Using a Comprehensive On-Site Assessment Process to Reduce Central Line-Associated Bloodstream Infection Rates.

Central line-associated bloodstream infection (CLABSI) rates increased substantially in the United States following the emergence of COVID-19 and subsequent surges. The pandemic resulted in hospital capacities being exceeded and crisis standards of care being implemented for sustained periods. As COVID-19 rates in the United States began to stabilize, some facilities did not return to previous CLABSI rates, indicating a change in practices that had a longer-term impact on CLABSI prevention. The authors' large health care system observed similar increases in CLABSI following the emergence of COVID-19, prompting investigation and intervention in the form of a quality improvement project. To identify changes related to ongoing increases in CLABSI, an assessment team conducted standardized on-site assessments at 11 facilities. Site assessments were considered an intervention, as they involved rigorous preassessment investigations and interviews, case reviews, practice observations, on-site staff interviews, and postassessment support for additional interventions. Nine facilities had enough postassessment data to analyze the impact of intervention. The overall CLABSI rate (infections per 1000 line days) at the 9 facilities in the 6 months prior to intervention was 1.42, and the postassessment rate in the 6 months following intervention was 0.44. This indicates the effectiveness of facility-specific investigation followed by targeted performance improvements to reduce the rate of CLABSI.

Implementing a Virtual Team Model in the Acute Care Setting.

Health care has forever changed in early 2021. Three years after the beginning of the COVID-19 world pandemic, we must seriously look at the role of the nurses and the model we deploy to ensure our health system's viability. In this article, the authors offer insights into the journey of deconstructing the nurses' role and planning for a Co-Caring Model where virtual and bedside nurses practice and unlicensed assisting personnel work as a team to care for those in need of health care. We also provide a list of actions for nurse leaders to consider. Finally, we aim to spark an international conversation on how we can bring back the joy of practice to ensure we create the best possible places to give and get care.

Novel manufacturing of simple masks in response to international shortages: Bacterial and particulate filtration efficiency testing.

Many healthcare systems have been forced to outsource simple mask production due to international shortages caused by the COVID-19 pandemic. Providence created simple masks using surgical wrap and submitted samples to an environmental lab for bacterial filtration efficiency testing. Bacterial filtration efficiency rates ranged from 83.0% to 98.1% depending on specific material and ply, and particular filtration efficiency rates ranged from 92.3% to 97.7%. Based on mask configuration, specific surgical wrap selected, and ply, the recommended filtration efficiency for isolation and surgical masks of 95% and 98%, respectively can be achieved. These alternative masks can allow for similar coverage and safety when hospital-grade isolation masks are in short supply.