Updates

April 1, 2010

On the importance of the Catheter Associated Blood Stream Infections (CABSI) initiative...

 

"Gabby"'s video has moved - click here to view

March 24, 2010

From the New York Times

Q. WASH YOUR HANDS? DON’T DOCTORS AUTOMATICALLY DO THAT?

A. National estimates are that we wash our hands 30 to 40 percent of the time. Hospitals working on improving their safety records are up to 70 percent. Still, that means that 30 percent of the time, people are not doing it.

At Hopkins, we tested the checklist idea in the surgical intensive care unit. It helped, though you still needed to do more to lower the infection rate. You needed to make sure that supplies — disinfectant, drapery, catheters — were near and handy. We observed that these items were stored in eight different places within the hospital, and that was why, in emergencies, people often skipped steps. So we gathered all the necessary materials and placed them together on an accessible cart. We assigned someone to be in charge of the cart and to always make sure it was stocked. We also instituted independent safeguards to make certain that the checklist was followed.

We said: “Doctors, we know you’re busy and sometimes forget to wash your hands. So nurses, you are to make sure the doctors do it. And if they don’t, you are empowered to stop takeoff on a procedure.”

Q. HOW DID THAT FLY?

A. You would have thought I started World War III! The nurses said it wasn’t their job to monitor doctors; the doctors said no nurse was going to stop takeoff. I said: “Doctors, we know we’re not perfect, and we can forget important safety measures. And nurses, how could you permit a doctor to start if they haven’t washed their hands?” I told the nurses they could page me day or night, and I’d support them. Well, in four years’ time, we’ve gotten infection rates down to almost zero in the I.C.U.

We then took this to 100 intensive care units at 70 hospitals in Michigan. We measured their infection rates, implemented the checklist, worked to get a more cooperative culture so that nurses could speak up. And again, we got it down to a near zero. We’ve been encouraging hospitals around the country to set up similar checklist systems.

March 4, 2010
The objective of this study was to reduce central line-associated blood stream infections (CLABSIs) among 13 collaborating regional neonatal intensive care units by 25%. We tested the hypothesis that change could be attributed to the quality improvement collaborative by testing for ‘special cause’ variation. More...
February 10, 2010
Process data which has been collected in the participating nurseries has been given back to the teams for their use in planning new strategies. We are half way through the initiative timeline and looking for tested strategies to consider standardization in the last third of our work together. Changes that are actual improvements will be shared across the collaborative and with all NC Newborn Critical Care Centers; standardizing these practices will help us hold the gains we have made in our work to reduce infections. Regional meeting are being planned for late April and will provide opportunity for continued sharing among teams.
February 1, 2010
The CABSI Initiative is well underway and the quality improvement teams in each nursery are busy testing “potentially better practices” to reduce infections in newborns with central catheters. Staff, parents and providers who care for these newborns are the best source of ideas to test. Will a sticker in the progress notes help assure that each day the potential of removing the line is discussed? What are the best reminders to prevent entry into a protected space without a mask when a line is being placed? Will a timer placed at the scrub sink improve compliance with initial hand hygiene scrub when entering the unit? Will twice daily antimicrobial wipe down of the bedside equipment effect our ability to prevent infections? These are examples of potentially better practices being tested in the units.
January 10, 2010

NC Childrens Hospital staff created video to promote awareness and
best practices in prevention of catheter associated bloodstream infections

 

August 24, 2009

The agenda and objectives are available:

 

 

Download:
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August 7, 2009
On September 2 & 3 2009, we're expecting over 75 participants from 13 hospitals to join us in our first CABSI learning session to develop aims and strategies, to commit to sharing what they learn on monthly conference calls, and to apply the model for improvement when they return to their setting. These individuals and these hospitals have made a huge commitment that attests to just how critical this work is and emphasizes our commitment to meeting the reasonable expectations of families and patients that a hospital environment will be safe.
August 5, 2009
Eleven of the thirteen participating Perinatal Quality Improvement Teams (PQITs) in the PQCNC CABSI Initiative met on August 4th 2009.  In addition to discussing an outline of the work we will be doing together, each team also gave a short synopsis of the work they have done in the past to focus on catheter associated infections.  PQITs were encouraged to identify parents who might help in designing a system to reduce these infections during the collaborative.

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