The book outlines the important steps that make up the Quality Improvement (QI) processes. First you must identify the needs that are most important. Second a multidisciplinary team must be put together to review the needs that have been identified. Third data must be collected to assess the current situation being evaluated. The fourth step should be to create goals and quality indicators that can be assessed and evaluated. The fifth step is where you develop and place into practice the plan to achieve the desired outcome/ goals. Lastly data must be collected to assess the effectiveness in the change of practice, and to see of all goals have been met.
The QI project that will be described in this analysis pertains to catheter related blood stream infections (CR-BSI). CR-BSI and the ability in which they can be prevented is a common focus in the healthcare industry. The Center for Disease Control (CDC) has reported that 5 CR-BSI per 1000 catheter days is the current rate of infection. This translates into 80,000 patients every year will acquire a CR-BSI. This infection can be introduced at the time of insertion, or by the way in which it is used and cared for. This report of 80,000 patients is only limited to studies based on patients in various Intensive Care Units. Current infection rates for medical surgical units, skilled nursing centers, home health, and ambulatory care patients does not exist. An estimate by many researchers would place the annual number of CR-BSI at 250,000 cases. The estimated deaths caused by CR-BSI at around 12-25% of the total infections. In addition to increased mortality the approximate cost per infection is $ 25, 000. (Posa, Harrison, & Vollman, 2006, p. 446) These numbers leave large room for improvement within the industry. (Hadaway, 2006) The Joint Commission Patent Safety Goal number 7: Reduce the risk of health care associated infection. A universal focus has been placed on hand hygiene. Additional areas of interest are on the prevention of drug resistant infections, central line blood stream infections, as well as surgical site infections. This safety goal was designed to bring about best practice in regards to central line placement and care. This safety goal requires education be provided to the patient/ family prior to a central line placement. As well as routine assessment of current infection rates that is provided to hospital staff, practitioners, and share holders.
The Problem/ root causes
CR-BSI prevention as outlined by the Joint Commission NPSG.07.04.01. The hospital's lack of policy, common practice, and standards in relation to ordering, inserting, and caring for central lines throughout the institution. The lack of standardization within the institutions has promoted the incidence CR-BSI. This has potentially increased the length of stay, rate of mortality, decreased the speed of patient recovery, and overall increased hospital cost.
With the goal of improving the...