Nurse-Sensitive Indicator Quality Improvement Toolkit: A Scalable Solution to Improve Health Care-Associated Infections.

BACKGROUND: Existing best practices to monitor and prevent health care-associated infections (HAIs) were ineffective during the COVID-19 pandemic due to increased patient susceptibility toward infections, reduced resources, and increased use of agency nurses. PROBLEM: A review of the US hospitals revealed a 60% increase in central line-associate bloodstream infections (CLABSIs) and a 43% increase in catheter-associated urinary tract infections (CAUTIs) in 2020. A large, academic, level 1 trauma center in Houston, Texas, experienced similar challenges at the start of the COVID-19 pandemic. APPROACH: An interdisciplinary team of nurses, infection preventionists, and hospital educators combined and adapted existing evidence-based practices in a novel way to create a nursing-led toolkit for quality improvement tracking, improving, and sustaining HAI improvements. OUTCOMES: CLABSI and CAUTI rates were reduced over time following the introduction of the Nurse-Sensitive Indicator Quality Improvement (NSIQI) Toolkit. The CLABSI standardized infection ratio (SIR) decreased by 19%, and the CAUTI SIR decreased by 19.4%. CONCLUSIONS: The novel NSIQI Toolkit is a scalable tool for improving and sustaining CLABSI and CAUTI rates, which may have the potential for other nurse-sensitive quality indicators.

Safe Handling of Snakes in an ED Setting.

Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. METHODS: A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. RESULTS: All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. IMPLICATIONS FOR PRACTICE: Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety.

Trauma Information Group: A Level I Trauma Center's Integrated Approach to Family Support.

As their loved one is admitted to the hospital, family members/significant others of trauma patients have specific needs for information, patient and health care provider access, and psychosocial support. The idea to offer an information group for family members of trauma patients was developed and implemented in a large, Level I Trauma Center in the Southwestern United States. The intervention, strategies, and considerations for successful implementation, program evaluation by family members, and implications for practice are described in this article. Providing specific, helpful information in response to family members' immediate needs can lead to improved patient outcomes and patient/family satisfaction with the care provided by an organization after a traumatic event.