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Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.” 
Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.”
Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.”