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Impact of Kamishibai Card Process on Compliance With the Central Venous Line Maintenance Bundle

Julia Frith1, Debbie Hampton, Michelle Pendleton

  • 1Norton Healthcare, Louisville, Kentucky (Drs Frith and Pendleton and Ms Isaacs); University of Kentucky College of Nursing, Lexington (Dr Hampton); and Pediatric Critical Care Medicine, University of Louisville, and Division of CARE Innovation at Norton Children's Hospital, Louisville, Kentucky (Dr Montgomery).

Journal of Nursing Care Quality
|April 19, 2019
PubMed

Insights

The Kamishibai Card (K-Card) process improved central venous line (CVL) maintenance bundle compliance. This storytelling method helped identify and address barriers to effective CVL care in a pediatric intensive care unit.

Area of Science:

  • Healthcare quality improvement
  • Patient safety research
  • Pediatric intensive care

Background:

  • The Kamishibai Card (K-Card) process is a storytelling methodology.
  • It is designed to identify and address barriers in healthcare processes.

Purpose of the Study:

  • To evaluate the K-Card process effectiveness.
  • To assess its impact on central venous line (CVL) maintenance bundle compliance.
  • Study conducted in a pediatric intensive care unit (PICU).

Main Methods:

  • Retrospective evaluation of K-Card implementation.
  • Utilized a pretest and posttest design.
  • 1003 central venous catheter maintenance observations were analyzed.

Main Results:

  • A statistically significant improvement was observed in tubing being timed and dated.
  • Incomplete communication during handoff was the primary cause of noncompliance.
  • Device-associated factors also contributed to noncompliance.

Conclusions:

  • The K-Card process positively impacted CVL maintenance bundle compliance.
  • The methodology is effective in improving adherence to care bundles in a PICU setting.
Abstract

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