Infection Control Bundles

Infection Control Bundles

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  3/31/2019 1
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  Definition Evidence-Based Care Bundles Abundle is a structured way of improving the processes of care and patient outcomes: a small, straightforward set of evidence-based practices — generally three to five — that, when performed collectively and reliably, have been proven to improve patient outcomes. 3/31/2019 2
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  Aim Care bundles aimto ensure that patients receive recommended treatments on a consistent basis 3/31/2019 3
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  Characteristic It is recommendedthat when planning bundle-based care, each aspect be well defined and based on evidence from at least 1 systematic review of multiple well-designed randomized controlled trials (RCT) or on data from at least 1 well-designed RCT 3/31/2019 4
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  List 1 •Central line 2•Urinary catheter 3 •Mechanical ventilation 4 •Surgical procedures 3/31/2019 5
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  CAUTI *Assess daily necessityof indwelling catheter *Use sterile technique for catheter insertion *Maintain a sterile closed drainage system *Position drainage bag below the level of the bladder *Secure indwelling catheter *Ensure daily catheter care hygiene measures 3/31/2019 6
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  CAUTI Bundle • Insertcatheters only for appropriate indications • Leave catheters in place only as long as needed • Properly trained persons insert and maintain catheters • Insert catheters using aseptic technique • Maintain a closed drainage system • Maintain unobstructed urine flow • Hand hygiene and Standard Precautions 3/31/2019 7
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  CLABSI *Hand hygiene *Maximal barrierprecautions upon insertion *Chlorhexidine skin antisepsis *Optimal catheter site selection (subclavian vein is the preferred site for non-tunneled catheters) *Daily review of line necessity and prompt removal of unnecessary lines 3/31/2019 8
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  Central line Bundle OPromptly remove unnecessary central lines O Follow proper insertion practices O Handle and maintain central lines appropriately 3/31/2019 9
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  SSI *Monitor appropriate useof antibiotics before and after surgery *Eliminate the use of razors to remove hair (can nick the skin and lead to infection) *Keep the patient warm during surgery *Monitor the patient's blood sugar after surgery 3/31/2019 10
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  SSI Bundle Administer antimicrobialprophylaxis Remote infections-whenever possible Do not remove hair at the operative site Skin Prep;do not use razor Maintain immediate postoperative normothermia Operating Room (OR) Traffic Surgical Wound Dressing Control blood glucose level during the immediate Post-operative period 3/31/2019 11
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  VAP 1.Elevation of thehead of the bed (HOB) 2. Daily sedation vacations and assessment to extubate 3. Peptic ulcer disease prophylaxis 4. Deep vein thrombosis (DVT) prophylaxis 5. Daily oral care with chlorhexidine (added in 2010) 3/31/2019 12
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  Bundle Controversies 1-A numberof different bundles exist, some targeting the same clinical condition. 2Differences in these bundles can lead to variability in bundle compliance rates and confusion when institutions attempt to benchmark performance. 3In addition, while it is maintained that a bundle encompasses a series of "proven" practices, healthcare clinicians need to evaluate the evidence behind the bundle components. 4-A scattering of clinical trial evidence exists for some of the components and the strength of evidence for each component varies. 3/31/2019 13
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  Strategies for PromotingBundle Forming a committee to: I. Review bundle care recommendations, II. Compare them to current unit practices, III. Generating a timeline for implementation, IV. Providing education and communication to unit staff, V. Conducting audits to assess compliance with bundle , VI. Regularly reporting the results back to unit staff. 3/31/2019 14
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  Thank you 3/31/2019 15