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Education, Teaching, and Quality Improvement |

Why Are Daily Checklists an Absolute Necessity to Reduce the Incidence of Preventable Infections in the Intensive Care Unit (ICU)?

Stelios Vantelas, MD; Kush Dholakia, MD; Ali Elsayed, MD; C. Meyer, BS; Ann Mueller, BS; D. Bolima, BS; Clara Quesada-Llopiz, BS; Joan Mayo, BS; Theresa Soroko, MD
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Hackesack UMC Mountainside, Montclair, NJ


Chest. 2013;144(4_MeetingAbstracts):578A. doi:10.1378/chest.1703467
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Abstract

SESSION TITLE: Quality Innovation, Transformation and Design Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To reiterate the necessity of daily checklists for reducing Central line-associated blood stream infections (CLABSI), Ventilator-associated pneumonia (VAP) & Catheter-associated urinary tract infections (CAUTI). CLABSIs, VAPs and CAUTIs are preventable infections that increase morbidity & mortality in critically ill patients & add billions of dollars in cost to the US healthcare system. The CDC is providing guideline bundles to help reduce the incidence of these healthcare associated infections (HAI). The ICU is a world of increasing complexity, similar to the most sophisticated aircrafts, where even the most expert professionals face difficulty in enlisting the bundles of care.

METHODS: We conducted a test in the Critical Care (CC) division of our 378-bed community hospital, which employs a 24 hours/day, 7 days/week in-house Intensivist model of CC. The test was distributed among CC RNs, respiratory therapists (RT) and senior residents in the Internal medicine (IM res) program. Participants were asked to list the elements of each bundle in accordance with CDC guidelines. Testing bias was reduced by requesting immediate return of the test. Anonymity of the results was ensured by a drop box submission. A passing score of 100% was required since all bundle elements have to be implemented together to be effective in improving patient outcomes.

RESULTS: A total of 23 healthcare professionals took the test. 52% were CC RNs, 17% were RTs and 31% were IM res. The median years of CC experience was 12 among the RNs & 21 among the RTs. The number of individuals with a passing score was 0, 3 & 0 for CLABSI, VAP & the CAUTI bundles respectively.

CONCLUSIONS: Across all levels healthcare professionals' awareness of bundles of care for CLABSI, VAPs, & CAUTIs is lacking, and would benefit from a daily checklist.

CLINICAL IMPLICATIONS: Besides increasing the awareness of the increased mortality & costs associated with CLABSIs, VAPs & CAUTIs, our study reiterates that a daily checklist is absolutely essential to ensure compliance with CDC recommended bundles for prevention of these HAIs.

DISCLOSURE: The following authors have nothing to disclose: Stelios Vantelas, Kush Dholakia, Ali Elsayed, C. Meyer, Ann Mueller, D. Bolima, Clara Quesada-Llopiz, Joan Mayo, Theresa Soroko

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