QAPI 119 - One Team Approach: Celebration of 300 Days Without a CLABSI as a Children’s Hospital

Background: Through a one team approach, a 226-bed pediatric hospital including a neonatal intensive care unit (NICU), a pediatric intensive care unit (PICU), a pediatric specialty care unit (PSCU), a pediatric medical/surgical unit (Peds M/S), a pediatric hematology/oncology unit (PHOOT) and a pediatric emergency department (Peds ED) collaborated to reduce central line-associated bloodstream infections (CLABSI).

Methods: In partnership with Quality, Infection Prevention, Nursing, and Medical Staff, a multidisciplinary team met to discuss the children’s hospital’s current benchmarked performance, debrief on opportunities with hospital-acquired infections (HAIs), brainstorm new ideas to bridge the gap between observed to expected outcomes and share insights on implementing best practices. This collaboration was achieved through a harm prevention meeting and infection prevention workgroups.
Special efforts were ensuring discussions for line removal, proper line maintenance, and daily device rounding. In addition, patient education on oral, personal, and hand hygiene were provided by bedside nurses to engage patients in their care.

Results: The pediatric hospital celebrated over 300 days without a CLABSI with >10,000 central line days between 2021 and 2022. Their Standardized Infection Ratio (SIR) decreased by 90% (0.572 to 0.060) and Standardized Utilization Ratio (SUR) increased by 3% (0.779 to 0.801). The increase in utilization but decrease in infections demonstrates the exemplary care of central lines.
Sustained through this workgroup is a multidisciplinary mindset in which previously-siloed departments are working cohesively to reduce HAIs through continued cognizance of line necessity and strict adherence to stellar care of lines while they are in place.

Conclusions: Stakeholders must be engaged, aware of opportunities, and involved in process improvement initiated to see true sustained positive outcomes.
Strategies, including, regularly scheduled meetings, bundle audit tool, and timeliness of HAI debriefs/discussions, that enabled this one team approach will be shared. The session will close with a discussion of the strategies and implementation barriers and limitations.