Neonatologist, NHS Lanarkshire CLABSI A confirmed primary blood - - PowerPoint PPT Presentation

▶
neonatologist nhs lanarkshire clabsi
SMART_READER_LITE
LIVE PREVIEW

Neonatologist, NHS Lanarkshire CLABSI A confirmed primary blood - - PowerPoint PPT Presentation

May 22, 2023 514 likes •669 views

Dr Augusta Anenih Neonatologist, NHS Lanarkshire CLABSI A confirmed primary blood stream infection in a patient that had a central line within the 48-hour period before the development of the blood stream infection, and is not related to an

slide-1
SLIDE 1

Dr Augusta Anenih Neonatologist, NHS Lanarkshire

slide-2
SLIDE 2

CLABSI

 A confirmed primary blood stream infection in a

patient that had a central line within the 48-hour period before the development of the blood stream infection, and is not related to an infection at another site.

slide-3
SLIDE 3

CLABSI

 Infections associated with

 Increased mortality and morbidity  Neurodevelopmental impact/ Poor outcome  Increased emotional burden  Increased length of hospital stay  Financial burden.

 Use of central line bundles associated with a decrease

in rates.

slide-4
SLIDE 4

 Xxxx

Aim: Reduction in CLABSI to < 8 per 1000 line days

Measures

  • A. Outcome measure: Number of CLABSI per 1000 line

days.

  • B. Process measure :
  • % compliance maintenance bundles
  • % compliance with access bundles
  • % Compliance with PVC access bundle
  • C. Balance measure
  • Increased expenditure.
  • Early establishment of full enteral feeds
  • Increased incidence of feed intolerance

Change ideas: ?

Plan Do Act Study

THE MODEL FOR IMPROVEMENT

What changes can we make that will result in improvement? What are we trying to accomplish? How will we know that change is an improvement?

slide-5
SLIDE 5

Identifying areas for improvement

 Review of cases of CLABSI

 Identify themes

 Practices around insertion  Day of onset  GA  Unit activity  Line access

 Review of current process, practice and culture  The human side of our everyday practice.

slide-6
SLIDE 6

Driver diagram or Ishikawa

slide-7
SLIDE 7
slide-8
SLIDE 8

Process measures

Tools used

slide-9
SLIDE 9

Hub Scrub & CVC Bundles CLABSI Prevention Bundle Badger Commenced

Quality Week Focus on Hand hygiene

10 20 30 40 50 60 70

Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18

Rate per 1000

Rate of CLABSI per 1000 line days

What the data tells us

slide-10
SLIDE 10

No Measuring ?Person Dependent

Data displayed

  • n QI Board

Badger commenced Quality Week Focus on hand hygiene

10 20 30 40 50 60 70 80 90 100

% Compliance

Monthly Compliance with CVC Insertion Bundle

What the data tells us

slide-11
SLIDE 11

What the data tells us

Data displayed

  • n QI Board

Badger Commenced

Quality Week Focus on Hand Hygiene

10 20 30 40 50 60 70 80 90 100 % Compliance

Monthly Compliance with CVC Maintenance Bundle

slide-12
SLIDE 12

Baby transferred with lines in situ Badger Commenced High Activity

  • n Ward

UCL LCL CLABSI Prevention Bundle

20 40 60 80 100 120 140 160

Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Rate per 1000 line days

U Chart showing rate of CLABSI per 1000 line days 2017/2018

Rate

CLABSI Rate in 2017 = 19.9 / 1000 line days CLABSI Rate in 2018 = 12.9 / 1000 line days demonstrating a 35% reduction

Where we are now

slide-13
SLIDE 13

Lessons

 Always test PDSA!  Spot data do not cut it.  Improvement is everyone’s business.  Accept marginal gains.

 Ambitious aim?

slide-14
SLIDE 14

Thank You