Bloodstream Infection
Quality Improvement Activity (QIA)

2018 NCC BSI QIA Learning and Action Network (LAN) Materials

• Presentation Objectives:
  • Promote implementation of the Centers for Disease Control (CDC) recommended core interventions for dialysis BSI prevention.
  • Share best practices in reducing Healthcare-Associated Infections, BSIs, and sepsis.
  • Sepsis Assessment Tool Development And Implementation Within One Dialysis Unit In The Midwest Kidney Network (ESRD Network 11).

• Recording Link

• Presentation Objectives:
  • Define challenges of the acute kidney injury/failure, end stage renal disease, and nursing home or long-term ambulatory care (LTAC) patient population.
  • Highlight recognized issues contributing to the increase of bloodstream infection (BSI) rates and hospitalization.
  • Identify how to improve collaboration with other healthcare providers
• Presentation Slides
• Recording Link

• Presentation Slides
• Recording Link
• National Evaluation with Promising Practices

• Presentation Objectives:
  • Discuss the importance of involving an interdisciplinary team, including patient representatives in infection reduction.
  • Utilize NHSN/CDC Tools for effective hand hygiene to avoid infection.
  • Share audit results from monitoring and observations to focus on what was working to eliminate infections.
• Recording Link

• Presentation Slides
• Recording Link

Quality Improvement Videos and Tools

• Quality Improvement in Healthcare (11:08 Minutes)
• Root Cause Analysis – Process to Identify Areas for Quality Improvement
  • What is a Fishbone Diagram? (3:08 Minutes)
  • Six-Sigma Fishbone Analysis Diagram for 4P's: A Template
  • Root Cause Analysis: 5 Whys (4:44 Minutes)
  • 5 Whys of Root Cause Analysis: A Template
• PDSA Cycles – Process to Achieve Quality Improvement (6:21 Minutes)

Tools and Resources for BSI Reduction

• Dialysis Core Interventions 
• Prevention Process Measures Audit Forms and Checklists 
• Prevention Process Measures - How to Collect and Document Data in NHSN
• Catheter Compatibility 
• CVC Scrub the Hub Protocol
• Patient Education
• Selecting an Antimicrobial Ointment for Hemodialysis Catheter Exit Sites
• Patient Engagement in Infection Prevention - AHRQ Patient Safety Video (4:54 Minutes)
• Patient Recruitment Letter for Participation in BSI Reduction
• Support for Use of Core Interventions: Recommendations of the Healthcare Infection Control Practices Advisory Committee
• Days Since Last Infection Poster
• Hospital Blood Culture Tracking Tool
• NHSN Excess Infection Report
• PDSA Cycle Tool – Generic
• PDSA Cycle Tool – PPMs
• Prevention Process Measures (PPMs) Timetable

Tools and Resources for Long Term Catheter (LTC) Subset

• Catheter Reduction Toolkit and Tools
• Peer Mentoring Patient Volunteer
• Peer Mentoring Program - ESRD NCC
• American Society of Nephrologists "Days Since Infection" Poster
• Hemodialysis Infection Prevention with Polysporin Ointment
• Selecting an Antimicrobial Ointment for Hemodialysis Catheter Exit Sites

References

1. Soi V, Moore CL, Kumbar L, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. International Journal of Nephrology and Renovascular Disease. 2016; 9:95-103. doi:10.2147/IJNRD.S76826.
2. Nguyen DB1, Shugart A2, Lines C2 et al. National healthcare safety network (NHSN) dialysis event surveillance report for 2014. Clin J Am Soc Nephrol. 2017 Jul 7;12(7):1139-1146. doi: 10.2215/CJN.11411116. Epub 2017 Jun 29.
3. Centers for Disease Prevention and Control. CDC approach to BSI prevention in dialysis facilities. CDC.gov. http://www.cdc.gov/dialysis/prevention-tools/core-interventions.html Last updated June 15, 2016. Accessed December 18, 2017.