PURPOSE: The purpose of this retrospective analysis was to assess the impact of Interdisciplinary (IDT) rounds on the number of indwelling foley and central venous line days in the Intensive Care Unit (ICU). We also examined the impact such rounds would have have on infection caused by the indwelling catheters.
METHODS: Interdisciplinary rounds were started at our institution in the medical ICU in May 2010. These rounds were led by the medical ICU director and included the following a Critical Care physician, ICU nurse, respiratory care practitioner, nutritionist, pharmacist, and a hospice and palliative care nurse. Each member of the IDT team presented data relevant to their specialty. Information from IDT rounds were documented on a form that became part of the medical record. Physician and nursing staff worked specifically to identify the number of days patients had foley catheters and central venous lines. Each catheter was identified by location, duration, and necessity. Catheters no longer indicated were removed.
RESULTS: We measure the number of foley days, the number of central venous line days, and the proportion of foley and central venous line infections in the medical ICU per month. We included data from all January 2010 through March 2011 and compared those months in which IDT rounds took place (May 2010 - March 2011, 10.5 months) to those prior to the initiation of these rounds (January - May 2010, 4.5 months). These data demonstrate that there was a significant difference in the number of foley line days between 2010 and 2011 (p = 0.015). There were less line days in 2011 versus 2010. There was also a significant difference in the number of urinary tract infections between 2010 and 2011 (p = 0.047). There were fewer urinary tract infections in 2011 versus 2010.
CONCLUSIONS: This retrospective analysis demonstrates that IDT rounds can do have a considerable impact on reducing the number of foley and central venous line days in the ICU patient. Furthermore, there was a notable reduction in the number of foley and central venous line infections with the implementation of this intervention.
CLINICAL IMPLICATIONS: Cather related infections remains a significant health care burden. This study demonstrates that an intervention as reviewing and assessing central lines and foley cathters with a multidisciplinary team approach can reduce the number of days catheters are placed, but also reduce infection. The overall IDT rounds can have an impact in reducing health care acquired infections.
DISCLOSURE: The following authors have nothing to disclose: Noeen Ahmad, Navneet Arora, Jennifer LaRosa, Sean Studer
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