Reducing catheter-related bloodstream infections using Lean Six Sigma methodology.

Autor: Feng X; Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA., Huang Q; Nursing Department, The Second Affiliated Hospital of Guangzhou, University of Chinese Medicine, Guangzhou, Guangdong, 510120, China., Yuan L; The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510405, China., Lu F; Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, China., Deng R; Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, China., Xia P; Department of Social Medicine and Health Management, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, China. xiaping1976@163.com.; Centre for Research on Health Economics and Health Promotion, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, China. xiaping1976@163.com.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2024 Sep 27; Vol. 24 (1), pp. 1121. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1186/s12913-024-11527-6
Abstrakt: Background: Central venous catheters (CVC) are used for dialysis in end-stage renal disease patients, presenting a significant risk for Catheter-Related Bloodstream Infections (CRBSI). While Lean Six Sigma has been effective in reducing CRBSI, its efficacy outside intensive care units (ICU) remains less explored. This study aims to evaluate the effectiveness of Lean Six Sigma in mitigating CRBSI risks among non-ICU hemodialysis patients.
Methods: The study was conducted in a nephrology department, focusing on patients undergoing hemodialysis with temporary CVC from February to December 2021. The Lean Six Sigma method, using Define-Measure-Analyze-Improve-Control (DMAIC) methodology, was implemented in 2022 to reduce CRBSI incidence. The 2021 CRBSI rate served as the benchmark, with a goal to reduce it by the end of 2022. Value-stream mapping, Fishbone Diagrams, and Root Cause Analysis identified potential CRBSI causes. After implementing targeted improvements, CRBSI rates before and after the intervention were compared.
Results: The Lean Six Sigma method significantly decreased CRBSI incidence from 12.79 to 2.32 per 1,000 catheter-days following the implementation of targeted interventions ([Formula: see text]=4.60, P = 0.05). This improvement was observed comparing February-December 2021 with January-December 2022.
Conclusion: The findings demonstrate the effectiveness of the Lean Six Sigma method in non-ICU settings, suggesting broader applicability in hemodialysis patient care.
(© 2024. The Author(s).)
Databáze: MEDLINE
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