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Use of electronic medical record-enhanced checklist and electronic dashboard to decrease CLABSIs.

Natalie M Pageler1, Christopher A Longhurst, Matthew Wood

  • 1Center for Excellence in Pulmonary Biology, Divisions of Pulmonary, Asthma and Critical Care Medicine.

Pediatrics
|February 26, 2014
PubMed
Summary
This summary is machine-generated.

A new electronic checklist and dashboard significantly reduced central line-associated bloodstream infections (CLABSI) in a pediatric ICU. Compliance with catheter care bundles improved, demonstrating the power of computerized interventions in preventing patient harm.

Keywords:
CLABSIEMRdashboardevidence-based guidelinesmaintenance bundle

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Area of Science:

  • Pediatric critical care medicine
  • Infection prevention and control
  • Health informatics

Background:

  • Central line-associated bloodstream infections (CLABSI) are a significant source of morbidity and mortality in pediatric intensive care units (PICUs).
  • Evidence-based catheter care bundles exist but achieving consistent compliance remains a challenge.

Purpose of the Study:

  • To evaluate the impact of an electronic medical record (EMR)-enhanced checklist and a unit-wide dashboard on compliance with a pediatric-specific catheter care bundle.
  • To assess the effect of this intervention on CLABSI rates in a PICU.

Main Methods:

  • A historical cohort study was conducted in a 24-bed PICU at an academic children's hospital.
  • The intervention involved implementing an EMR-enhanced checklist and a unit-wide dashboard for catheter care.
  • CLABSI rates, bundle compliance, and staff perceptions were compared pre- and post-intervention.

Main Results:

  • CLABSI rates decreased from 2.6 to 0.7 per 1000 line-days post-intervention.
  • Compliance with daily documentation of line necessity increased significantly (30% to 73%).
  • Compliance with dressing changes, cap changes, and port needle changes improved, though insertion bundle documentation compliance decreased slightly.

Conclusions:

  • An EMR-enhanced checklist and unit-wide dashboard were associated with improved compliance with catheter care bundles.
  • This intervention led to a sustained decrease in CLABSI rates, highlighting the effectiveness of computerized tools in promoting best practices and patient safety.