Virtual Breakthrough Series, Part 1: Preventing Catheter-Associated Urinary Tract Infection and Hospital-Acquired Pressure Ulcers in the Veterans Health Administration
| Autor: | Shoshana Boar, Sarah L. Krein, Lisa Zubkoff, Mary Ellen Dellefield, Yinong Young-Xu, Beth J. King, Julia Neily, Peter D. Mills |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Quality management Inservice Training Quality Assurance Health Care Leadership and Management Hospitals Veterans Iatrogenic Disease Veterans Health 01 natural sciences 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Indwelling catheter medicine Humans 030212 general & internal medicine 0101 mathematics Disease management (health) Cooperative Behavior Intensive care medicine Veterans Affairs Catheter-associated urinary tract infection Patient Care Team Pressure Ulcer business.industry 010102 general mathematics Disease Management Baseline data Veterans health Quality Improvement United States Catheter United States Department of Veterans Affairs Catheter-Related Infections Models Organizational Emergency medicine Urinary Tract Infections business Delivery of Health Care |
| Zdroj: | Joint Commission journal on quality and patient safety. 42(11) |
| ISSN: | 1553-7250 |
| Popis: | In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs).During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims. The action phase consisted of educational conference calls, coaching, and monthly team reports. Learning was conducted via phone, web-based options, and e-mail. The CAUTI bundle focused on four key principles: (1) avoidance of indwelling urinary catheters, (2) proper insertion technique, (3) proper catheter maintenance, and (4) timely removal of the indwelling catheter. The HAPU bundle focused on assessment and inspection, pressure-relieving surfaces, turning and repositioning, incontinence management, and nutrition/hydration assessment and intervention.For the 18 participating units, the mean aggregated CAUTI rate decreased from 2.37 during the prework phase to 1.06 per 1,000 catheter-days during the action (implementation) phase (p0.001); the rate did not change for CAUTI nonparticipating sites. HAPU data were available only for 21 of the 31 participating units, whose mean aggregated HAPU rate decreased from 1.80 to 0.99 from prework to continuous improvement (p0.001). Staff education and documentation improvement were the most frequently implemented changes.This project helped improve CAUTI and HAPU rates in the VHA and presents a promising model for implementing a virtual model for improvement. |
| Databáze: | OpenAIRE |
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