The Role of the CNS in Dissemination and Implementation of Collaborative Standards for Prevention of Line- Related Bacteremias

2.50
Hdl Handle:
http://hdl.handle.net/10755/164171
Category:
Abstract
Type:
Presentation
Title:
The Role of the CNS in Dissemination and Implementation of Collaborative Standards for Prevention of Line- Related Bacteremias
Author(s):
Brush, Katie
Author Details:
Katie Brush, MS, RN, CCRN, FCCM, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.org
Abstract:
Purpose: The Institute of Medicine identified a devastating blow to patients and healthcare professionals in 1999 when they identified potentially 98,000 patients who were dying annually secondary to errors in their care. Patient safety goals have been recommended by agencies such as AHRQ and the Joint Commission on Accreditation of Healthcare Organizations. However, healthcare professionals must do more. The Clinical Nurse Specialist (CNS) is uniquely positioned to identify new patient safety opportunities. Soundly based research can result in new evidence-based practices. Additionally, the CNS is responsible for benchmarking against national indicators identifying performance improvement issues that benefit patient care and safety. Issues such as nosocomial infection, provide new challenges. Catheter Related Blood Stream Infections (CRBSI) will be discussed. The approximate cost of each CRBSI is between $35,000 and $56,000 to treat and an increased length of stay. The importance of the role of the CNS in working collaboratively to analyze data, create evidence based guidelines for prevention, the skills to disseminate this information, and use implementation strategies across all disciplines utilizing these central venous catheters. Making this a reality on a local, regional and national level can prove to be both challenging and rewarding. The three spheres of influence, provide the CNS with the ultimate opportunity to effect patients, staff, and systems to reduce these nosocomial infections. Significance: The Institute of Medicine identified a devastating blow to patients and healthcare professionals in 1999 when they identified potentially 98,000 patients who were dying annually secondary to errors in their care. Patient safety goals have been recommended by agencies such as AHRQ and the Joint Commission on Accreditation of Healthcare Organizations. However, healthcare professionals must do more. The Clinical Nurse Specialist (CNS) is uniquely positioned to identify new patient safety opportunities. Soundly based research can result in new evidence- based practices. Additionally, the CNS is responsible for benchmarking against national indicators identifying performance improvement issues that benefit patient care and safety. Issues such as nosocomial infection, provide new challenges. Catheter Related Blood Stream Infections (CRBSI) will be discussed. The approximate cost of each CRBSI is between $35,000 and $56,000 to treat and an increased length of stay. The importance of the role of the CNS in working collaboratively to analyze data, create evidence based guidelines for prevention, the skills to disseminate this information, and use implementation strategies across all disciplines utilizing these central venous catheters. Making this a reality on a local, regional and national level can prove to be both challenging and rewarding. The three spheres of influence provide the CNS with the ultimate opportunity to effect patients, staff, and systems to reduce these nosocomial infections. Background/Design: Although our Catheter Related Blood Stream Infections were below the National Nosocomial rate for institutions of similar size, we believed that there was an opportunity to aim for a lower rate. Eventually several of the ICUs achieved a rate of zero. Methods: Central venous catheter kits were improved working with a vendor to develop a patient/clinician safety kit. CDC recommendations for maximal barrier protection and skin preparation were developed. A central venous line insertion guideline was developed, disseminated and implemented using the Clinical Nurse Specialist as an interdisciplinary collaborator. Additionally, nurses were empowered to stop any procedure that had breaks in technique. This strategy was disseminated across the state using lessons learned in the Patient Safety Improvement Core. Another opportunity for this CNS was to sit on the UHC committee to create a tool for assessment at all hospital participants to respond to, develop guidelines, and to plan an implementation strategy. Findings: Several of the ICUs had quarterly reports of zero percent incidence of Central Venous Catheter Bloodstream Infections. The entire facility of 940 bed achieved a level of 0.02% for a year. Conclusions: The Clinical Nurse Specialist is in the unique role of creating an environment that recognizes nosocomial infection as a risk to patient safety. The Clinical Nurse Specialist works through the three spheres of influence to disseminate and implement strategies toward patient safety goals. Implications for Practice: The role of the Clinical Nurse Specialist as a change agent positions them to strongly influence practice at the bedside to all clinicians responsible for central venous catheters.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
CNS Outcomes: Ensuring Safety and Quality
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Phoenix, Arizona, USA
Description:
