Pediatric Nursing Commons^™

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

Mindful Cleanliness: Resetting Expectations For Environmental And Personal Hygiene To Reduce The Clabsi Rate In A Level Iv Nicu, Rebecca Palmer, Kymeyone Lanehart, Jerithea Tidwell, Sushmita Yallapragada, Jeanne Gaines, Courtney Campbell

2024

QUALITY

Background
/="/">CLABSIs place patients at high risk for mortality and morbidity, increasing length of stay, and additional costly and detrimental therapeutic interventions. Our NICU historically had a better than national average CLABSI rate, however, since 2022, our CLABSI rate spiked to above average. During this timeframe the unit experience higher census and acuity leading to increased workload and needs of patients and staff. In 2022, the CLABSI rate spiked from 0.53 in 2021 to 1.04 and 1.12 CLABSIs/1000 line days in 2022 and 2023, respectively.

Methodology
/="/">Utilizing Quality Improvement methodology allowed identification of the root cause of …

Implementation Of Chlorhexidine Gluconate Dressings And The Effect On Bloodstream Infections In Extracorporeal Membrane Oxygenation Patients At A Pediatric Hospital, Kaitlin Vernier

Dissertations

Extracorporeal membrane oxygenation (ECMO) is an advanced lifesaving therapy used for patients with significant cardiorespiratory failure not responding to conventional therapies. The most common and life-threatening complications associated with ECMO are blood stream infections (BSIs). In addition to increased mortality, BSI's increase patient length of stay and cost. Chlorhexidine Gluconate (CHG) is known to be a significant factor in BSI reduction. The purpose of this quality improvement project is to assess the utilization of CHG-impregnated dressings on the incidence of BSI rates in pediatric ECMO patients. The setting was a 40-bed pediatric intensive care unit (PICU) and a 30-bed cardiac …

Best Practice: Implementation Of A Central Line Bundle To Reduce Central Line-Associated Bloodstream Infections, Alexis N. Montero

MSN Capstone Projects

Central line-associated bloodstream infections (CLABSIs) are among the most frequent health care-associated infections and are reported to be correlated with an increased number of inpatient days, higher cost, and attributable mortality rates (Devrim et al., 2016). For this reason, central line bundles (CLB) have been widely used in hospitals to aid in the decrease of CLABSIs. Through implementation of the prevention strategies included in CLBs, CLABSIs can be reduced by greater than fifty percent (Devrim et al., 2016). A decrease in CLABSIs is clinically significant with the avoidance of negative patient outcomes and a decrease in healthcare costs (Rinke et …

Contributing Factors And Interventions For Increased Central Line-Associated Bloodstream Infection (Clabsi) Rates During The Covid-19 Pandemic: A Literature Review, Brittney Perry

Honors Undergraduate Theses

The purpose of this literature review is to determine the contributing factors of CLABSI rate increases during the COVID-19 pandemic and identify interventions which restored CLABSI rates to pre-pandemic levels to guide healthcare professionals’ actions during the next pandemic. Background: In the first two decades of the 21^st century, CLABSI rates were reduced in United States hospitals by innovating safer patient care practices. However, there was a significant increase in the annual CLABSI rate in 2020 and 2021, increasing the average length of stay, mortality rate, and cost to the U.S. healthcare system. Methods: An extensive search of CINAHL …

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Tiered Centralized Education In The Transition-To-Practice Program To Improve Nurses' Level Of Confidence On Nursing Sensitive Indicators Outcomes, Froiland Agana Ascaño

Doctoral Projects

A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses' Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses' confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that …

Clabsi Prevention Through Prevention Huddles And Clabsi Risk Assessment And Prevention Form In Electronic Medical Record, Tara Benton, Barb Haney, Lacey Bergerhofer, Yolanda Ballam, Kaitlyn Hoch

Posters

Our aim is to increase the awareness of high risks for central line associated bloodstream infection (CLABSI) and decrease the CLABSI rate with the implementation of CLABSI prevention huddles and an electronic medical record (EMR) "CLABSI Risk Assessment and Prevention" form.

