McVey Caitlin, von Wenckstern Toni, Mills Courtney, Yager Lauren, McCauley Christopher, Rivera Yvana, Reed Elizabeth
Memorial Hermann-Texas Medical Center (Mss McVey, von Wenckstern, Mills, McCauley, Rivera, and Reed), Houston, Texas; and Children's Memorial Hermann Hospital, Houston, Texas (Ms Yager).
J Nurs Care Qual. 2022;37(4):295-299. doi: 10.1097/NCQ.0000000000000634. Epub 2022 Jul 8.
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.
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.
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.
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%.
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.
由于患者对感染的易感性增加、资源减少以及机构护士使用增加，在新冠疫情期间，现有的监测和预防医疗保健相关感染（HAIs）的最佳实践方法效果不佳。
对美国医院的一项审查显示，2020年中心静脉导管相关血流感染（CLABSIs）增加了60%，导尿管相关尿路感染（CAUTIs）增加了43%。德克萨斯州休斯顿的一家大型学术一级创伤中心在新冠疫情开始时也面临类似挑战。
一个由护士、感染预防专家和医院教育工作者组成的跨学科团队以一种新颖的方式结合并调整了现有的循证实践方法，创建了一个由护士主导的工具包，用于质量改进跟踪、改善和维持HAIs的改善。
在引入护士敏感指标质量改进（NSIQI）工具包后，CLABSI和CAUTI率随时间下降。CLABSI标准化感染率（SIR）下降了19%，CAUTI SIR下降了19.4%。
新颖的NSIQI工具包是一种可扩展的工具，用于提高和维持CLABSI和CAUTI率，可能对其他护士敏感质量指标也有潜在作用。
