- Email: [email protected]
N066 Decreasing central line infection rates: The combination of best practice and the introduction of an antimicrobial IV connector
S358
symptoms suspicious of ischemic heart disease. It was hypothesized that there was a similar need for rapid assessment for those who present to suburban regional ED where limited cardiovascular resources exist. Accordingly, the CPP protocol was streamlined for implementation in the regional ED and initiated in 3 suburban sites outside of Edmonton . The goal of the Peripheral Chest Pain Program (PCPP) was to achieve patient assessment by a NP within 5 working days of original ED presentation with concurrent non-invasive cardiac assessment when appropriate. In a 12 month period, 157 patients (48% female) were referred with a mean age of 57.0 years. Risk factors include 48% hypertension, 43% dyslipidemia, 42% smoking, 38% family history, and 20% diabetes. The average wait time was 4.7 days including data for those who delayed appointment confirmation. Exercise stress testing was completed in 103 (66%) with 46 (25%) booked for other diagnostics including MIBI or stress echocardiogram. No patients suffered ischemic events prior to PCPP assessment. This program demonstrates the need for a rapid access systematic approach for assessment of patients presenting to regional emergency departments with a diagnosis of potential ischemic chest pain. Through the NP-led program, patient care has been enhanced by timely assessment, appropriate investigations and treatment in centers where such resources were not previously available.
N065 THE CHALLENGE OF CHANGING COMMUNICATION PRACTICE BETWEEN NURSES C Frewin, H Andrews, A Fong, A Kaan, J Knoll, S Lauck St. Paul’s Hospital, Vancouver, BC
Patients are increasingly admitted with numerous comorbidities and complex diagnoses. Recently, Care Delivery Model Redesign (CDMR) has suggested a need for improved communication. Nurses communicate with members of the allied health team and other nurses during shift changes. As such a communication tool has evolved to incorporate the different needs of units within our program. The latest version – a Care Map – was conceptualized by a multidisciplinary committee as a tool that would help direct and ensure safety and continuity of care. Recently, 100 draft Care Maps were evaluated. During the evaluation, it was noted that RNs often continue to rely on “cheat sheets” (paper on which RNs write down their own notes from shift change). Cheat sheets, although convenient, do not foster consistent communication across disciplines. The purpose of this paper is to report why RNs on one unit continue to rely on “cheat sheets” rather than the Care Map. We will utilize a short survey to elicit from nurses why the use of these cheat sheets continues despite introduction of the Care Map. The survey results will be incorporated into the data obtained from the initial statistical analysis of the 100 draft Care Maps. By incorporating the results of this survey, our hope is to be able to further amend the design so that nurses become less reliant on individual cheat sheets and therefore create a com-
Canadian Journal of Cardiology Volume 27 2011
munication tool that nurses will feel comfortable relying on for communicating patient information, status and care plans.
N066 DECREASING CENTRAL LINE INFECTION RATES: THE COMBINATION OF BEST PRACTICE AND THE INTRODUCTION OF AN ANTIMICROBIAL IV CONNECTOR K Charron UOHI, Ottawa, ON
With the public reporting of Patient Safety Indicators in Ontario , hospitals are more accountable than ever for hospital acquired infections (HAIs). HAIs have also been a central focus for hospitals due to the cost of infections, and increased length of stay for patients. Safer Health Care Now (SHN) rolled out ten initiatives targeted at addressing a number of preventable deaths and adverse events that occur due to HAIs. Central Line Infections (CLIs) are one of the HAIs focused on by SHN. They account for 90 per cent of catheter related infections, and contribute to a 20 per cent mortality rate for central line associated-blood stream infections (Canadian Patient Safety Institute, 2010). In 2006, an Ontario cardiac facility (in partnership with SHN) committed to addressing HAIs. The intention was not only to monitor and report infection rates, but to eliminate such infections from occurring. This was done through the implementation of a SHN CLI intervention. Implementation results showed a reduction in CLI rates to below the provincial average. With a goal of eliminating CLIs, staff felt that there was an opportunity to further improve. An audit of best practice and equipment utilized was completed. This was done to determine what other resources would be available to the healthcare worker to further improve their ability to deliver patient care and decrease CLI risk. It was decided that an antimicrobial IV connector (V-Link) would be introduced. Upon implementation of the IV connector, CLI rates were further decreased. This presentation will show how best practice and antimicrobial IV connector (V-Link) decreased CLI rates.
