St. Anthony Hospital – Chicago, Illinois
Implementation of interventions to increase provider awareness of central venous catheters and indwelling urinary catheters and indications can impact device utilization rates. High device utilization rates are correlated with device-associated complications such as central line associated bloodstream infections (CLABSI) and catheter associated urinary tract infections (CAUTI).
We implemented a daily interdisciplinary safety huddle (DISH) involving all hospital units. Devices were reported and plans for removal were reviewed daily. Barriers were identified and addressed within 24 hours. As a result, hospital-wide in device utilization and hospital-associated infections have occurred since DISH implementation. A 90% reduction in CLABSIs and CAUTIs occurred with an estimated cost savings of $498,000. The impact of DISH was most profound in non-ICU settings, where devices may remain without indication or awareness.
While spreading this intervention through the innovation challenge in 2018 we found there were some important characteristics which led to successful high impact implementation:
Must Have:
- A strong need for change related to CAUTI, CLABSI, and device utilization
- Infection prevention buy-in and support
- Strong administrative/executive buy-in
- Ability for key players to meet daily via a safety huddle that includes unit managers, infection prevention and ID physician leadership
- Ability to identify in real-time patients with an indwelling urinary catheter and/or central venous catheter on every unit
Should Have:
- Nursing support
- A well-established daily safety huddle
- Non-infection prevention disciplines present in the huddle
- At least 1.0 FTE infection preventionist on site
- Similarly sized hospital (150-200 beds)
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