Learning Objective 1: The learner will be able to state four nursing interventions to prevent Catheter Associated Blood Stream Infections in Pediatric Hematology/Oncology/Bone Marrow Transplant patients.
Learning Objective 2: The learner will be able to discuss at least three efforts to implement a Catheter Associated Blood Stream Infection initiative with inpatient staff.
Background: In October of 2009, the Hem/Onc/BMT population at CHM joined the NACHRI initiative for CA-BSI. A committee was established, including key members of the nursing, medical, and epidemiology teams. The committee was charged with rolling out NACHRI CA-BSI Bundles #1 and #2 to the inpatient staff and with garnering staff involvement in the implementation.
Methods: A combination of efforts were employed in support of the NACHRI CA-BSI initiative for the Hem/Onc/BMT population at CHM. Included were; inservices, audits, committee and sub-committee meetings, Plan Do Study Act (PDSA), democratic voting, tipsheets, workshops, skills assessments, and Root Case Analyses (RCA).
Results: From January through December of 2009, there were nine CA-BSI at CHM in the Hem/Onc/BMT population. To date, there has only been three CA-BSI at CHM in the Hem/Onc/BMT population. Currently it has been 192 days since the last CA-BSI.
Discussion: The NACHRI CA-BSI initiative for the Pediatric Hem/Onc/BMT population at CHM was started in October of 2009 and fully implemented on the inpatient unit by the end of April 2010. As each portion of the NACHRI CA-BSI Bundles was implemented, the staff showed great initiative in bringing the new practices to their patient care. Staff was engaged in giving feedback, forming sub-committees to work on the workflow and procedures and continues to work on process improvement.
Implications: This initiative has the potential to significantly decrease the CA-BSI in the Pediatric Hem/Onc/BMT population. Process improvement projects currently include standardizing the NACHRI CA-BSI bundles in the ambulatory setting.