2.50
Hdl Handle:
http://hdl.handle.net/10755/164213
Category:
Abstract
Type:
Presentation
Title:
You Never Know Who Is Looking: Changing Physician Behavior During Central Line Insertion
Author(s):
McHugh, Renee
Author Details:
Renee McHugh, MSN, RN, CCNS, Cleveland Clinic, Cleveland, Ohio, USA, email: nacnsorg@nacns.org
Abstract:
Purpose: To increase patient safety during central line insertion by having a nurse observer document key behaviors of physicians during central line placement in a large teaching hospital. Significance: Use of proper sterile technique for central line insertion can be problematic. Observation of physicians placing central lines by a staff RN using a check list improves adherence to CDC recommended guidelines for central line placement. Background/Design: In response to staff reporting anecdotal incidences of central lines being placed under suboptimal conditions, the unit's CNS and infection control practitioner, with the support of the nurse manager and the medical director, implemented a check list (based on a CDC form) for the bedside nurse to fill out at the time of central line insertion. Methods: In an observational study of physician practice by RN's, a RN fills out a check list each time a central line is placed. The physician is given the opportunity to see the checklist prior to starting the procedure. Findings: This is an ongoing process. What we have improved so far: 1) More subclavian lines are now placed as recommended by the CDC. 2) Physicians are placing fewer femoral lines as this is not a preferred site. 3) Improved adherence for using recommended skin preparation. What we have confirmed is that we have continued adherence to CDC guidelines for: 1) full sterile drape 2) sterile gown and gloves 3) mask/ eye shield and head covering for line insertions and 4) hand hygiene. Conclusions: This study, which began in 2005, is still in process. By observing central line placement, nurses feel empowered to facilitate safe practice by using a checklist that can be shown to the physician prior to starting the procedure. We expect that by focusing more on the actual process of central line insertion, and placing less focus on the blood stream infection rates, that we will see a decline in our blood stream infection rates. Implications for Practice: Observing techniques used for central line placement changes behavior by increasing adherence to CDC guidelines for central line placement.
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.titleYou Never Know Who Is Looking: Changing Physician Behavior During Central Line Insertionen_GB
dc.contributor.authorMcHugh, Reneeen_US
dc.author.detailsRenee McHugh, MSN, RN, CCNS, Cleveland Clinic, Cleveland, Ohio, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164213-
dc.description.abstractPurpose: To increase patient safety during central line insertion by having a nurse observer document key behaviors of physicians during central line placement in a large teaching hospital. Significance: Use of proper sterile technique for central line insertion can be problematic. Observation of physicians placing central lines by a staff RN using a check list improves adherence to CDC recommended guidelines for central line placement. Background/Design: In response to staff reporting anecdotal incidences of central lines being placed under suboptimal conditions, the unit's CNS and infection control practitioner, with the support of the nurse manager and the medical director, implemented a check list (based on a CDC form) for the bedside nurse to fill out at the time of central line insertion. Methods: In an observational study of physician practice by RN's, a RN fills out a check list each time a central line is placed. The physician is given the opportunity to see the checklist prior to starting the procedure. Findings: This is an ongoing process. What we have improved so far: 1) More subclavian lines are now placed as recommended by the CDC. 2) Physicians are placing fewer femoral lines as this is not a preferred site. 3) Improved adherence for using recommended skin preparation. What we have confirmed is that we have continued adherence to CDC guidelines for: 1) full sterile drape 2) sterile gown and gloves 3) mask/ eye shield and head covering for line insertions and 4) hand hygiene. Conclusions: This study, which began in 2005, is still in process. By observing central line placement, nurses feel empowered to facilitate safe practice by using a checklist that can be shown to the physician prior to starting the procedure. We expect that by focusing more on the actual process of central line insertion, and placing less focus on the blood stream infection rates, that we will see a decline in our blood stream infection rates. Implications for Practice: Observing techniques used for central line placement changes behavior by increasing adherence to CDC guidelines for central line placement.en_GB
dc.date.available2011-10-27T11:44:08Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:44:08Z-
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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