CLABSI Supplemental Call Series

Best Practices: How Successful Units

Engaged Their Senior Executive Leaders
October 18, 2011

Presenters:
Jonathan Kling, BSN, BHA, RN, CCRN
Scott Raynes, MA, MBA
Joan Chatham, MSN, RN
Melissa Allen, MS, RN
CLABSI Supplemental Call Series

Jonathan Kling, BSN, BHA, RN, CCRN

Director, Critical Care
NCH Healthcare System
Naples, Florida

Slide 2
 Initial Challenges & Solutions

• Challenges
– Buy-in from staff, physicians, and senior leadership
– Inconsistent data collection and reviewing of data
– Outdated, non-evidence-based policies and procedures
• Solutions
– Consistent audit process with weekly meetings with senior
leadership, physicians, and staff
– With consistent data and timely communication, the cost
benefits of quality care were clearly observed
– Revision of policies in line with evidence-based practice

Slide 3
 Best Practices

• Consistent application of insertion bundle always

– Identification of appropriate site
– Sterile technique, head-to-toe coverage
– Everyone in room sterile or clean at all times
– Sterile dressing and documentation of line
– Continuous assessment of lines
– Consistent line care and maintenance at all times -- “scrub
the hub”

Slide 4
 Lessons to Bring Back to Your Hospitals

• Collaborative, multidisciplinary team approach is key

– Mandatory staff education
– Quality contracts
• Policies must be in line with evidence-based practice
• Clear direction set with senior leadership
• Strong physician champion is vital to success
• Invest in products with proven success
• Consistently use evidence-based practice “bundles” on all
insertions
• Consistently re-educate and audit on daily basis

Slide 5
 Final Thoughts

• Keys to success
– Clear vision and direction of strong senior leadership
– Buy-in of physicians and staff
– Cannot be done quickly or without the support of a
large multidisciplinary team
– Never say good is good enough; the challenge to be
the best requires daily follow through and effort

Slide 6
 CLABSI Supplemental Call Series

Scott Raynes, MA, MBA,

Chief Executive Officer
NorthCrest Medical Center
Springfield, Tennessee

Melissa Allen, MS, RN Joan Chatham, MSN, RN

Director, Infection Control Director, Quality
NorthCrest Medical Center NorthCrest Medical Center
Springfield, Tennessee Springfield, Tennessee
Initial Challenges & How they were Overcome

• Initial CLABSI project started with IHI Save 100,000 Lives

Project
• A CLABSI bundle was established and has been in use
since then
• Initial challenges were physician buy-in and compliance
• Results were reported quarterly to the Quality Review
Committee, which includes senior administrators,
physicians, and board members
• This group provided the support necessary to get
physicians involved; nurses were empowered to speak
up and stop the process if the physician was not
compliant
Slide 8
 Best Practices
• Leadership best practices
– Keep senior leadership informed of progress and failures
– Make success an organizational goal to keep everyone involved
– Look constantly at your processes for opportunities for
improvement
– Monitor every insertion and share compliance results with staff
• Clinical best practices
– Have a central line kit that contains all necessary items
– Have a checklist attached to the bundle to make it immediately
available
– Have a procedure cart with extra supplies immediately available in
case an item in the kit is contaminated
– Include consents and time outs on your checklist
Slide 9
Lessons to Bring Home to your Hospitals

• Zero infections is achievable if everyone complies with the

bundle
• We have had no CLABSI in our CCU since July 2008
• If you make the process simple and convenient, you are
more like to achieve compliance
• Leadership support is essential

Slide 10
 Final Thoughts

• We teach this process to new graduate

nurses during their orientation so they start
out knowing the process
• We are happy to share our checklist with
anyone who is interested

Slide 11
CLABSI Supplemental Call Series

Craig Becker,
President and CEO
Tennessee Hospital Association
Nashville, TN

Slide 12
Tennessee Hospital Association Board Aim
Vision: Healthier, Safer Tennessee
Aim: Zero Preventable Harm
Targets:
- Zero infections within 3 years
- Top quartile performance on public measures
Priorities
• Focus on achieving THA Board Aim of Zero Preventable Harm.
• Position Tennessee as a leader on patient safety efforts and
healthcare-acquired infection reduction strategies.
• Accelerate Tennessee’s efforts by focusing on
– Alignment among partner organizations
– Leadership
– Culture change
– Accountability
Questions?

Slide 14