Challenges Encountered

Since the hospital elected to implement a central line bundle insertion system , the rates of Catheter Associated Blood Stream Infection in both adults and neonates with PICC lines before and after  the implementation of the Central Line bundle and the dedicated PICC line team was initiated.  The goal was to improve the quality of care for patients by reducing catheter-related bloodstream infections.   As all four of the EBP projects were implemented, several challenges were discovered which crossed over between projects. An initial road block was related to the accessing of the data needed for each project.  The teams had to dig information from patients’ electronic charts. Information was not easy to retrieve due to the fact that patient information was located on 2 different computer programs. Nursing documentation was obtained from the QS computer system while everything else was retrieved through the physician portal.  A second challenge was time. Nurses were asked to obtain the information needed and implement the projects when they had time during their regular shift work.  Occasionally, they were allotted a few hours outside of their shift work. Since they had patients that required their attention, it was difficult for the nurses to do the data collection and to implementation while on duty. The time they used to review charts and address other project assignments outside of their scheduled shift was limited due to budget constraints.  Challenges always confront individuals who are involved in change.  Managing the challenges to reach the expected outcome of improved patient safety must be embraced.  By seeking solutions to the problems encountered, while being open to innovative strategies, results in a win-win outcome for the agency and the patients.