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Nurse-Sensitive Indicator Quality Improvement Toolkit: A Scalable Solution to Improve Health Care-Associated
Caitlin McVey1, Toni von Wenckstern, Courtney Mills
1Memorial Hermann-Texas Medical Center (Mss McVey, von Wenckstern, Mills, McCauley, Rivera, and Reed), Houston, Texas; and Children's Memorial Hermann Hospital, Houston, Texas (Ms Yager).
Background:
Existing best practices to monitor and prevent health care-associated infections (HAIs) were ineffective during the COVID-19 pandemic due to increased patient susceptibility toward infections, reduced resources, and increased use of agency nurses.
Problem:
A review of the US hospitals revealed a 60% increase in central line-associate bloodstream infections (CLABSIs) and a 43% increase in catheter-associated urinary tract infections (CAUTIs) in 2020. A large, academic, level 1 trauma center in Houston, Texas, experienced similar challenges at the start of the COVID-19 pandemic.
Approach:
An interdisciplinary team of nurses, infection preventionists, and hospital educators combined and adapted existing evidence-based practices in a novel way to create a nursing-led toolkit for quality improvement tracking, improving, and sustaining HAI improvements.
Outcomes:
CLABSI and CAUTI rates were reduced over time following the introduction of the Nurse-Sensitive Indicator Quality Improvement (NSIQI) Toolkit. The CLABSI standardized infection ratio (SIR) decreased by 19%, and the CAUTI SIR decreased by 19.4%.
Conclusions:
The novel NSIQI Toolkit is a scalable tool for improving and sustaining CLABSI and CAUTI rates, which may have the potential for other nurse-sensitive quality indicators.
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