Champions for success cover bases with infection control bundles

Healthcare Purchasing News, June, 2008 by Jeannie Akridge

Dr. Rupp of the University of Nebraska recently led one of two studies presented at the 2008 SHEA Annual Scientific Meeting that evaluated 3M's new Tegaderm CHG IV Securement Dressing. Dr. Rupp's study (2) compared the 3M Tegaderm product to the facility's standard transparent dressing and concluded that "the Tegaderm CHG dressing containing a chlorhexidine gel pad is an innovative means to potentially minimize CA-BSI', and also that "the Tegaderm CHG dressing is well-tolerated and judged to be superior to the comparator dressing with regard to catheter securement and overall satisfaction." Dr. Rupp commented that while additional studies are still needed to determine if the 3M Tegaderm dressing does indeed reduce BSIs, "all of these preliminary studies are very optimistic. They're very, reassuring that the dressing performs well and does have some good microbiologic effects."

Leading change management

Support from the top is essential for any successful infection prevention program, said Dr. Ramsey. "First of all you have to have administrative support. Secondly, you have to have buy-in from your staff, physicians and nurses."

A successful HAI reduction program also needs a champion for that change as well as empowerment of staff and clinicians. Said Dr. Shulkin, "We have really empowered our staff--every nurse, nursing assistant, housekeeper, physician--any member of the team who sees anybody who is not using an appropriate kit for insertion, or violating one of the infection control practices can declare Red Rule, and that can stop the insertion process in its tracks so that every healthcare team member has the power if they see something that puts a patient at risk to stop the process. And they know that they will be supported in this."

Dr. Weinstein advised, "Create high expectations from staff, create a culture of safety, educate and hold staff responsible for their actions and patient outcomes, treat HAIs as internal sentinel events that trigger an analysis of what happened and what was preventable. Don't settle for less."

References

(1) "Achieving Zero Catheter Related Blood Stream Infections: 15 Months Success in a Community Based Medical Center," by Sophie A Harnage, BSN, RN, The Journal of the Association for Vascular Access, Vol. 12, No 4 Dec 2007

(2) Prospective, Randomized, Controlled Thai Assessing the Clinical Performance of a Transparent Chlorhexidine Gel Pad Intravascular Catheter Dressing, Mark E. Rupp, Jennifer Cavalieri, Katie Delaney, Kelly Lundgren, Lisa Stammers, Susan Beach, University of Nebraska Medical Center and Nebraska Medical Center, Omaha, NE Abstract 115. The 18th Annual Meeting of the Society for Healthcare Epidemiology of America, Orlando, FL, April 5-8, 2008