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Recommended Citation
Yates J, Witkofski H. The Influence of a Culture of Inquiry on Device Utilization. Quality Improvement 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
Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background: Hospital infections caused by invasive devices can lead to significantly poor patient outcomes and life-threatening complications (Sepsis Alliance, 2024). Reducing invasive devices, when not clinically indicated, and improving compliance with evidence-based prevention standards is a proven strategy to reduce infections (Dadi et al., 2021).
Local Problem: Aurora St. Luke’s South Shore was responsible for three catheter associated urinary tract infections (CAUTIs) and one central line associated blood stream infection (CLABSI) with standardized utilization ratios (SURs) for both trending over target 3 out of 4 quarters in 2022-2023. Nursing was not an active participant in device audits, so improvement opportunities were unknown.
Method: Using the Plan-Do-Study-Act (PDSA) methodology, South Shore implemented a daily device huddle to increase operational awareness of device usage and provide a forum for open discussion regarding device indications and adherence to prevention standards (Mena Lora et al., 2020). The huddle was conducted in a virtual manner and led by the charge nurses from each nursing unit, with participation from an interdisciplinary team. Each central line and foley catheter were reported, including the current indication, plan for removal if known, and compliance with care standards.
Results: After the implementation of the daily device huddle, the central line SUR was reduced from 0.796 to 0.576 with only one reported CLABSI. Foley catheter utilization also improved with SUR reduction from 0.677 to 0.584. Three CAUTIs occurred in a small cluster from December 2023 to January 2024. Nursing now owns the audit process and follow-up.
Implications for Practice: Having a dedicated forum for real-time discussions about device appropriateness creates a culture of inquiry and sense of ownership, encouraging nurses to have proactive conversations with providers about device removal criteria and planning. Missed opportunities with care standards are corrected in real-time, further mitigating infection risk. Between January 2024 and April 2024, seventy-five devices were removed through device huddle.
References
Dadi, N. C. T., Radochova, B., Vargova, J., & Bujdakova, H. (2021). Impact of healthcare-associated infections connected to medical devices – An update. Microorganisms, 9(2332). https://doi.org/10.3390/microorganisms9112332
Mena Lora, A. J., Ali, M., Krill, C., Spencer, S., Takhsh, E., & Bleasdale, S. C. (2020). Impact of a hospital-wide huddle on device utilization and infection rate: A community hospital’s journey to zero. Journal of Infection Prevention, 21(6), 228-233. https://doi.org/10.1177/1757177420939239
Sepsis Alliance. (2024, January 19). Sepsis and invasive devices. https://www.sepsis.org/sepsisand/invasive-devices/
Document Type
Poster
Publication Date
11-13-2024
The Influence of a Culture of Inquiry on Device Utilization
Background: Hospital infections caused by invasive devices can lead to significantly poor patient outcomes and life-threatening complications (Sepsis Alliance, 2024). Reducing invasive devices, when not clinically indicated, and improving compliance with evidence-based prevention standards is a proven strategy to reduce infections (Dadi et al., 2021).
Local Problem: Aurora St. Luke’s South Shore was responsible for three catheter associated urinary tract infections (CAUTIs) and one central line associated blood stream infection (CLABSI) with standardized utilization ratios (SURs) for both trending over target 3 out of 4 quarters in 2022-2023. Nursing was not an active participant in device audits, so improvement opportunities were unknown.
Method: Using the Plan-Do-Study-Act (PDSA) methodology, South Shore implemented a daily device huddle to increase operational awareness of device usage and provide a forum for open discussion regarding device indications and adherence to prevention standards (Mena Lora et al., 2020). The huddle was conducted in a virtual manner and led by the charge nurses from each nursing unit, with participation from an interdisciplinary team. Each central line and foley catheter were reported, including the current indication, plan for removal if known, and compliance with care standards.
Results: After the implementation of the daily device huddle, the central line SUR was reduced from 0.796 to 0.576 with only one reported CLABSI. Foley catheter utilization also improved with SUR reduction from 0.677 to 0.584. Three CAUTIs occurred in a small cluster from December 2023 to January 2024. Nursing now owns the audit process and follow-up.
Implications for Practice: Having a dedicated forum for real-time discussions about device appropriateness creates a culture of inquiry and sense of ownership, encouraging nurses to have proactive conversations with providers about device removal criteria and planning. Missed opportunities with care standards are corrected in real-time, further mitigating infection risk. Between January 2024 and April 2024, seventy-five devices were removed through device huddle.
References
Dadi, N. C. T., Radochova, B., Vargova, J., & Bujdakova, H. (2021). Impact of healthcare-associated infections connected to medical devices – An update. Microorganisms, 9(2332). https://doi.org/10.3390/microorganisms9112332
Mena Lora, A. J., Ali, M., Krill, C., Spencer, S., Takhsh, E., & Bleasdale, S. C. (2020). Impact of a hospital-wide huddle on device utilization and infection rate: A community hospital’s journey to zero. Journal of Infection Prevention, 21(6), 228-233. https://doi.org/10.1177/1757177420939239
Sepsis Alliance. (2024, January 19). Sepsis and invasive devices. https://www.sepsis.org/sepsisand/invasive-devices/
Affiliations
Aurora St. Luke's South Shore