Critical Care Patient Case Study

Critical Care Patient Case Study-75
Safety principles have been spread outside the hospital setting to the systemâs home care group.Success factors include setting ambitious goals, empowering frontline staff to make improvements, involving executives and the board in change, and rigorously measuring and holding units accountable for results.

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As part of their efforts to improve care, the intensivists recommended use of an evidence-based CLABSI prevention protocol that includes the use of a checklist to promote compliance.

To ensure the protocol was followed, the hospital trained and empowered nurses to enforce standards during the placement process and restricted the number and type of hospital personnel permitted to insert lines.

As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics.

A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale.

OSF has enhanced these efforts during the past five years by continuing to build awareness of safety risks through systemwide error reporting and local risk assessment, by identifying clinicians who can serve as models for their peers, and by engaging staff in intraorganizational learning and competition to spur improvement.

It also has raised performance expectations by educating hospital- and system-level board members about patient safety issues and quality improvement techniques.Four case studies--of the Department of Veterans Affairs, Sentara Healthcare, OSF Health Care, and Johns Hopkins Medicine--document the progress achieved in the past five years by health care organizations that were early leaders in patient safety improvement.Their experience reflects an expansion of interventions from individual hospital units to whole facilities and delivery systems, including new settings such as home health care.This report synthesizes lessons from four hospitals that reported they did not experience any central line-associated bloodstream infections in their intensive care units in 2009.Lessons include: the importance of following evidencebased protocols to prevent infection; the need for dedicated teams to oversee all central line insertions; the value of participation in statewide, national, or regional CLABSI collaboratives or initiatives; and the necessity for close monitoring of infection rates, giving feedback to staff, and applying internal and external goals.The model has been spread to hospitals nationwide and was associated with reductions in central lineâassociated bloodstream infections in intensive care units.Through its safety efforts, Hopkins has achieved improvements in safety practices such as increased hand-washing, in patient outcomes such as fewer pressure ulcers among patients, and in the hospital staffâs perceptions of the organizational safety culture.The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients' daily care plans.A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence.Contact us if you experience any difficulty logging in.This private hospital has a designated team, known as the Vascular Access Specialist Team, comprising about 10 registered nurses who have a minimum of two years of nursing experience and are specially trained in central line insertion techniques, ultrasound guidance, and Centers for Disease Control and Preventioninfection prevention guidelines.


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