Q: How has your hospital made strides to reduce hospital-acquired infections? How were you able to change your processes? What advice or best practice would you share with other hospital teams?
Texas Health Harris Methodist Hurst-Euless-Bedford
DIRECTOR, QUALITY, PATIENT SAFETY, RISK
Our hospital has taken a multi-pronged approach to reducing Healthcare-Acquired Infections that engages providers across all disciplines. With the support of our system, Texas Health Resources, we researched evidence-based best practices across the industry and implemented them by creating Reliable Care Blueprinting™ to standardize process. Reliable Care Blueprinting clearly communicates to staff and licensed independent practitioners the practices that must be done with every patient, every time to prevent hospital acquired infections. To support implementation of these practices we have harnessed the power of our electronic health record to alert clinicians to patients at risk and integrated alerts to remind clinicians of actions that should be taken to prevent infections in these patients.
We have invested in our caregivers by providing training and education, then reinforcing it often and holding our team accountable for using the training and education provided to them. Emphasizing the ‘why’ behind what we are asking of our clinical teams helps to gain their buy-in and ensures they will do whatever it takes to keep our patients safe.
Engaging not just employed staff but also our licensed independent practitioners has created a collaborative environment and decreased the authority gradient. This empowers our staff to speak up when opportunities exist to reduce a patient’s risk of acquiring a Hospital-Acquired Infection by removing invasive lines and tubes as soon as medically safe or avoiding the use of them altogether when appropriate.
Our infection prevention team serves as subject matter experts to support our clinicians when questions arise about what is best for an individual patient or a population of patients. Under the leadership of our infection prevention team, we conduct a root cause analysis when infections happen to learn what the failure point was and how we can prevent it from happening again.
Our advice would be to engage licensed independent practitioners and staff in identifying the cause of an infection concern and in finding the solutions. Take an evidence-based approach. Provide support through reminders, algorithms or decision trees and focus on failure because this allows you to identify and mitigate failure points. Once all of this is done, monitor to ensure implementation is sustained and hold individuals accountable for their practice.
Valley Baptist Medical Center - Harlingen
LINDA PIERCE, BSN, RN, CEN, CPEN, NE-BC
The time to stop Healthcare Acquired Infections is before they begin. I attribute our biggest strides in reducing HAIs to increased awareness, transparency, adhering to best practices, and communication. We have incorporated best practices and accountability at all levels in our process.
We were able to change our processes by adopting standard key performance indicators and providing hospital wide education emphasizing high reliability and subsequently excellent outcomes. We used small group presentations with question and answer to distribute information as well as get feedback on barriers to compliance. Completing an intensive analysis on all HAIs has helped us identify opportunities for improvement and hold staff and leadership accountable. The key was making sure staff understood what was expected by utilizing bundle sheets, daily tracking and rounding for compliance.
Some best practices that we have initiated include daily medical necessity meetings for lines and tubes, as well as weekly multidisciplinary HAI meetings. Hand hygiene is the simplest and best way to prevent the spread of infection and is a major initiative at our facility. To increase awareness, we have secret shopper audits conducted by front-line staff to the hospital’s CEO. Results are shared one on one as well as displayed on department and hospital dashboards. We also utilize The Joint Commissions Tracer methodology available through the TJC website. This allows us to assess and track individual or system care processes through direct observation, interviews and assessment. In addition, it helps us engage staff and practitioners and identify opportunities for improvement.