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Strength in numbers: Utilization of an innovative electronic audit to enhance the completion of central line
Anna Fritz1, Ibukunoluwa C Kalu2, Tammy L Candito1
1Duke Children's Hospital and Health Center, Pediatric Intensive Care Unit, Durham, NC.
Insights
Implementing an electronic audit process significantly improved central line maintenance bundle compliance and audit completion rates in a children's hospital, enhancing infection prevention efforts.
Area of Science:
- Healthcare quality improvement
- Infection prevention and control
- Health informatics
Background:
- Healthcare systems rely on auditing to ensure adherence to evidence-based practices.
- A previous audit process for central line-associated bloodstream infection prevention at a children's hospital was ineffective.
- A revised audit and feedback process was needed to improve compliance monitoring.
Purpose of the Study:
- To implement and evaluate a new electronic audit and feedback data collection process.
- To assess changes in the number of completed audits for central line maintenance bundles.
- To determine the impact on central line maintenance bundle compliance rates.
Main Methods:
- An electronic audit process was developed for real-time data entry by infection prevention champions.
- Data were collected and visualized through an electronic dashboard.
- A 52-month period (26 months pre- and post-implementation) was analyzed using statistical process control charts.
Main Results:
- The number of audits increased significantly from 36 to 64 per month (P=.001).
- Central line maintenance bundle compliance scores rose from 76.3% to 89.3% (P=.001).
- Statistical process control charts indicated special cause variation, suggesting a significant impact.
Conclusions:
- An electronic audit process effectively captures compliance data for quality improvement.
- This electronic system enhanced the auditing process for infection prevention bundles.
- Other institutions can adopt similar electronic audit processes to monitor infection prevention compliance.
Background:
Health care systems use auditing processes to monitor compliance with evidence-based practices. The auditing process for a bundle targeting central line-associated bloodstream infection prevention at a large children's hospital was suboptimal. The purpose of this project was to implement a revised audit and feedback data collection process. The specific aims of the project were to evaluate (1) the number of completed audits and, (2) central line maintenance bundle compliance rates before and after implementing a new process.
Methods:
An innovative, electronic audit process was developed to allow data entry in real-time as central line-associated bloodstream infection prevention champions conducted audits. Data were fed into a robust electronic dashboard, allowing units to readily visualize their performance. Data was analyzed over a 52-month period (26 months pre- and post-implementation).
Results:
The number of central line maintenance bundle audits significantly increased post-implementation from an average of 36 to 64 per month, P = .001. Central line maintenance bundle compliance scores also increased from an average compliance score of 76.3% to 89.3%, P = .001. Special cause variation was also noted in the statistical process control charts.
Discussion:
This project demonstrated the effectiveness of using an electronic process to capture audit data to assist with quality improvement efforts.
Conclusions:
Other institutions may consider implementing a similar electronic audit process to capture infection prevention compliance data.
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