Never Declare Victory against CLABSI Patty Kampf BSN RN CRNI Valarie Goitiandia RN CCRN CRNI

1. Never Declare Victory against CLABSI Patty Kampf BSN RN CRNI Valarie Goitiandia RN CCRN CRNI Susan Imhoff MSN RN Logo Logo Methods Abstract Results • At JFK we say Never to Declare Victory against CLABSIs.  We are exhibiting our highest level of skill to decrease CLABSI rates from insertion of appropriate line to discharge and beyond. • Cost of care ($30,000 per occurrence) • Mortality associated with CLABSI* (18%) • Increase Length of Stay • Public reporting impacts the hospital’s reputation • Established an organizational Goal to eliminate CLABSIs house wide • Evidence based practices • Adapted practices locally • Data driven assessments and action • Simulation • Peer Checking and Peer Coaching • Comprehensive Unit Based Safety Program approach Using Organizational Values Objective • Eliminate CLABSI at JFK • Sustainable unit based ownership for CLABSI prevention • Protect patients from harm associated with CLABSIs • Avoid unnecessary hospital costs • Improve the hospital’s position on Value Based Purchasing and Hospital Acquired Conditions • Sustained downward trend in CLABSI occurrences • Decrease in CLABSIs house wide 2012 - 31 CLABSIs 2013 - 11 CLABSIs • Decrease in critical care CLABSIs • Cost avoidance from 2012 – 2013 Blood Culture Draw Video References • Deshpande, K. S. (2003, July). Total parenteral nutrition and infections associated with use of central venous catheters [Guest Editorial]. American Journal Of Critical Care, 12(4), 326-327. Retrieved from ajcc.aacnjournals.org • Halm, M., Hickson, T., Stein, D., Tanner, M., & VandeGraaf, S. (2011, July). Blood cultures and central catheters: Is the “easiest way” best practice? American Journal of Critical Care, 20(4), 335-338. http://dx.doi.org/10.4037/ajcc2011519 • Health Care Improvement Foundation Delaware Valley Healthcare. (2006). Partnership for patient care: Failure mode and effects analysis central line catheter-related bloodstream infections: Insertion and maintenance practices. Retrieved from The Healthcare Improvement Foundation: http://www.hcifonline.org/ • Holder, C., & Zellinger, M. (2012). Daily bathing with chlorhexidine in the icu to prevent central line-associated bloodstream infections. Critical Care Medicine, 40(11). • Infusion nursing standards of practice [Supplemental material]. (2011, January/February). Journal of Infusion Nursing, 34(1S). • Marsteller, J. A., Sexton, J. B., Hsu, Y., Hsiao, C., Holzmueller, C. G., Pronovost, P. J., & Thompson, D. A. (2012). A multicenter, phased, cluster-randomized controlled trial to reduce central line-associated bloodstream infections in intensive care units. Critical Care Medicine, 40(11), 1-7. http://dx.doi.org/10.1097/CCM.0b013e31825fd4d8 • TargetBSI.com (Producer). (2011, May 31 and June 1). Show me the evidence - Should blood cultures be obtained through an intravascular catheter? [Webinar transcript]. Retrieved from http://TargetBSI.com/ Add Image Intervention and ResltsGra

3. Blood Culture Draw Technique https://www.dropbox.com/s/0q0bds6jkr7f5ci/Blood%20Culture%20Video.mpg