C. diff Stinks!! An Interdisciplinary Approach to ...Housekeeping Items •All lines will be...
Transcript of C. diff Stinks!! An Interdisciplinary Approach to ...Housekeeping Items •All lines will be...
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C. diff Stinks!! An Interdisciplinary Approach to
Combatting Hospital Acquired Clostridium difficile
December 19, 201812:00 pm – 1:00 pm PST
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Moderator
Claire Manneh Director of Programs CHPSO, a Division of the Hospital Quality Institute
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Housekeeping Items
• All lines will be muted. Raise your hand if you wish to be unmuted.
• The presentation slides and recording will be available within 1-3 business days.
• 1 CE unit will be provided to CHPSO/HQI/CHA Members:– Complete the survey by December 28, 2018
– CE certs will be emailed by January 4, 2019
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How to ask a question
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Today’s Speakers
Shelley Johnson, RN, DNP, MHA, CENP, CNLDirector, Critical Care ServicesNorthBay Healthcare
Heather Resseger, MSN, RN, CNLDirector, Quality DivisionNorthBay Healthcare
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C. diff Stinks!!
An Interdisciplinary Approach to
Combatting Hospital Acquired
Clostridium difficile
Shelley Johnson, RN, DNP, MHA, CENP, CNL
Heather Resseger, MSN, RN, CNL
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About NorthBay Healthcare• NorthBay Healthcare is an independent health system with two
community hospitals:
– NorthBay Medical Center in Fairfield, CA
– VacaValley Hospital in Vacaville, CA
• 184 licensed beds
• Trauma Level II Center
• Neurosurgery, Open Heart Surgery, NICU, Primary and Specialty Outpatient Care, Ambulatory Center, Cancer Center, Wound Center
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Background• Hospital acquired infection (HAI) rates in 2016
were greater than in 2015
• Rising above benchmarks for C. diff, CAUTIs, and CLABSIs
• High HAIs not
aligned with our
organizational
mission or
strategic plan
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Background
Many HAIs are preventable, HAIs harm patients, HAIs are costly
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Background
• Organizational leaders formed a HAI
steering committee to ensure organizational
buy in and support for improvement efforts
• Asked that a group of front line staff form to
work through the issues
• Set the aim
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Aim
Decrease C. diff from 2016 to 2017 by at least 20%. Continue to decrease by 20% year over year to the ultimate goal of zero HAIs.
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Methods• Organization wide HAI workgroup met every other
week
• Nine RNs/CNLs
• Emergency (2)
• Intensive Care (2)
• Three (3) Acute Care
• Maternal-Child (2)
• Physicians (Infectious Disease, Intensivist, Hospitalist)
• Ancillary team members from Lab, Vascular Access
RNs, Environmental Services, Clinical IT, Infection
Prevention, Pharmacy, Rad/Procedural areas, CNS,
Improvement Advisor, Quality Analyst
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Methods
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Methods
C. diff Interventions
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Interventions
• In late 2016, acquired two “robots” to disinfect using UVC.• This technology effectively kills pathogens such as C. diff, MRSA, CRE• Implemented on C. diff discharges, ORs nightly, and as needed for other
areas/issues
Robots are
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Interventions
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Interventions
The team created new
isolation signs that
included some of the
evidence based
standard work that had
been rolled out (hand
washing, doffing PPE)
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Interventions
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Interventions
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Interventions
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Results
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Results
References:
Institute for Healthcare Improvement: How to guide: Prevent catheter associated urinary tract infection. (2011). Retrieved from
http:/www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCatheterAssociatedUrinaryTractInfection.aspx
Institute for Healthcare Improvement: How to guide: Prevent central line associated bloodstream infection. (2012). Retrieved from
http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCentralLineAssociatedBloodstreamInfection.aspx
Shah, D. N., Aitken, S. L., Barragan, L. F., Bozorgui, S. Goddu, S., Navarro, M. E., … Garey, K. W. (2016). Economic burden of primary
compared with recurrent Clostridium difficile infection in hospitalized patients: A prospective cohort study. The Journal of Hospital Infection,
93(3), 286-289. https://doi.org/10.1016/j.jhin.2016.04.004
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Next Steps• Continue case review of all HA C. diff cases
• Clinical decision support from EHR for stool specimen
collection—Aligned stool descriptors with Bristol Stool
Chart in EHR
– This was the beginning phase to create a clinical
decision support tool for C. diff testing by leveraging
documentation in EHR
• Changing our C. diff testing method
• Electronic communication boards for more real time
communication about successes and issues
• Replicate this model for improvement for other
initiatives/opportunities that arise
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Questions?
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How to ask a question
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Upcoming HQI-CHPSO Webinars
Date Time Topic
January 910:00 am – 11:00 am PST
Reducing Hospital Acquired Pressure Injuries Through Focusing on the Braden Scale Sub Categories, in a Safety Net Hospital
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Upcoming CHPSO Safe Tables
Date Time Topic
January 1610:00 am – 11:00 am PST via teleconference
Medical Device Associated Pressure Injuries
January 3010:00 am – 11:00 am PST via teleconference
Failure to Rescue and Early Warning Systems
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HQI’s 2019 Conference
October 14 - 15, 2019Sacramento
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CHPSO Job Board
CHPSO has the following opportunities:
• HQI Vice President• Roles available at other organizations in San Francisco,
Stockton, the San Diego area. Check out the job board and let us know if you would like to post anything at your facility!
• http://www.chpso.org/career-opportunities
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Follow-up Email
• Click here for the survey link
– Please share potential topics for future meetings
• CE Information
– For CHPSO/HQI/CHA Members only
• Slides
• Recording
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Thank You and Happy Holidays!
• Follow @CHPSO and @HQInstituteon Twitter!