Improving compliance with central venous catheter care bundles using electronic records

Abstract

Implementation of evidence-based care bundles reinforced by real-time feedback on the performance of caregivers can significantly reduce the rate of catheter-related bloodstream infection in the intensive care unit. Ensuring that change processes are seamlessly integrated in the workflow with minimal administrative burden is crucial to the quality improvement process.

Impact of two bundles on central catheter-related bloodstream infection in critically ill patients

“…In this study, the simultaneous implementation of two bundles may have compensated for the lack of reports on the insertion bundle and the low compliance with the maintenance bundle. The level of compliance with the maintenance bundle was low compared to other studies 18 - 19 . A 95% adherence is suggested in order to achieve a substantial reduction in CRBSI rates, which is usually not achieved 20 .…”

“…A 95% adherence is suggested in order to achieve a substantial reduction in CRBSI rates, which is usually not achieved 20 . The maintenance bundle, on the other hand, reached high compliance levels for each individual measure and included the daily evaluation of the CVC insertion site, a measure that is not frequent, despite its presence in the bundles that led to a decrease in the CRBSI rate 18 - 19 .…”

Building a central vascular access device registry in an adult intensive care unit: feasibility study

“…We propose that this limitation may be solved by allocating a unique PICC device number at time of insertion, in order to connect the PICC data between the first and subsequent admissions. However, despite inherent shortcomings, EMRs have been shown to achieve a higher degree of accuracy than manual data collection and also aid in reducing health care-associated infection [36][37][38] . For future registry projects to be successful, there is a need for infrastructure of accessible EMRs throughout the episode of care, which would preserve valuable personnel resources 36,39 .…”

Improving outcome of sepsis on the ward: introducing the ‘Sepsis Six’ bundle

“…The team has previously implemented significant changes in the smaller critical care setting to reduce the rate of catheter‐related bloodstream infections (Hermon et al, ). The lessons learnt from that project were applied to the introduction of Sepsis Six and Sepsis bags.…”