Standardizing Central Line Safety Lessons Learned for Physician Leaders

被引：14

作者：

Mueller, Jeff T. ^{[1
]}

Wright, Alan J. ^{[2
]}

Fedraw, Leslie A. ^{[2
]}

Murad, M. Hassan ^{[2
]}

Brown, Daniel R. ^{[2
]}

Thompson, Kristine M. ^{[3
]}

Flick, Randall ^{[2
]}

Seville, Maria Teresa A. ^{[1
]}

Huskins, W. Charles ^{[2
]}

机构：

[1] Mayo Clin, Phoenix, AZ USA

[2] Mayo Clin, Rochester, MN USA

[3] Mayo Clin, Jacksonville, FL 32224 USA

来源：

AMERICAN JOURNAL OF MEDICAL QUALITY | 2014年 / 29卷 / 03期

关键词：

clinical practice guidelines; health care delivery; central lines; best practices; leading change; CLINICAL-PRACTICE GUIDELINES; BLOOD-STREAM INFECTIONS; PATIENT SAFETY; CARE; CANNULATION; MALPRACTICE; QUALITY; IMPLEMENTATION; STRATEGIES; CATHETERS;

D O I：

10.1177/1062860613494752

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

A comprehensive central venous catheter (CVC) safety program reduces mechanical and infectious complications and requires an integrated multidisciplinary effort. A multistate health care system implemented a discovery and diffusion project addressing CVC insertion, maintenance, and removal. Process and outcome measures were collected before and after the intervention. The project was completed in 12 months. It was associated with statistically significant improvement in 6 process measures and reduction in the rate of ICU central line-associated bloodstream infection (from 1.16 to 0.80 infections/1000 catheter days; incidence rate ratio = 0.69; 95% confidence interval = 0.51, 0.93). A comprehensive CVC standardization project increased compliance with several established best practices, was associated with improved outcomes, produced a refined definition of discovery and diffusion project components, and identified several discrete leadership principles that can be applied to future clinical improvement initiatives.

引用

页码：191 / 199

页数：9

共 41 条

[1] Practice Guidelines for Central Venous Access A Report by the American Society of Anesthesiologists Task Force on Central Venous Access [J].

ANESTHESIOLOGY, 2012, 116 (03) :539-573

[2] An unseen danger: Frequency of posterior vessel wall penetration by needles during attempts to place internal jugular vein central catheters using ultrasound guidance [J].