Hospital Story Jennifer Zeck, RN, BSN, CNOR Infection Preventionist Good Samaritan Regional Medical Center Corvallis, Oregon
About Us • Largest hospital of five that are a part of Samaritan Health Services • 188 Beds • Level 2 Trauma Center • Offers multiple comprehensive surgical specialties • Teaching institution 2
SSI Prevention Team Formation • Multi-disciplinary – Physician champion(s) – Administrative support – Front line staff • Recruit a “mole” inside the departments! • Find a “Mamma/Daddy hen” (project organizer) 3
AIM Selection • Focused on NHSN reportable procedures • AIM development: – “Zero Tolerance” was initial goal – Standardized Infection Ratio (SIR) change – Allow change 4
Measure Selection • Reviewed literature, toolkits, “best - practices” • Actions to achieve outcomes component: – Core and supplemental prevention strategies from CDC – SCIP measures 5
Tests of Change- What to Test • Low hanging fruit – Removing razors – Patient warming • Biggest “bang for the buck” measures – Antibiotic management – Environment of care • Standardizing processes – Order sets 6
Tests of Change • Who: – Mother Hen delegates – Rally the mole • How: – Accountability essential – Small tests of change – Stay flexible • Assess Change: Infection Preventionist 7
Barriers, and How We Resolved those Barriers • “We have always done it that way” – Literature – Positive peer pressure – Data • Inertia vs. Apathy – Make it relevant to each department/person – Visibility – “Success breeds success” 8
Advice for Fellows • Get involved in something larger than yourself • Find the key players • Achieve early successes and SHARE them! • Don’t take on too much • Stay organized • Listen to front line staff • Audit practices periodically 9
GSRMC Total NHSN Rate: 2010-2012 4.5 4 Total SSI% 3.5 Linear (Total 3 SSI%) SSI % 2.5 2 1.5 1 0.5 0 • 2012 overall NSHN Reportable Rate= 0.72% • 60% Decrease from 2010 Rate
Wrap Up and Next Steps • Questions? • Next Tests of Change (TOC) – Glucose management – Expanded MRSA/Staph screening program
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