With hospital acquired infections peaking across the nation during the pandemic, CHS hospitals were looking for ways to reverse this trend and protect their patients. Last August, CHS hospitals introduced daily device huddles and weekly device rounds as a way to reduce infections. The number of HAIs across the organization has declined and one CHS hospital – Northwest Medical Center in Tucson – embraced these concepts to achieve a truly notable accomplishment: more than 12 months without a single CAUTI, CLABSI or MRSA infection.
“It all began with a deep commitment from hospital leadership,” says CHS Senior Director of Quality and former Tucson Market Chief Quality Officer Heather Bulman. “Everyone from the hospital CEO and CNO to the chief quality officer, director of infection prevention, physicians and frontline staff made this effort about education, trust and a culture of caring.”
The team started getting together every morning for a device huddle to discuss each patient with a line or catheter and whether or not it was still warranted. If a patient still meets clinical indications, the line or catheter remains; if not, they are removed as soon as possible. These actions are validated each afternoon during a follow-up meeting.
Additionally, a nursing champion and infection preventionist round twice weekly to ensure that the evidence-based measures that prevent infections in patients with lines and devices are being followed (i.e., proper placement of a foley bag, absence of a dependent loop in foley tubing, daily baths, etc.). Time is spent educating or re-educating staff if deficiencies are found.
According to Bulman, physicians are equally vested in the effort. They are more thoughtful and deliberate about whether they need to put in a central line or foley catheter. They are open to using midline catheters in lieu of central or PICC lines, and they are willing to consider using external alternatives to indwelling urinary catheters for both male and female patients. In patients for whom a line can’t be avoided, physicians at NWMC are more conscientious than ever about getting the lines out as soon as a patient’s condition improves. “NWMC provider have set the expectation that they’re going to get those lines out of the patients as soon as possible, and that they are going to provide evidence-based care when indwelling lines are required no matter what,” says Bulman.
A physician involved with this renewed focus on preventing infections, NWMC Chief Medical Officer Dr. Terry Loftus believes the device huddles and rounds are a game changer for NWMC. “The team clearly understands the role diligence plays in helping prevent infections – not just in CAUTI, CLABSI and MRSA – but in other potentially fatal and avoidable HAIs,” says Dr. Loftus. “The device huddles and rounds have brought a new level of awareness to what every member of the care team can do to keep our patients safer.”
NWMC Tucson CEO Brian Sinotte agrees. “Very few hospitals of our size can claim a zero incidence rate of these infections over this length of time,” he says. “We can achieve this due to our people and processes. Our culture is committed to safety, which provides a tremendous foundation to save even more lives.”