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Recommended Citation
Marler B, Cox H. Meet Me in the Midline: Decreasing Risks of CLABSI in Rehabilitation. Nurse-driven Innovations in Care Redesign and Delivery poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Nurse-driven Innovations in Care Redesign and Delivery poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Introduction and Context
The problem identified is a recent increase in Central Line Associated Blood Stream Infections (CLABSI). The rationale for addressing this problem is to decrease the number of infections through the use of a nurse-led decision tree and the development of a midline IV access program. The goal is to improve patient care by reducing the incidence of CLABSI infections and to empower nurses by giving them more autonomy and decision-making power in patient care. These initiatives allow nurses to take a more active role in preventing CLABSI infections and improving patient outcomes.
Implementation Strategy
A nurse-led education program was developed to train nurses in the use of ultrasound technology for midline placement. This included simulation training, as well as education on the risks, benefits, and contraindications of midline use. Nurses were also trained to assess patient history for appropriateness and to offer midline use as an alternative for extended antibiotic treatment and continuous IV fluids. The two-part class included use of ultrasound for basic peripheral sticks followed by a class for midline insertion. Successful candidates were observed and deemed competent by midline trained preceptors.
Outcomes and Impact
Upon completion, participants will be able to identify risk factors of central line associated bloodstream infections, list the benefits of midline verses central line catheters, and be able to state the benefits of ultrasound guided venipuncture.
Insights
Since the implementation of the education program and the use of the nurse-led decision tree, we have seen a significant increase in midline use throughout all four hospitals. This has resulted in a decrease in unsuccessful venipuncture attempts, reducing patient discomfort and improving the overall patient experience.
Implications
The use of midlines has helped to reduce the incidence of CLABSI infections, improving patient outcomes and reducing healthcare costs.
References
Marsh, N., Larsen, E. N., O’Brien, C., Groom, P., Kleidon, T. M., Alexandrou, E., Young, E., McCarthy, K., & Rickard, C. M. (2023). Comparing the use of midline catheters versus peripherally inserted central catheters for patients requiring peripherally compatible therapies: A pilot randomized controlled trial (the compact trial). Infection, Disease & Health, 28(4), 259–264. https://doi.org/10.1016/j.idh.2023.03.007
Farhat R, Minoff J, Burke S, Patolia S. Options to Minimize the Use of Central Lines: Midodrine, Peripheral Venous Lines, and Midline Catheters. American Journal of Respiratory & Critical Care Medicine. 2021;204(12):1473-1475. doi:10.1164/rccm.202103-0685RR
Penoyer, D., Bennett, M., Geddie, P. I., Nugent, A., & Volkerson, T. (2020). Evaluation of Processes, Outcomes, and Use of Midline Peripheral Catheters for the Purpose of Blood Collection. Journal of the Association for Vascular Access, 25(4), 8–17. https://doi.org/10.2309/JAVA-D-20-00028
Document Type
Poster
Publication Date
11-13-2024
Meet Me in the Midline: Decreasing Risks of CLABSI in Rehabilitation
Introduction and Context
The problem identified is a recent increase in Central Line Associated Blood Stream Infections (CLABSI). The rationale for addressing this problem is to decrease the number of infections through the use of a nurse-led decision tree and the development of a midline IV access program. The goal is to improve patient care by reducing the incidence of CLABSI infections and to empower nurses by giving them more autonomy and decision-making power in patient care. These initiatives allow nurses to take a more active role in preventing CLABSI infections and improving patient outcomes.
Implementation Strategy
A nurse-led education program was developed to train nurses in the use of ultrasound technology for midline placement. This included simulation training, as well as education on the risks, benefits, and contraindications of midline use. Nurses were also trained to assess patient history for appropriateness and to offer midline use as an alternative for extended antibiotic treatment and continuous IV fluids. The two-part class included use of ultrasound for basic peripheral sticks followed by a class for midline insertion. Successful candidates were observed and deemed competent by midline trained preceptors.
Outcomes and Impact
Upon completion, participants will be able to identify risk factors of central line associated bloodstream infections, list the benefits of midline verses central line catheters, and be able to state the benefits of ultrasound guided venipuncture.
Insights
Since the implementation of the education program and the use of the nurse-led decision tree, we have seen a significant increase in midline use throughout all four hospitals. This has resulted in a decrease in unsuccessful venipuncture attempts, reducing patient discomfort and improving the overall patient experience.
Implications
The use of midlines has helped to reduce the incidence of CLABSI infections, improving patient outcomes and reducing healthcare costs.
References
Marsh, N., Larsen, E. N., O’Brien, C., Groom, P., Kleidon, T. M., Alexandrou, E., Young, E., McCarthy, K., & Rickard, C. M. (2023). Comparing the use of midline catheters versus peripherally inserted central catheters for patients requiring peripherally compatible therapies: A pilot randomized controlled trial (the compact trial). Infection, Disease & Health, 28(4), 259–264. https://doi.org/10.1016/j.idh.2023.03.007
Farhat R, Minoff J, Burke S, Patolia S. Options to Minimize the Use of Central Lines: Midodrine, Peripheral Venous Lines, and Midline Catheters. American Journal of Respiratory & Critical Care Medicine. 2021;204(12):1473-1475. doi:10.1164/rccm.202103-0685RR
Penoyer, D., Bennett, M., Geddie, P. I., Nugent, A., & Volkerson, T. (2020). Evaluation of Processes, Outcomes, and Use of Midline Peripheral Catheters for the Purpose of Blood Collection. Journal of the Association for Vascular Access, 25(4), 8–17. https://doi.org/10.2309/JAVA-D-20-00028
Affiliations
Carolinas Rehabilitation Mount Holly