Pediatric Cardiac Critical Care Featured Success

2012 Pediatric Cardiac Critical Care Quality Outcomes

In 2011, we reduced bloodstream infections by 60 percent.

To eliminate bacteria in the bloodstream, we have focused on reducing Catheter Line Associated Blood Stream Infections (CLABSI).

The inpatient-unit team at Nationwide Children’s has been focused on reducing CLABSI infections for several years. Much of the improvement is attributed to their compliance with the insertion and maintenance bundles developed through the National Association of Children’s Hospitals and Related Institutions (NACHRI) national collaborative. Through the team’s initiative, these bundles were implemented easily and naturally.

In 2011, we significantly outperformed the Centers for Disease Control and Prevention national average.

CTICU

• 2011 NCH = .9 per 1,000 catheter days
• 2011 CDC Pediatric Cardiothoracic = 2.1 per 1,000 catheter days

Step-Down Unit

• 2011 NCH = 1.6 per 1,000 catheter days
• 2011 CDC Pediatric Step-Down = 1.0 per 1,000 catheter days

With new safety checks, we reduced Adverse Drug Events by 91 percent.

An Adverse Drug Event (ADE) is an injury resulting from the use of a drug. Our goal is to avoid harm caused by a drug, such as overdoses, dose reductions, or a discontinuation of drug therapy.

The Heart Center’s most successful project of 2011 resulted in the reduction of ADEs, due to the unit teams’ efforts to identify causes and change processes. Focusing on events that caused harm to the patient, CTICU was able to reduce ADEs by 91 percent from the 2010 total. The implementation of the safety systems checklist, and its accompanying process, was the key intervention that changed the outcome. In this process, infused medications, lines and connections are double-checked from the bag to the patient during every shift change. The cardiac step-down unit was also successful in reducing ADEs by 70 percent during the same time period. Both units are making significant strides in reducing verbal orders, where higher risks of errors exist.

Our inpatient satisfaction continues to grow every year.

Nationwide Children’s utilizes the nationally recognized independent research organization, Press Ganey, to obtain patient and family feedback on inpatient services.

We survey all of our inpatients in order to continue to learn, grow and provide two-way communication between our staff and our patients. Our ultimate goal is to provide an environment in which our patients and families feel comfortable and heal.

We’ve not only standardized our OR to CTICU handoffs, but also improved them.

Nationwide Children’s has developed a handoff standard, in which a patient’s name, description of care, pertinent past history, plan or procedure, as well as any precautions (the “5Ps”), are presented.

Effective patient handoffs are an important step in the care continuum. The Heart Center has developed a customized handoff specifically for the OR to CTICU handoff, in which a team of OR staff escorts the patient to the CTICU, where the anesthesiologist from the case facilitates the handoff by the patient’s bedside, while the CTICU APN records all information on a standard form and posts it by the bedside. This process ensures safety, accurate communication, and a seamless continuum of care for our patients.

2010 Pediatric Cardiac Critical Care Quality Outcomes

• A dedicated team comprised of eight cardiac intensivists, NP’s and ANP’s resides in-house in our CTICU, 24/7.

(as of February 2010)

• 110 days since last BSI
• 216 days since last VAP
• 438 days since last UTI

Featured Heart Center Quality Initiatives

This book features a snapshot of quality initiatives and program outcomes from The Heart Center at Nationwide Children's Hospital.

• Read 2012 snapshot »
• Read 2009 outcomes »