Jefferson Health: Tackling CLABSI with Fundamentals
When Jefferson Health set reducing its rate of central line-associated bloodstream infections (CLABSI) as a primary focus for 2020, it didn’t need to reach for new, fancy or exotic methods to achieve this goal.
Relying on the tools and expertise already represented within the assembly of infection prevention teams, the Philadelphia-headquartered, multistate health system was able to reduce the standardized infection ratio for CLABSI in intensive care units by 16.5% from 2020 to 2021, bucking a national trend that saw a 10% increase overall.
The successful interventions that resulted in improved performance were basic but effective. Across the system, care teams standardized two-person dressing changes, daily chlorhexidine gluconate bathing for patients, line placement with observations, enhanced patient and family education, and data tracking and transparency of leading metrics in real time.
An informatics team developed real-time dashboards and reports that are available on a systemwide platform for all health care professionals to review at any time. The information also can be drilled down to the unit level. Reviewing the dashboard for compliance is encouraged during daily huddles to allow for immediate actions by clinicians.
The standardized initiatives and availability of real-time dashboards helped drive improvements and reduce infections.
Jefferson Health leaders also credit organizational culture for some of the progress in driving down infection rates. The health system has a history of effective communication, multidisciplinary collaboration and engagement, as well as strong infection prevention teams at each of its hospitals.
Across all hospitals, infection prevention leaders work together to create one message and direction, which helps establish trust with colleagues. The IP program is “heavily incorporated into the fabric of Jefferson Health,” noted Kelly Zabriskie, the health system’s vice president of infection prevention.
Buoyed by its success with CLABSI, Jefferson Health is targeting reductions in catheter-associated urinary tract infections (CAUTI).
Key Takeaways
Targeted Problem: CLABSI
Interventions Used:
- Standardized two-person dressing changes and daily CHG bathing, observations of line placement, patient and family education, and data transparency of leading metrics
- Developed real-time dashboards and reports of patients with central lines, patients with femoral central lines, compliance with daily CHG bathing and dressing changes, and documentation of line necessity
- Encouraged review of dashboards at any time, particularly at daily huddles
- Collaborated across hospitals to create one IP message
Impact: Reduced CLABSI by 16.5% in ICUs from 2020 to 2021