N067 HYBRID MODEL TO FILL THE VOID IN THE ATRIAL FIBRILLATION COMMUNITY P Colley, E Tang, M Sidsworth, K Gin, J MacGillivray Vancouver Coastal Health, Vancouver, BC
Atrial Fibrillation affects approximately 250,000 Canadians with an annual hospitalization cost of $143 million. The increased burden of AF has greatly impacted the medical community. In order to meet this demand, some centres have formed specialized AF clinics staffed by a multidisciplinary team including electrophysiologists (EP). However, many regions throughout Canada are underserved by EPs. The purpose of this presentation is to highlight Vancouver General Hospital
symptoms suspicious of ischemic heart disease. It was hypothesized that there was a similar need for rapid assessment for those who present to suburban regional ED where limited cardiovascular resources exist. Accordingly, the CPP protocol was streamlined for implementation in the regional ED and initiated in 3 suburban sites outside of Edmonton . The goal of the Peripheral Chest Pain Program (PCPP) was to achieve patient assessment by a NP within 5 working days of original ED presentation with concurrent non-invasive cardiac assessment when appropriate. In a 12 month period, 157 patients (48% female) were referred with a mean age of 57.0 years. Risk factors include 48% hypertension, 43% dyslipidemia, 42% smoking, 38% family history, and 20% diabetes. The average wait time was 4.7 days including data for those who delayed appointment confirmation. Exercise stress testing was completed in 103 (66%) with 46 (25%) booked for other diagnostics including MIBI or stress echocardiogram. No patients suffered ischemic events prior to PCPP assessment. This program demonstrates the need for a rapid access systematic approach for assessment of patients presenting to regional emergency departments with a diagnosis of potential ischemic chest pain. Through the NP-led program, patient care has been enhanced by timely assessment, appropriate investigations and treatment in centers where such resources were not previously available.
N065 THE CHALLENGE OF CHANGING COMMUNICATION PRACTICE BETWEEN NURSES C Frewin, H Andrews, A Fong, A Kaan, J Knoll, S Lauck St. Paul’s Hospital, Vancouver, BC
Patients are increasingly admitted with numerous comorbidities and complex diagnoses. Recently, Care Delivery Model Redesign (CDMR) has suggested a need for improved communication. Nurses communicate with members of the allied health team and other nurses during shift changes. As such a communication tool has evolved to incorporate the different needs of units within our program. The latest version – a Care Map – was conceptualized by a multidisciplinary committee as a tool that would help direct and ensure safety and continuity of care. Recently, 100 draft Care Maps were evaluated. During the evaluation, it was noted that RNs often continue to rely on “cheat sheets” (paper on which RNs write down their own notes from shift change). Cheat sheets, although convenient, do not foster consistent communication across disciplines. The purpose of this paper is to report why RNs on one unit continue to rely on “cheat sheets” rather than the Care Map. We will utilize a short survey to elicit from nurses why the use of these cheat sheets continues despite introduction of the Care Map. The survey results will be incorporated into the data obtained from the initial statistical analysis of the 100 draft Care Maps. By incorporating the results of this survey, our hope is to be able to further amend the design so that nurses become less reliant on individual cheat sheets and therefore create a com-
Canadian Journal of Cardiology Volume 27 2011
munication tool that nurses will feel comfortable relying on for communicating patient information, status and care plans.
N066 DECREASING CENTRAL LINE INFECTION RATES: THE COMBINATION OF BEST PRACTICE AND THE INTRODUCTION OF AN ANTIMICROBIAL IV CONNECTOR K Charron UOHI, Ottawa, ON
With the public reporting of Patient Safety Indicators in Ontario , hospitals are more accountable than ever for hospital acquired infections (HAIs). HAIs have also been a central focus for hospitals due to the cost of infections, and increased length of stay for patients. Safer Health Care Now (SHN) rolled out ten initiatives targeted at addressing a number of preventable deaths and adverse events that occur due to HAIs. Central Line Infections (CLIs) are one of the HAIs focused on by SHN. They account for 90 per cent of catheter related infections, and contribute to a 20 per cent mortality rate for central line associated-blood stream infections (Canadian Patient Safety Institute, 2010). In 2006, an Ontario cardiac facility (in partnership with SHN) committed to addressing HAIs. The intention was not only to monitor and report infection rates, but to eliminate such infections from occurring. This was done through the implementation of a SHN CLI intervention. Implementation results showed a reduction in CLI rates to below the provincial average. With a goal of eliminating CLIs, staff felt that there was an opportunity to further improve. An audit of best practice and equipment utilized was completed. This was done to determine what other resources would be available to the healthcare worker to further improve their ability to deliver patient care and decrease CLI risk. It was decided that an antimicrobial IV connector (V-Link) would be introduced. Upon implementation of the IV connector, CLI rates were further decreased. This presentation will show how best practice and antimicrobial IV connector (V-Link) decreased CLI rates.
N067 HYBRID MODEL TO FILL THE VOID IN THE ATRIAL FIBRILLATION COMMUNITY P Colley, E Tang, M Sidsworth, K Gin, J MacGillivray Vancouver Coastal Health, Vancouver, BC
Atrial Fibrillation affects approximately 250,000 Canadians with an annual hospitalization cost of $143 million. The increased burden of AF has greatly impacted the medical community. In order to meet this demand, some centres have formed specialized AF clinics staffed by a multidisciplinary team including electrophysiologists (EP). However, many regions throughout Canada are underserved by EPs. The purpose of this presentation is to highlight Vancouver General Hospital