458 Maintaining Low Healthcare Associated Device Driven Infections in a Regional Burn Center

J Rood; C Hendrickson; W J Mohr

doi:10.1093/jbcr/irz013.353

Abstract Introduction Infection reduction is a key component in the effort to improve quality care. The work to improve safety and quality is never finished. This continuous endeavor is the essence of our organization’s overall strategy to reduce CLA-BSI (Central Line Associated Bloodstream Infections) and CA-UTI (Catheter Associated -Urinary Tract Infections). Methods Overall strategies include the Heroes for Zeros program which focuses on reducing infections and preventing pressure injuries. Teams formed to focus on each ADDI (Associated Device Driven Infection) assuring Best Practice (CDC guidelines) were being followed. Members of each team include Physician and Nursing Leadership, Education, Infection Prevention and Performance Improvement. Key to our infection reduction is the charge nurse who rounds with each nurse each shift using a structured checklist. A checklist with key action elements of the Safe 7 is reviewed for accelerating interventions such as line or device removal. Targeted initiatives for reduction of CLA-BSI include standard insertion checklist for CL insertion, alcohol disinfecting caps on all central and peripheral lines, CL Chlorhexidine patch and bathing, focus on flushing protocols and dressing management. Targeted initiatives for CA-UTI have an intense focus on avoiding catheter insertion or removal of urinary catheters or safer alternatives. A change in practice for obtaining a urine culture from a catheter that had been in place >48 hours required the removal of the device or change prior to collection. Infection Prevention will identify a device related infection and send the “Review Form” on to the Nurse Manager and APN. The case review team of DON, APN, NM, MD, Nursing Education and Performance Improvement review cases. The CLA-BSI & CA-UTI instances are analyzed, looking for trends and opportunities for improvement. Results CA-UTI 2015: Cases: 2 Device Days: 1278 Incidence Rate: 1.6 per1000/device days 2016: Cases: 0 Device Days: 1212 Incidence Rate: 0.0 per 1000/device days 2017: Cases: 2 Device Days: 1043 Incidence Rate: 1.9 per 1000/device days CLA-BSI 2015: Cases: 3 Device Days: 880 Incidence Rate: 3.4 per 1000/central line days 2016: Cases: 0 Device Days: 856 Incidence Rate: 0.0 per 1000/central line days 2017: Cases: 2 Device Days: 910 Incidence Rate: 2.2 per 1000/central line days Conclusions The continued low rates of Device related Infections is proof that when all levels of a hospital care team are engaged to reduce infection, the focus on quality and safety is achieved. Applicability of Research to Practice Maintaining low device related infection rates is an ongoing challenge. The goal of Zero infections can be achieved. It requires an organizational culture that encourages champions at all levels of the care team.

458 Maintaining Low Healthcare Associated Device Driven Infections in a Regional Burn Center

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