On the AHRQ web site there are many useful resources to apply evidence-based practice tools in your own practice settings. Of course you may use resources related to your practice area of interest, and related datasets that may correspond. The idea here is to become familiar with outcomes that monitor outcomes at a systems level, using external reference databases to help determine baselines or performance thresholds. There are spreadsheets with hospital compare measures (medicare.gov) data for hospital acquired infections (HAI); other measures are also reported. Open the file, look for your hospital and look through the rates posted. You can also ask your Case Manager if this is the person who keeps this data.
As an example: AHRQ is a government agency funded to produce programs for health care providers, systems and public health to reduce costly errors and promote safety in health care systems. Look at the tool kits and programs developed by this group. Read the CUSP associated infections program (CUSP), and look at your own institution for the number of CLABSI and CAUTI in one quarter of this year, or the last quarter of 2020, or 2019 if 2020 is not available. How does your institution measure against the suggested use of tools of the CUSP program as offered by AHRQ?
What is your institutional policy for prevention of CLABSI and CAUTI? What is measured? How is it measured? Find at least one EBP research article to support your opinion of the information provided from AHRQ.gov.
The Joint Commission, Joint Commission Resources ® (JCR®) and Joint Commission International published an excellent monograph, “Preventing central line associated blood stream infections: A global challenge. A global perspective”. It describes the detrimental effects and cost of CLABSI in the United States and countries around the world, provides background information about the five steps in CLABSI prevention, Evolution of Health care associated infection surveillance, and CLABSI rates in the United States and around the world. It is interesting to note that the AHRQ and JCR® CLABSI Tool kits are used in hospitals all over the world. Standardized data is collected on CLABSI rates worldwide so that comparisons can be made between facilities in the United States and several other countries in the world (The Joint Commission, 2012).
A study by Ben-David et al., (2019) divides CLABSI prevention recommendations into Primary Tier and Secondary Tier prevention measures. Primary-tier bundle measures including hand hygiene, Chlorhexidine (CHD)- alcohol skin preparation, full barrier precautions during line insertion, preference for subclavian site, and removal of unnecessary lines, have been implemented as the standard of care in hospitals. Second Tier measures, including audits of insertion and maintenance practices, staff education, unit champions, performance assessment, provision of feedback, use of teamwork are not consistently implemented. This study demonstrated that the consistent use of second Tier measures is associated with lower CLABSI rates (Ben-David et al., 2019).
References
Agency for Healthcare Research and Quality (2017). Comprehensive Unit-Based Safety Program: Accelerating the adoption of Evidence – Based Practices to prevent Healthcare associated infections. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from: https://www.ahrq/hai/cusp/summary/inde.html
Ben-David, D., Vaturi, A., Solter, E., Temkin, E., Carmeli, Y., Schwaber, M.J., the Israel CLABSI Prevention working group (2019). The association between implementation of second tier prevention practices and CLABSI incidence: A national survey. The Society for Healthcare Epidemiology of America, 40 (10), 1094-1099. Doi: https://doi-org.libauth.mskcc.org/10.1017/ice.2019.190
The Joint Commission (2012). Preventing Central line- associated blood stream infections: A Global challenge, a Global perspective. Oak Brook, Il: Joint Commission Resources. Retrieved from