CLAB free since

data collection commenced

against project definitions! Our

compliance rates for Insertion

and Maintenance Bundles are

improving with every week and

we are currently preparing

to expand the programme to

theatres by August 2012.”

Tairawhiti“The presentation at the

Intravenous Nurses of New Zealand

annual conference in April 2012,

that focused on the challenges of

implementing Insertion and

Maintenance Bundles in a small

DHB was well received.”

Northland“The last CLAB case was

reported on 16 January 2011.

One of our biggest challenges

has been determining the roles

and responsibilities of the team

members and adapting current

practice to reflect the national

programme expectations.”

Why target CLAB Zero?Each year 19,000 patients are

admitted to Intensive Care Units

(ICUs) and approximately 50%

of these will have a Central Line

in situ. Infections that occur as

a direct result of this procedure

(CLABs) can have serious health

implications with mortality rates

between 10 and 50%. In addition

to this, there are also significant

cost implications, with each

CLAB infection costing DHBs

between $20,000 and $54,000

for increased care and length

of stay in hospital.

Achieving zero CLAB is an

achievable goal that will be a

significant contribution to the

quality of ICU care in New Zealand

and a clear indication of our

professionalism.

Ultimately it’s up to each of us

to play our part in making CLAB

Zero a proud and sustainable

achievement.

What have we achieved?Eight months ago we began

an 18 month campaign with

the aim of achieving zero CLAB

in participating DHBs, and

the results have been very

encouraging. There is now a

robust measurement system

for counting CLAB rates per

1,000 line days and a regional

network of health professionals

who contribute to our national

CLAB database.

The National Clinical Lead

Dr Shawn Sturland (also Central

Regional Clinical Lead) is

supported by Dr David Knight,

Dr Pranesh Jogia and Dr Dave

Buckley who have made a

significant positive contribution

to the success achieved to

date. The collaborative has also

had significant support from

Dr Mary Seddon and the team

at Counties Manukau DHB.

Participating ICUs have

made good progress in the

implementation of the

insertion and maintenance

bundles; incorporating the

monitoring and data reporting

into their daily activities. The

collaborative is building local

and regional capacity in the

implementation of the IHI

Model for Improvement as

they implement small scale

changes that they are then

able to spread. The national

CLAB rate for the country

in April was zero and at

Middlemore Hospital, Counties

Manukau they reported zero

CLAB hospital wide.

from our District Health Board teams around the country

Southern“The Associate Minister of Health

- Jo Goodhew, the National Chief

Medical Officer - Dr Don Mackie

and Tessa Buchanan - Advisor

visited the DHB. All of them were

very impressed with the work

completed to date.”

Canterbury“Despite the earthquakes and

snow, Christchurch Hospital

continues to show progress with

194 days CLAB free. The team has

had an electronic data base up

and running since the beginning

of April 2012, and there are now

computers at all bedsides.”

Lakes“Having access to the

collaborative network has been

valuable in helping us to achieve

some noteable successes,

including Insertion Bundle

implementation and 100%

compliance to the Maintenance

Bundle during May 2012.”

Bay of Plenty“Being part of the national

collaborative has given us

the opportunity to develop a

network of valuable colleagues

across our region. This helps

to affirm the efforts already

directed at preventing CLAB,

and to standardise and improve

processes and resources.”

Waitemata“We’re pleased with the support

from the team in our ICU. All

members have been positive and

eager to learn more about

an initiative that will improve

patient outcomes.”

Auckland“We’re very pleased to have

achieved broad organisational

support for the programme

with three ICU teams enrolled.

This has resulted in the

Cardiovascular ICU reaching

100 days CLAB free by May, the

Paediatric Intensive Care Unit

reporting zero cases for 100 days

by June and the Department of

Critical Care Medicine on track to

achieve the same.”

Nelson Marlborough“The implementation of the

CVL Insertion and Maintenance

Bundles in our CCU has

been both challenging and

rewarding.”

Counties Manukau“Middlemore Hospital is making

great progress with CLAB rates

declining from 6.6/1000 line days

to close to zero. There have been

no CLAB cases reported across

the hospital during April 2012,

and we have saved approximately

220 inpatient bed days with

a conservative cost saving of

NZ$520,000 since July 2011!”

Northland

Waitemata Auckland

CountiesManukau

WaikatoBay of Plenty

Tairawhiti

Hawke’s Bay

Wairarapa

Whanganui

Taranaki

MidCentral

Wellington

Nelson Marlborough

West Coast

SouthCanterbury

Otago

Southland

Canterbury

Lakes

Hutt Valley

www.koawatea.co.nz

Insertion Bundle Hand Hygiene

Chlorhexidine Skin Antisepsis

Maximum Barrier Precautions

Maintenance Bundle Daily necessity review

Dedicated port for TPN

Daily site check

Chlorhexidine prior to each access

Insertion Bundle

Insertion Bundle & Maintenance Bundle

Insertion Bundle & Maintenance Bundle & Rollout

No Central Lines inserted

NationalProgress Map