6th December 2010
Goals & Roll Out
Urinary catheter care bundles
Step 1
Already in
Place?
Organising a team
Identifying pilot sites
(3 areas)
Baseline Data
Step 2
Agree care bundle for
local use
Step 3
Goal December 2010
Testing of care bundle in
pilot sites
Implementation in pilot
sites
Step 4
Demonstrate reliable
implementation
Spread beyond pilot
sites
Goal - February
2011
Goal - August
2011 ongoing
Forming a Team
• Heterogeneous in make up, Homogenous in
mindset.
• Multi-disciplinary
– Not too dependant on continence specialists or
infection control specialists.
– Frontline staff engagement
– Doctors??
• Enthusiasts and champions
Pilot Sites
•
•
•
•
Three areas
Areas of high use of urinary catheters
Interested in taking part / engaged
Good leaders / champions for later work.
Baseline Data
• Numbers of urinary catheters being
placed
• Audit of indications for use
• Assessment of infection rate
– Unit / ward based
– Patient based
Urinary
Catheter
Insertion
Bundle
Urinary Catheter
Maintenance
Bundle
Step 1
Already in
Place?
Organising a team
Identifying pilot sites
(3 areas)
Baseline Data
Step 2
Agree care bundle for
local use
Step 3
Goal December 2010
Testing of care bundle in
pilot sites
Implementation in pilot
sites
Step 4
Demonstrate reliable
implementation
Spread beyond pilot
sites
Goal - February
2011
Goal - August
2011 ongoing
SBAR
•
•
•
•
Situation
Background
Assessment
Recommendation
Team Work
• Using SBAR to report back
• Consider your current position
–
–
–
–
–
Team in place?
Pilot sites chosen / volunteered?
Care bundles agreed?
Baseline data collected?
Testing underway?
• Provide a short piece of background to your work to date
• Assess your successes / any barriers to taking the work
forward
• Make recommendations for how the work will be progressed
during January / February 2011.
• What will you do on your return to work tomorrow.
6th December 2010
Goals & Roll Out
Peripheral Venous Catheter (PVC)
care bundles
Step 1
Goal - January
2011
Organising a team
Identifying pilot sites
(3 areas)
Baseline Data
Step 2
Agree care bundle for
local use
Step 3
Goal - March
2011 (LS3)
Testing of care bundle in
pilot sites
Implementation in pilot
sites
Step 4
Demonstrate reliable
implementation
Spread beyond pilot
sites
Goal - October
2011
Goal - June
2012 ongoing
Forming a Team
• Heterogeneous in make up, Homogenous in
mindset.
• Multi-disciplinary
– Not too dependant on I.V. specialist nurses or
infection control specialists.
– Frontline staff engagement
– Doctors??
• Enthusiasts and champions
Pilot Sites
• Three areas
• Areas of high use of peripheral venous
catheters
– A&E or Admissions units – consideration of when
to use them and when not to.
• Interested in taking part / engaged
• Good leaders / champions for later work.
Baseline Data
• How many PVCs are being placed on the
pilot wards
• How many are necessary?
• How many per day require removal /
replacement on the basis of their Visual
Infusion Phlebitis Score (VIP) – examples
of VIP score tables follow
Baseline Data
• MRSA / MSSA blood stream infection
data on the pilot wards
• Consider total blood stream infection data
• Hand hygiene compliance may be worth
noting at baseline also.
DoH England
High Impact
Intervention
Peripheral Venous
Catheter care bundle.
Issues
• Pre placement antisepsis
– DoH guidance
– CDC guidance currently under review
– Licensed products
– Cost
– Current practice
The Health Foundation
Safer Patients Network –
“Pass it on” collaborative
• NHS Tayside are supporting three health boards in
Wales to reduce blood stream infections by
implementing the PVC bundle.
• Same principles
• Supporting through a “Virtual” mini-collaborative
• Goals and aims are the same
• The three organisations will benefit from double the
support to implement theses changes.
Step 1
Goal - January
2011
Organising a team
Identifying pilot sites
(3 areas)
Baseline Data
Step 2
Agree care bundle for
local use
Step 3
Goal - March
2011 (LS3)
Testing of care bundle in
pilot sites
Implementation in pilot
sites
Step 4
Demonstrate reliable
implementation
Spread beyond pilot
sites
Goal - October
2011
Goal - June
2012 ongoing
SBAR
•
•
•
•
Situation
Background
Assessment
Recommendation
Team Work
• Using SBAR to report back
• Consider your current position
– Team in place?
– Pilot sites chosen / volunteered?
• Provide a short piece of background to your work to
date
• Assess your successes / any barriers to taking the
work forward
• Make recommendations for how the work will be
progressed during January - March 2011, so that
some baseline data and agreed care bundle can be
presented at LS3
• What will you do on your return to work tomorrow?