Patient Safety: Healthcare- Associated Infection

Quality Improvement Activities

For questions and comments, please contact:
Sarah Keehner,
RN, BSN, CNN
Quality Improvement Director
skeehner@nw1.esrd.net (203) 285-1214
ACTION REQUIRED:
Please be aware of the dates associated with each activity.
 
Please complete the July Monthly Summary Report.
 
Please register for the NCC BSI QIA LAN August 7, 2018, 3:00-4:00 PM  
Provider Resources :
In 2017 the Center for Disease Control and Prevention (CDC) updated the recommendation of the use of Chlorhexidine- Impregnated Dressing to aid in the reduction of central venous catheter. Please click on the following link to review the updated recommendations and guidelines.   
 

The Network  is asking that all provides review the  CDC " Scrub The Hub" protocol with staff members during the month of August. Click on the following link to download the "Scrub the Hub" work sheet.

 

The Network is requesting that a minimum of five (5) hemodailaysis catheter exit site care audits are completed and entered into NHSN.

 

Checklist: Hemodialysis catheter exit site care

Patient Resources :

Patient Education is the number one way that we as health care providers can ensure that our patients are making the most informed decisions about their health care options. The following link provides some frequently asked question about catheter-associated bloodstream infection. Please share this document with patient 

 

FAQs about Catheter-Associated Bloodstream Infections

 

Patient Safety

Dear Providers,

Thank you to all the facilities involved in the Patient Safety Quality Improvement Activity. Each month the facility is required to fill out a Monthly Summary Report (MSR) to let the Network know what activates and changes are occurring in the facility that will foster a culture of positivity and untimely create sustainable changes.
 
In the month of August the Network is asking facilities to focus on reducing bloodstream infections by reviewing facility specific skin preparation policy and procedures to ensure they meet all the CDC and NKF KDOQI guidelines.
 
Aseptic techniques must be used whenever an arterial venous site is being accessed for treatment. The first step in the process is to get the patient to wash their access site with soap and water upon arrival to the unit. The second step in the process is to make sure the skin over the access site is prepped with an appropriate antiseptic solution. In 2011 both the CDC and Healthcare Infection Control Practices Advisory Committee(HICPAC) recommend a greater then 0.5% chlorhexidine with alcohol, 70% alcohol, or 10% povidone-iodine be used. If a facility is using 70% alcohol skin prep pads, please ensure that they are labeled as sterile.
 
For additional information on the CDC"s Core Intervention for Dialysis Bloodstream Prevention and access to the audit tool and checklists, please follow the link below.
Project Activities

*Implement CDC core interventions

*Complete NHSN training if not completed

*Complete 5 Catheter dressing change audits

*Complete July's Monthly Summary Report

Long Term Catheter Reduction
 
The Network understand that for some patients a central venous catheter (CVC) is this their only access option. Therefore, it is imperative that as heath care provides, we take ever step possible to protect these easily susceptible access from infection.
 
The CDC developed the Scrub-the-Hub protocol to help reduce and ultimately eliminate catheter related bloodstream infections.The Scrub-the-Hub protocol provide healthcare personal catheter related definition so that all staff member are referring to all parts of the catheter the same way. This will assist in reducing  confusion when handing off a patient  to a new nurse or when a technician is reporting to a nurse. The protocol also outlines very detailed steps for both the catheter connection to the bloodlines and also the catheter disconnection from the bloodlines. It is important to remember that heather care worker need to scrub the hub with a clean antiseptic wipe every time the catheter is accessed.
 
This includes but is not limited to :
  • Before attaching syringes to remove hep-block prior to treatment  
  • After the limbs are flushed with saline before attaching the blood lines
  • After any medication is injected into the catheter
  • Changing the catheter caps
  • Before a patient goes back on the machine after needing to pause treatment.
Project Activities

*Designate a vascular access coordinator

*Complete Patient Safety Monthly Summary Report

*Review Cather put and take off policy and procedure

Heath Information Exchange

Communications does not always happen in the same way for every facility. If your facility has developed an effective method of communicating with hospitals when a patient is admitted please share with the Network Quality Improvement Department. The Network would like to help promote and spread any best practices that are identified.