Getting to zero: how Waccamaw tackled blood-stream infections

Waccamaw Hospital, part of the Tidelands Health system, is a 167 bed facility located in Murell’s Inlet, just south of Myrtle Beach.

The Waccamaw team has now sustained more than 30 months of zero central-line associated infections – their last recorded CLABSI was in June of 2012. The hospital recently received an SC Certified Zero Harm Award from the SC Hospital Association to publicly celebrate their achievement.

Tidelands Health patient safety officer Greg Nobles, R.Ph. said if they were asked 20 years ago to eliminate central line bundled infections, he would have thought it impossible.

Now the staff employs a variety of methods to stop the infections before they start. One of these is an evidence-based central line insertion procedure checklist that outlines best practices caregivers should use each time a line is put in, from hand hygiene to antiseptic use to covering the site with a sterile dressing.

The team had used the checklist, called CLIP, in paper form for several months before they joined a statewide CLABSI initiative led by the SCHA. During their work with the initiative they decided to create an electronic version of the checklist that staff could pull up on a computer screen before each insertion.

They examined their criteria for central line necessity and made some adjustments. And now central line audits are done during daily care team roundings to ensure that the lines are removed as soon as they are no longer necessary.

According to Angie Harris, RN, Waccamaw’s infection preventionist nurse, of all the methods they use to keep infections at bay, one of the most effective is chlorhexidine baths (an antibacterial often used to treat gingivitis). Every patient with a central line receives a daily bath (of the upper body). Surgery patients receive them before procedures as well. “The chlorhexidine has helped Waccamaw make tremendous strides in lowering our CLABSI rates,” said Harris.

Surgery patients are also tested for MSRA risk during pre-admission testing. Any patient at risk undergoes a decolonization process.

Nobles and Harris think SCHA’s Zero Harm Awards program has helped inspire the hospital community to improve their processes and sustain success. “It really recognizes our everyday front-line staff,” said Harris. “They are the ones making the difference for us, and preventing those infections.”

Nobles values the collaborative spirit among the state’s hospitals, and said the Waccamaw staff were more than happy to share their infection prevention strategies with facilities in South Carolina and beyond. “We value it so much when others do the same for us.”

The photo above was taken in the new Tidelands Health Simulation Lab, which has also been instrumental in the team's successful infection prevention efforts. (Left to right: Tara Smith, BSN, RN; Megan Parks, BSN, RN; Tammy Buffkin, BSN, RN; Critical Care Clinical Director Ashley Capps, BSN, RN; and Tidelands Health Infection Control Manager Angela Harris.)

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11-12-2015 03:57 (EST)