ORLANDO, FL—A central line associated blood stream infection (CLABSI) prevention roadshow effectively provides education to nurses about central line care and maintenance as well as the importance of documentation, according to a presentation at the Oncology Nursing Society (ONS) 40th Annual Congress.
This innovative teaching strategy for best practices in the prevention of CLABSIs “was created to provide education to all nurses in [an] easily accessible, thorough, hands-on manner that allowed the ability to interact while performing central line maintenance,” said Ashley Mickiewicz, BSN, RN, OCN®, of Robert Wood Johnson University Hospital in New Brunswick, New Jersey.
In 2013, the hospital had 91 CLABSIs, for a rate of 1.66 infections per 1,000 catheter days. New products and initiatives had been implemented with accompanying education programs; however, “staff continued to demonstrate incorrect technique with central line care,” she said.
“Quality audit data showed lower than expected compliance with dressing changes (approximately 94%), central line maintenance (approximately 87%), and central line documentation (approximately 83%). Not exactly where we wanted them to be,” Michiewicz said during the presentation.
During their shifts, nurses have difficulty leaving units for education. For that reason, the CLABSI committee members developed the CLABSI prevention roadshow to bring the education to the unit.
“The roadshow is mobile and able to travel to multiple units during a day,” Mickiewicz said. “Sessions include return demonstration of central line dressing change, medication administration, electronic medical record (EMR) documentation, and various CLABSI prevention initiatives. The primary goal of this initiative is to create an educational environment that is practical for the bedside nurse and facilitates best practice in central line care.”
The effect of the prevention roadshow initiative on CLABSI is monitored by prevalence rates and monthly chart review audits. To date, 100 nurses have participated in the initiative.
Among respondents to a volunteer survey to evaluate the effectiveness of the teaching methods, 100% reported “a change in practice resulted from the teaching and 1:1 skill training.”
Other findings include a need for hands on demonstration education with interaction and a change in wording in the EMR due to interactions in the roadshow and to increase documentation compliance.
One limitation is that the educational format is time inefficient, with an average of 2 hours needed to educate the staff on shift for one unit.
“Select staff nurses have been trained as instructors, to increase the number of offerings, and provide peer-to-peer feedback,” she concluded.