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Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections

BACKGROUND: Implementation of interventions to increase provider awareness of central venous catheters (CVC) and indwelling urinary catheters (IUC) and indications can impact device utilization rates. Device utilization rates (DUR) correlate with device-associated complications. We implemented a Dai...

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Autores principales: Lora, Alfredo Mena, Hannahs, Dawn, Ashley, Paula, Spencer, Sherrie, Takhsh, Eden, Bleasdale, Susan C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631549/
http://dx.doi.org/10.1093/ofid/ofx163.1671
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author Lora, Alfredo Mena
Hannahs, Dawn
Ashley, Paula
Spencer, Sherrie
Takhsh, Eden
Bleasdale, Susan C
author_facet Lora, Alfredo Mena
Hannahs, Dawn
Ashley, Paula
Spencer, Sherrie
Takhsh, Eden
Bleasdale, Susan C
author_sort Lora, Alfredo Mena
collection PubMed
description BACKGROUND: Implementation of interventions to increase provider awareness of central venous catheters (CVC) and indwelling urinary catheters (IUC) and indications can impact device utilization rates. Device utilization rates (DUR) correlate with device-associated complications. We implemented a Daily Interdisciplinary Safety Huddle (DISH) involving all hospital units. Devices were reported and plans for removal reviewed. Barriers identified were addressed within 24 hours. The purpose of this study was to evaluate the impact of DISH on DUR and HAI at a 151-bed urban, community hospital. METHODS: This is a retrospective review of DUR for IUC, CVC and the relationship to HAI. DISH is a daily 15-minute meeting at 8am. Key participants include the chief nursing officer (CNO), infection control practitioner (ICP), and managers of all hospital units. CVC and IUC usage are reported by nurse managers. The ICP reviews indications, duration, and plans for device removal. When barriers for removal remain, such as provider preference, the CNO, Medical Director of Infection Control or Chief Quality Officer are involved. Data before and after implementation of DISH was compared. Paired T-test was used to assess for differences between DUR means of both groups. RESULTS: Mean DUR for CVC was reduced from 0.2858 to 0.178 (device days/patient-days, P <0.001, CI 95%). For IUC, there was reduction from a mean of 0.586 to 0.176 (device days/patient-days, P <0.001, CI 95%). There was a significant reduction for IUC DUR in intensive care units (ICU) and non-ICU settings. The decrease in CVC DUR was significant in only the non-ICU setting. CONCLUSION: Hospital-wide reductions in DUR and HAI occurred after DISH. A 90% reduction in HAI occurred with estimated cost savings of $498,000. The impact of DISH was more profound in non-ICU settings, where devices may remain without indication or awareness. DISH may help mitigate this behavior. To our knowledge, a hospital-wide safety huddle with infection control components and its effect on DUR and HAIs has not been reported in the literature. DISH is a forum that promotes device removal, accountability and promotes a culture of safety. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56315492017-11-07 Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections Lora, Alfredo Mena Hannahs, Dawn Ashley, Paula Spencer, Sherrie Takhsh, Eden Bleasdale, Susan C Open Forum Infect Dis Abstracts BACKGROUND: Implementation of interventions to increase provider awareness of central venous catheters (CVC) and indwelling urinary catheters (IUC) and indications can impact device utilization rates. Device utilization rates (DUR) correlate with device-associated complications. We implemented a Daily Interdisciplinary Safety Huddle (DISH) involving all hospital units. Devices were reported and plans for removal reviewed. Barriers identified were addressed within 24 hours. The purpose of this study was to evaluate the impact of DISH on DUR and HAI at a 151-bed urban, community hospital. METHODS: This is a retrospective review of DUR for IUC, CVC and the relationship to HAI. DISH is a daily 15-minute meeting at 8am. Key participants include the chief nursing officer (CNO), infection control practitioner (ICP), and managers of all hospital units. CVC and IUC usage are reported by nurse managers. The ICP reviews indications, duration, and plans for device removal. When barriers for removal remain, such as provider preference, the CNO, Medical Director of Infection Control or Chief Quality Officer are involved. Data before and after implementation of DISH was compared. Paired T-test was used to assess for differences between DUR means of both groups. RESULTS: Mean DUR for CVC was reduced from 0.2858 to 0.178 (device days/patient-days, P <0.001, CI 95%). For IUC, there was reduction from a mean of 0.586 to 0.176 (device days/patient-days, P <0.001, CI 95%). There was a significant reduction for IUC DUR in intensive care units (ICU) and non-ICU settings. The decrease in CVC DUR was significant in only the non-ICU setting. CONCLUSION: Hospital-wide reductions in DUR and HAI occurred after DISH. A 90% reduction in HAI occurred with estimated cost savings of $498,000. The impact of DISH was more profound in non-ICU settings, where devices may remain without indication or awareness. DISH may help mitigate this behavior. To our knowledge, a hospital-wide safety huddle with infection control components and its effect on DUR and HAIs has not been reported in the literature. DISH is a forum that promotes device removal, accountability and promotes a culture of safety. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5631549/ http://dx.doi.org/10.1093/ofid/ofx163.1671 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Lora, Alfredo Mena
Hannahs, Dawn
Ashley, Paula
Spencer, Sherrie
Takhsh, Eden
Bleasdale, Susan C
Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title_full Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title_fullStr Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title_full_unstemmed Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title_short Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections
title_sort impact of a hospital-wide daily interdisciplinary safety huddle on device utilization and device-related hospital acquired infections
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631549/
http://dx.doi.org/10.1093/ofid/ofx163.1671
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