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Recommended Citation
Niendorf S. A Quality Improvement Project to Improve Adherence of Disinfecting Needleless Connectors in the Emergency Department. 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
At Aurora Oshkosh Emergency Department, the nurses, paramedics, and technicians were not consistently disinfecting needleless connectors before blood draws or intravenous medications, increasing the risks of postinsertion catheter-related infections.
Local Problem
In a pre-audit, disinfection of needleless connectors prior to access occurred 40% of the time, failing to meet the Aurora Oshkosh Emergency Department goal of 80%. A knowledge gap was discovered through interviews when only 23% of staff could verbalize the system’s intravenous access policy correctly on disinfection and dry times.
Method
Forty-five audits were completed pre and post interventions, observing adherence to policy including disinfecting the needleless connector and allowing adequate dry time. Interviews were completed with 39 staff members to identify root causes. Interventions included multiple environmental adjustments, such as hanging passive disinfection caps on cupboards in patient rooms, placing one cap in intravenous start kits, and increased accessibility to alcohol wipes in the medication room. Additionally, a visual cue was created using policy guidelines and posted in the medication room and all patient rooms next to disinfection supplies. Educational interventions included a PowerPoint presentation at a staff meeting, emails, and one-on-one coaching.
Results
After interventions were implemented, another 45 audits were completed, which showed improvement of needleless connector disinfection from 40% to 77%. Post intervention interviews found 75% of staff self-report that they disinfect needleless connectors more than 70% of the time. Compliance of policy knowledge improved by 28% on required disinfection time and 46% on dry time.
Implications for Practice
Overall, staff demonstrated improvement in both knowledge of policy and compliance with disinfecting needleless connectors prior to access. During post intervention interviews, staff vocalized recognition of the problem and shared subsequent change in their practice. The PowerPoint presentation is now being shared with other units, such as radiology, to further spread awareness of these issues.
Document Type
Poster
Publication Date
11-13-2024
A Quality Improvement Project to Improve Adherence of Disinfecting Needleless Connectors in the Emergency Department
Background
At Aurora Oshkosh Emergency Department, the nurses, paramedics, and technicians were not consistently disinfecting needleless connectors before blood draws or intravenous medications, increasing the risks of postinsertion catheter-related infections.
Local Problem
In a pre-audit, disinfection of needleless connectors prior to access occurred 40% of the time, failing to meet the Aurora Oshkosh Emergency Department goal of 80%. A knowledge gap was discovered through interviews when only 23% of staff could verbalize the system’s intravenous access policy correctly on disinfection and dry times.
Method
Forty-five audits were completed pre and post interventions, observing adherence to policy including disinfecting the needleless connector and allowing adequate dry time. Interviews were completed with 39 staff members to identify root causes. Interventions included multiple environmental adjustments, such as hanging passive disinfection caps on cupboards in patient rooms, placing one cap in intravenous start kits, and increased accessibility to alcohol wipes in the medication room. Additionally, a visual cue was created using policy guidelines and posted in the medication room and all patient rooms next to disinfection supplies. Educational interventions included a PowerPoint presentation at a staff meeting, emails, and one-on-one coaching.
Results
After interventions were implemented, another 45 audits were completed, which showed improvement of needleless connector disinfection from 40% to 77%. Post intervention interviews found 75% of staff self-report that they disinfect needleless connectors more than 70% of the time. Compliance of policy knowledge improved by 28% on required disinfection time and 46% on dry time.
Implications for Practice
Overall, staff demonstrated improvement in both knowledge of policy and compliance with disinfecting needleless connectors prior to access. During post intervention interviews, staff vocalized recognition of the problem and shared subsequent change in their practice. The PowerPoint presentation is now being shared with other units, such as radiology, to further spread awareness of these issues.
Affiliations
Aurora Oshkosh Medical Center