CLABSI Supplemental Call Series

Best Practices: How Successful Units Engaged Their Senior Executive Leaders

October 18, 2011

Presenters:Jonathan Kling, BSN, BHA, RN, CCRN

Scott Raynes, MA, MBA

Joan Chatham, MSN, RN

Melissa Allen, MS, RN

Slide 2

CLABSI Supplemental Call Series

Jonathan Kling, BSN, BHA, RN, CCRNDirector, Critical Care

NCH Healthcare SystemNaples, Florida

Slide 3

Initial Challenges & Solutions

• Challenges– Buy-in from staff, physicians, and senior leadership– Inconsistent data collection and reviewing of data– Outdated, non-evidence-based policies and procedures

• Solutions– Consistent audit process with weekly meetings with senior

leadership, physicians, and staff– With consistent data and timely communication, the cost

benefits of quality care were clearly observed– Revision of policies in line with evidence-based practice

Slide 4

Best Practices

• Consistent application of insertion bundle always– Identification of appropriate site– Sterile technique, head-to-toe coverage– Everyone in room sterile or clean at all times– Sterile dressing and documentation of line– Continuous assessment of lines– Consistent line care and maintenance at all times -- “scrub

the hub”

Slide 5

Lessons to Bring Back to Your Hospitals

• Collaborative, multidisciplinary team approach is key– Mandatory staff education– Quality contracts

• Policies must be in line with evidence-based practice• Clear direction set with senior leadership• Strong physician champion is vital to success• Invest in products with proven success • Consistently use evidence-based practice “bundles” on all

insertions• Consistently re-educate and audit on daily basis

Slide 6

Final Thoughts

• Keys to success

– Clear vision and direction of strong senior leadership

– Buy-in of physicians and staff

– Cannot be done quickly or without the support of a large multidisciplinary team

– Never say good is good enough; the challenge to be the best requires daily follow through and effort

CLABSI Supplemental Call Series

Scott Raynes, MA, MBA, Chief Executive Officer

NorthCrest Medical CenterSpringfield, Tennessee

Melissa Allen, MS, RNDirector, Infection ControlNorthCrest Medical Center

Springfield, Tennessee

Joan Chatham, MSN, RNDirector, Quality

NorthCrest Medical CenterSpringfield, Tennessee

Slide 8

Initial Challenges & How they were Overcome

• Initial CLABSI project started with IHI Save 100,000 Lives Project

• A CLABSI bundle was established and has been in use since then

• Initial challenges were physician buy-in and compliance• Results were reported quarterly to the Quality Review

Committee, which includes senior administrators, physicians, and board members

• This group provided the support necessary to get physicians involved; nurses were empowered to speak up and stop the process if the physician was not compliant

Slide 9

Best Practices

• Leadership best practices– Keep senior leadership informed of progress and failures

– Make success an organizational goal to keep everyone involved

– Look constantly at your processes for opportunities for improvement

– Monitor every insertion and share compliance results with staff

• Clinical best practices– Have a central line kit that contains all necessary items

– Have a checklist attached to the bundle to make it immediately available

– Have a procedure cart with extra supplies immediately available in case an item in the kit is contaminated

– Include consents and time outs on your checklist

Slide 10

Lessons to Bring Home to your Hospitals

• Zero infections is achievable if everyone complies with the bundle

• We have had no CLABSI in our CCU since July 2008• If you make the process simple and convenient, you are

more like to achieve compliance• Leadership support is essential

Slide 11

Final Thoughts

• We teach this process to new graduate nurses during their orientation so they start out knowing the process

• We are happy to share our checklist with anyone who is interested

Slide 12

CLABSI Supplemental Call Series

Craig Becker,President and CEO

Tennessee Hospital AssociationNashville, TN

Tennessee Hospital Association Board Aim

Vision: Healthier, Safer TennesseeAim: Zero Preventable HarmTargets:

- Zero infections within 3 years - Top quartile performance on public measuresPriorities • Focus on achieving THA Board Aim of Zero Preventable Harm.• Position Tennessee as a leader on patient safety efforts and

healthcare-acquired infection reduction strategies.• Accelerate Tennessee’s efforts by focusing on

– Alignment among partner organizations– Leadership – Culture change– Accountability

Slide 14

Questions?