INFECTION PREVENTION Front line staff were involved in
the solution and implementation process, they explained. Departments involved included the MSICU, clini- cal excellence, infection prevention, and quality improvement. Results: Theraworx use was started November 2015. “A significant reduc- tion was achieved after implementing enhanced perineal and urinary-cath- eter care. After implementation, the MSICU celebrated 351 days without a CAUTI. In FY16, there were five CAUTIs (SIR 1.85). In FY17, there were three CAUTIs (SIR 1.30). The success continues, as the unit recently celebrated 365 days CAUTI-free,” stated Hargett and Anderson. “Rates have progressively decreased since the implementation
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of the CAUTI bundle. It is important to acknowledge the success is not the result of one single intervention, but multiple interven- tions designed to reduce CAUTIs.”
St. Louis Children’s Hospital St. Louis, MO
St. Louis Children’s Hospital is a full-service Magnet hospital with 280 beds, including a level-I trauma center and level-III neonatal intensive care unit. What they did: Jennifer Hoermann, BSN, RN, VA-BC, Super-
visor, Vascular Access Department, explained their goal. “In 2014, we began to focus heavily on reducing hospital-acquired infections (HAIs). While the focus was on all HAIs, there was a particular goal to reduce central-line–associated bloodstream infections (CLABSIs). CLABSIs have a high mortality rate and are expensive to treat, so we made them a priority. “We formed a house-wide CLABSI Reduction Committee to concentrate on our high-risk patient populations,” continued Hoermann. “It was, and still is, a multi-disciplinary team with representation from all inpatient units, as well as the infection- prevention team, the unit medical directors, and nursing man- agement. “A nurse from the high-risk Pediatric Intensive Care Unit (PICU) was on the committee and suggested a trial of 3.15 percent chlorhexidine/70 percent isopropyl alcohol swabs (Prevantics Swab by PDI), to scrub the hubs of central lines, instead of using 70 percent isopropyl alcohol swabs alone. The committee agreed to a trial in the PICU. In mid-2014, the PICU staff was edu- cated on a 15-second scrub and 15-second dry at the start of the trial. All plain alcohol swabs were removed from the nursing supply. The trial lasted 6 months.” Results: “When the trial began, the PICU
Prevantics Device Swab
had experienced 12 CLABSIs in the previous 12 months, a rate of 2.8 infections per 1,000 line-days. At the conclusion of the trial, there was only one reported CLABSI for a rate of 0.48 infections per 1,000 line-days,” reported Hoermann. “This was an 83 percent decrease in the CLABSI rate. The committee determined house-wide implementation of Prevantics was a must. Since we implemented Prevantics Swab, we have been able to maintain lower-than-expect-
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ed CLABSI rates. With the change in how CLABSIs are reported (from a line-day rate to the SIR, it’s difficult to do a year-over-year comparison. However, I’m happy to report the PICU had a 2017 year-end SIR of 0.35. Currently, all units are using Prevantics Swab for scrubbing the hub and for skin prep prior to IV starts.”
Complying with hand hygiene
Bingham Memorial Hospital Blackfoot, ID
Bingham Memorial is a state-of-the art, non-profit, critical-access hospital, providing more than 100 types of patient services, includ- ing inpatient, outpatient, critical care, emergency, rehabilitation, same-day surgery, and transitional care. What they did: According to Maryann Smout, RN, BSN, Man- ager of Employee Health/Infection Control, “Bingham earned a reputation as a trusted healthcare provider throughout Eastern Idaho. Close attention is paid to patient-satisfaction scores. Lis- tening to patients’ feedback constantly improves every aspect of services and facilities.” One area of improvement that Bingham discovered needed to
be addressed was how their patients perceived the staff’s attention to hand hygiene. “Consistent hand hygiene is key to reducing healthcare-associated infections, and assessing compliance with hand-hygiene protocols is vital for hospital infection-control staff,” observed Smout. “Bingham wanted patients to have a way of knowing whether a
staff member washed or sanitized his or her hands,” said Smout. “Therefore, the following three key changes were implemented in November 2016.” (1) Hand-sanitizer machines were installed in every patient room within clear view of the patient’s bed, so they could see and hear the machine being used. Previously, hand-sanitizer machines were placed outside patient rooms. (2) BioVigil’s hand-hygiene solution was introduced to hospital protocol. Included in this solution is a badge clipped to a uniform or lab coat worn by hospital staff. It has a green light indicating hands have been washed and sanitized, and a red light indicating that a staff member’s hands have not been washed or sanitized. Upon admission, each patient is educated about the BioVigil badge, drawing their attention to it throughout their stay. (3) A patient-care coordinator visits every patient’s room several times a day to assure all their needs are being met, as well as to reinforce their patients’ understanding of BioVigil’s hand-hygiene solution.
Biovigil Hand Hygiene Solution
Results: “Before Bingham Memorial implemented these three
key changes, including addition of the BioVigil system, hand- hygiene compliance fluctuated between 55 and 70 percent,” said Smout. “Additionally, Bingham Memorial wanted to improve patient satisfaction and engagement ratings, which were consis- tently in the 37th percentile for hand hygiene by hospital staff. Since the three changes were implemented, Bingham rose to the 90th percentile in overall hand-hygiene compliance and patient satisfaction.” HPN
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