Clean It Like You Mean It Hospital Name: New York Presbyterian/Morgan Stanley Children’s Hospital (New York, NY) CSI Nurses: Kathy Lee, RN, BSN, CCRN Regan Morimoto, RN, CCRN Anisha Soman, RN, MSN Svetlana Streltsova, RN, MSN, CCRN Brian Harding, RN, BSN, CCRN (9/13-7/14) Project Topic: Central Lin Associated Bloodstream Infection (CLABSI) Prevention Project Goals/Objectives: 1. 2. 3. 4. 5. 6. To reduce the morbidity associated with CLABSIs in our patient population To improve patient outcomes To reinforce and improve best practices To decrease hospital overall cost To decrease hospital length of stay associated with CLABSIs To reduce the incidence of CLABSI by 50% within the three units Project Outcomes: 1. 2. 3. 4. The NICU CLABSI rate increased by 55%. The PICU CLABSI rate decreased by 21%. The PCIUC CLABSI rate decreased by 100% to zero. The average length of stay (LOS) decreased by 4% (1.11 days) in the NICU and by 35% (4.87 days) in the PICU since 2013. It increased by 2% (0.32 days) in the PCICU. 5. The total number of CLABSIs for all units decreased by 25% 6. These outcomes resulted in a fiscal impact of $37,134 over 9 months, with a projected annual savings of $99,024. Process Steps: Project Steps Held educational “Kick-Off” carnival Identified and trained central venous line champions Conducted bedside education Utilized IV pole hang tags Conducted meetings with medical team to explain project goals and obtain interdisciplinary support Conducted Chlorhexidine bath re-education Changed protocol based on current evidence based practice Target Nurses Nurses Physicians Nurse Practitioners Nurses Nurses Families Month 1-2 3-6 1-9 1-9 Physicians Nurse Practitioners 7 Nurses 8 Nurses 4-Current Assessment/Audit Steps: Assessment/Audit Steps Conducted weekly Central Venous Line (CVL) surveillance audits Conducted root cause analysis with every potential CLABSI Created CVL insertion checklist Created CVL maintenance checklist Target Month Nurses 1-9 Nurses 1-9 Nurses Nurses 1-9 1-9