Nurse-Sensitive Indicator Quality Improvement Toolkit: A Scalable Solution to Improve Health Care-Associated...

Area of Science:

• Infection Prevention and Control
• Nursing Quality Improvement
• Healthcare Management

Background:

• Standard healthcare-associated infection (HAI) prevention strategies proved insufficient during the COVID-19 pandemic.
• Increased patient vulnerability, resource limitations, and reliance on agency staff exacerbated infection risks.
• US hospitals saw significant increases in central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) in 2020.

Purpose of the Study:

• To develop and implement a novel, nursing-led toolkit to address rising HAI rates.
• To improve and sustain reductions in CLABSIs and CAUTIs within a large academic medical center.
• To adapt evidence-based practices into a scalable quality improvement tool.

Main Methods:

• An interdisciplinary team, including nurses, infection preventionists, and educators, collaborated to create the toolkit.
• The Nurse-Sensitive Indicator Quality Improvement (NSIQI) Toolkit was developed by combining and adapting existing evidence-based practices.
• The toolkit focused on tracking, improving, and sustaining reductions in HAIs.

Main Results:

• Implementation of the NSIQI Toolkit led to a sustained decrease in CLABSI and CAUTI rates.
• The standardized infection ratio (SIR) for CLABSIs decreased by 19%.
• The SIR for CAUTIs decreased by 19.4% following the toolkit's introduction.

Conclusions:

• The NSIQI Toolkit is a scalable and effective intervention for reducing and sustaining CLABSI and CAUTI rates.
• This nursing-led approach demonstrates the potential for broader application to other nurse-sensitive quality indicators.
• The toolkit offers a practical solution for enhancing infection control in healthcare settings.