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Implementation of an ICU Exit Checklist

Implementation of an ICU Exit Checklist . Ashley Dobuzinsky, BSN, RN, CCRN Lynn Orser , MSN, RN, CCRN, PCCN St. Vincent’s Medical Center . Objectives. Discuss: D evelopment of the ICU Exit Checklist Implementation process Outcomes. Our Goals.

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Implementation of an ICU Exit Checklist

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  1. Implementation of an ICU Exit Checklist Ashley Dobuzinsky, BSN, RN, CCRN Lynn Orser, MSN, RN, CCRN, PCCN St. Vincent’s Medical Center

  2. Objectives Discuss: • Development of the ICU Exit Checklist • Implementation process • Outcomes

  3. Our Goals • To address increasing incidence of HAI among hospitalized patients through the utilization of an ICU Exit checklist • To decrease utilization of central venous catheters (CVC) and indwelling catheters • Improve communication among the healthcare team

  4. Methods • Setting • 30-bed mixed surgical/medical ICU, inclusive of 6 bed PCU • Closed unit-Intensivist led model • Pre-implementation data • Collected over a 30-day period from August 2012-September 2012 on patients transfers from the ICU/PCU. Monitoring for the presence of CVC or indwelling catheters at time of transfer.

  5. Pre-Implementation Data • Of the 84 patients tracked, 23 patients (27%) were transferred with a CVC in place • 42 patients (50%) were transferred with an indwelling catheter in place

  6. Implementing the Checklist • Engaging the multidisciplinary team • Expanding goals of checklist to include: • Narrowing antibiotic coverage • Evaluation of proton pump inhibitor therapy for discontinuation • Notification of accepting physician at time of transfer • Staff education

  7. Outcomes

  8. Outcomes • ICU Indwelling Catheter Utilization • 37% reduction in utilization from Sept 2012-Nov 2013 • No ICU CAUTIs Aug 2013-Oct 2013 • ICU CVC • 14.5% reduction in patient transfers with CVC in place • One reported CLABSI over 12 month period

  9. Summary • ICU process improvement project • Primary goal to decrease HAI by reducing the utilization of CVC and indwelling catheters • Involved a multidisciplinary team approach • Observations included overall decline in utilization of CVC and indwelling catheters

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