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 12211 (703) Reducing Catheter-Associated Bloodstream Infection (CABSI) $15.00   

12211 (703) Reducing Catheter-Associated Bloodstream Infection (CABSI)
Using Six Sigma and Statewide Collaborative Initiatives
Diane Hudson-Barr, PhD RN

Abstract

BACKGROUND OF PROBLEM: Hospital-acquired infection (HAI) is a major complication faced by infants in the NICU. Neonates, especially those born prematurely, are at increased risk for infection due to their immature immune system, invasive interventions, and large number of caregivers. NICU infants often require central venous access to administer essential nutrients and medications, yet insertion and use of central venous catheters is associated with the risk of HAI.
Purpose of Practice Change: Eliminating HAI in our NICU.

SUPPORTING RESEARCH EVIDENCE: The Institute for Health Care Improvement (IHI) has identified a bundle of best practices to aid in the reduction of catheter-associated blood stream infections (CABSI). The Vermont Oxford Network National Evidence-Based Quality Improvement Collaborative for Neonatology has identified similar ‘potentially better practices’ to decrease HAI.

PRACTICE CHANGE METHODS: In our ongoing efforts to improve the quality of care provided in our NICU, nursing leadership and bedside nurses have been trained in Six Sigma Quality Improvement. Two Six Sigma projects focusing on eliminating HAI are underway: Improving Hand Hygiene and Eliminating Central Line Catheter Infections. Members of the interdisciplinary team also have joined a state-wide collaborative that has chosen reducing CABSI as one of its first projects. The presence of three different initiatives could result in confusion, duplication of activities, and staff overload. Our three teams are utilizing different quality improvement strategies yet work collaboratively towards the common goal of decreasing the incidence of HAI in our NICU.

RESULTS: Change incomplete

COMPARISON TO RESEARCH: Change incomplete

RECOMMENDATIONS: Change incomplete

Learning Objectives
1. Describe two Six Sigma quality improvement processes to decrease catheter-associated bloodstream infection (CABSI) rates.
2. Discuss strategies used by a statewide collaborative to decrease CABSI rates in one NICU.
3. Identify challenges and rewards of integrating quality improvement initiatives to decrease CABSI rates.

Bibliography
Cooley, K., & Grady, S. (2009). Minimizing Catheter-Related Bloodstream Infections: One Unit's Approach. Advances in Neonatal Care., 9(5):209-226.

Curry S, Honeycutt M, Goins G, & Gilliam C. (2009). Catheter-associated bloodstream infections in the NICU: getting to zero. Neonatal Network., 28(3):151-5.

The Joint Commission (2009). Measuring Hand Hygiene Adherence: Overcoming the Challenges.

Schulman, J., Wirtschafter D.D., & Kurtin, P. (2009). Neonatal intensive care unit collaboration to decrease hospital-acquired bloodstream infections: From comparative performance reports to improvement networks. Pediatric Clinics of North America., 56(4):865-92.

 






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