Identifying Structural Factors Associated With Central Line-Associated Bloodstream Infections (Clabsi) Risk In A Single-Center Pediatric Academic Hospital, Elizabeth Monsees, Paul N. Bauer, Yolanda Ballam, Brian R. Lee

Posters

Objective: compare unit structure and process-related factors against unit-specific CLABSI rate.

Conclusion: CLABSI mitigation requires more than individual competence with task-related practices; the unique work ecology of each clinical area may broadly influence CLABSI as an outcome; extending analyses to consider organizational structure can inform resource allocation and recalibrate traditional prevention strategies.

Evaluating The Use Of Stopcocks For Lab Collections From Central Venous Access Devices Related To Central Line Associated Blood Stream Infections, Heather Hollingsworth

DNP Projects

PURPOSE: Central line associated blood stream infections pose a threat to patient safety and are costly to healthcare systems. Heath care professional frequently access central venous access device (CVAD) to obtain blood samples for laboratory analysis. A commonly accepted procedure practice involves exchanging 3-4 syringes during the collection process. Each time a syringe is exchanged during the lab collection process the opportunity for bacteria to be introduced into the bloodstream exists. Decreasing the number of times a CVAD is accessed removes opportunities for bacteria to be introduced to the line thus decreasing the risk of infection. Due to the occurrence …

Implementing Strategies To Reduce Central Line-Associated Blood Stream Infections On An Inpatient Pediatric Unit, Sherryann St. Pierre, Nicole Manchester, Jessica Howe, Melanie Lord, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Barbara Bush Children's Hospital

Operations Transformation

STRATEGIES TO REDUCE CENTRAL LINE ASSOCIATED BLOODSTREAM INFECTIONS

Every central line associated bloodstream infection (CLABSI) leads to poor outcomes, increased mortality and increased healthcare costs. A pediatric care team in an academic tertiary medical center set a goal to reduce the number of these infections on their unit.

The team’s research showed that daily bathing greatly decreases CLABSI. Their baseline metrics demonstrated an unacceptable level of those with central lines being bathed. A root cause analysis revealed that patient and family refusal was the leading cause for those who did not bathe.

A performance improvement plan was initiated that consisted …

Peer Accountability Improves Performance For Daily Chg Bathing To Reduce Clabsis, Sara Crawford, Stacy Pennington, Jeremy Affolter, Kathlyn Baharaeen, Paul N. Bauer, Tara Benton, Shekinah Hensley, Tiffany Mullen, Michelle Waddell

Posters

No abstract provided.

The Lifecycle Of A K-Card: Improving Data Collection While Improving Bundle Reliability, Tara Benton, Barb Haney, Lacey Bergerhofer, Susan Burns, Yolanda Ballam, Kaitlyn Hoch

Posters

No abstract provided.

Leveraging Human Factors To Improve Clabsi: Implementation Of A Central Line Dressing Change Kit, Tara Benton, Barb Haney, Lacey Bergerhofer, Susan Burns, Yolanda Ballam, Kaitlyn Hoch

Posters

No abstract provided.

Reducing Clabsi In The Nicu With Iv Tubing Competency, Tessa A. Toscano Ms

Master's Projects and Capstones

Central line-associated bloodstream infection (CLABSI) is a significant problem in a Level IV neonatal intensive care unit (NICU) on the West Coast of California. A clinical nurse leader (CNL) student joined a team consisting of the unit’s nursing manager, nursing educator, clinical nurse specialist (CNS), and CNS student. Literature review highlighted the association between the development of CLABSI and the practice of changing central line intravenous (IV) tubing. Five interviews of nurses and 15 observations of nurses performing IV tubing change revealed practice variations within six major steps of the procedure. The team revised the IV tubing change policy to …