During the COVID-19 pandemic, Phelps Health in Missouri noticed a sudden increase in central line-associated bloodstream infection (CLABSI) rates, and in response created a multidisciplinary team to address the issue.
The rise in CLABSI rates occurred at the arrival of COVID-19 and escalated as the virus peaked. “The pandemic was an event of catastrophic proportion that no one in this day and age had ever seen, nor could have been prepared to handle,” said Brandy Parks, BSN, RN, Clinical Quality Analyst with Phelps Health.
The facility faced a surge of unstable patients who required central venous lines for lifesaving measures, while at the same time confronting staffing shortages. The issue was compounded even further due to the lack of knowledge on how to effectively treat patients with COVID-19, which possibly led to pre-emptive central venous line placements. Also, these patients were often critically ill for lengthy periods of time, requiring lines to being in place for longer.
The number of CLABSIs per 1,000 central line days rose from 1.6 in 2020 to 4.5 as of September 2021, Parks said.
The project team formed to improve this rate trialed and reassessed multifaceted interventions for effectiveness. Two such activities included conducting daily central venous line necessity checks during morning rounds and encouraging nurses to speak with physicians daily to review and assess central venous line necessity.
Additionally, facilitators presented all findings and interventions at mandatory staff meetings, and staff were provided education on their CLABSI rates, charting deficiencies and rationale for the interventions that had been implemented.
Education also included a Simple Step Standard Operating Procedure (SOP) that was posted in breakrooms, restrooms and nurses’ stations.
As a result of this project, Phelps Health’s CLABSI rate is the lowest it has been in six years with only one occurrence in 2022.
“Being a rural health care system with limited resources during the pandemic proved to be even more challenging (in addressing COVID-19), but our staff never let their limited numbers or limited resources affect the care we provide to our community,” Parks said.
Phelps Health is a 2022 Health Quality Innovator of Year winner in the Rural Health Category. Click HERE to learn more about their success in reducing their CLABSI rates during the COVID-19 pandemic.