Conference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleThe Role of the CNS in Dissemination and Implementation of Collaborative Standards for Prevention of Line- Related Bacteremiasen_GB
dc.contributor.authorBrush, Katieen_US
dc.author.detailsKatie Brush, MS, RN, CCRN, FCCM, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164171-
dc.description.abstractPurpose: The Institute of Medicine identified a devastating blow to patients and healthcare professionals in 1999 when they identified potentially 98,000 patients who were dying annually secondary to errors in their care. Patient safety goals have been recommended by agencies such as AHRQ and the Joint Commission on Accreditation of Healthcare Organizations. However, healthcare professionals must do more. The Clinical Nurse Specialist (CNS) is uniquely positioned to identify new patient safety opportunities. Soundly based research can result in new evidence-based practices. Additionally, the CNS is responsible for benchmarking against national indicators identifying performance improvement issues that benefit patient care and safety. Issues such as nosocomial infection, provide new challenges. Catheter Related Blood Stream Infections (CRBSI) will be discussed. The approximate cost of each CRBSI is between $35,000 and $56,000 to treat and an increased length of stay. The importance of the role of the CNS in working collaboratively to analyze data, create evidence based guidelines for prevention, the skills to disseminate this information, and use implementation strategies across all disciplines utilizing these central venous catheters. Making this a reality on a local, regional and national level can prove to be both challenging and rewarding. The three spheres of influence, provide the CNS with the ultimate opportunity to effect patients, staff, and systems to reduce these nosocomial infections. Significance: The Institute of Medicine identified a devastating blow to patients and healthcare professionals in 1999 when they identified potentially 98,000 patients who were dying annually secondary to errors in their care. Patient safety goals have been recommended by agencies such as AHRQ and the Joint Commission on Accreditation of Healthcare Organizations. However, healthcare professionals must do more. The Clinical Nurse Specialist (CNS) is uniquely positioned to identify new patient safety opportunities. Soundly based research can result in new evidence- based practices. Additionally, the CNS is responsible for benchmarking against national indicators identifying performance improvement issues that benefit patient care and safety. Issues such as nosocomial infection, provide new challenges. Catheter Related Blood Stream Infections (CRBSI) will be discussed. The approximate cost of each CRBSI is between $35,000 and $56,000 to treat and an increased length of stay. The importance of the role of the CNS in working collaboratively to analyze data, create evidence based guidelines for prevention, the skills to disseminate this information, and use implementation strategies across all disciplines utilizing these central venous catheters. Making this a reality on a local, regional and national level can prove to be both challenging and rewarding. The three spheres of influence provide the CNS with the ultimate opportunity to effect patients, staff, and systems to reduce these nosocomial infections. Background/Design: Although our Catheter Related Blood Stream Infections were below the National Nosocomial rate for institutions of similar size, we believed that there was an opportunity to aim for a lower rate. Eventually several of the ICUs achieved a rate of zero. Methods: Central venous catheter kits were improved working with a vendor to develop a patient/clinician safety kit. CDC recommendations for maximal barrier protection and skin preparation were developed. A central venous line insertion guideline was developed, disseminated and implemented using the Clinical Nurse Specialist as an interdisciplinary collaborator. Additionally, nurses were empowered to stop any procedure that had breaks in technique. This strategy was disseminated across the state using lessons learned in the Patient Safety Improvement Core. Another opportunity for this CNS was to sit on the UHC committee to create a tool for assessment at all hospital participants to respond to, develop guidelines, and to plan an implementation strategy. Findings: Several of the ICUs had quarterly reports of zero percent incidence of Central Venous Catheter Bloodstream Infections. The entire facility of 940 bed achieved a level of 0.02% for a year. Conclusions: The Clinical Nurse Specialist is in the unique role of creating an environment that recognizes nosocomial infection as a risk to patient safety. The Clinical Nurse Specialist works through the three spheres of influence to disseminate and implement strategies toward patient safety goals. Implications for Practice: The role of the Clinical Nurse Specialist as a change agent positions them to strongly influence practice at the bedside to all clinicians responsible for central venous catheters.en_GB
dc.date.available2011-10-27T11:43:21Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:21Z-
dc.conference.date2007en_US
dc.conference.nameCNS Outcomes: Ensuring Safety and Qualityen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPhoenix, Arizona, USAen_US
dc.descriptionConference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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