Authors (including presenting author) :
Wong YS, Ng YB, Ngai YM, Lei WS, Kwok KC, Pang CK, Poon KM, Ho PY, Wong YH, Ng PW, Lam CY, Chak YC, Wong MN
Affiliation :
Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
Heavy workload causes nursing staff burnout and health care quality issues. Our team decides to implement new product (disinfectant cap) to reduce workload. Proper disinfection is important before access the central venous catheter (Hickman catheter) for injection or blood taking. Current practice is using alcohol swab to rub the outlet of catheter over 15 seconds. Using disinfectant cap can reduce Catheter Related Blood Stream Infection (CRBSI) rate because of passive disinfection mechanism and without human performance discrepancy. The disinfectant cap is placed on needleless over 3 minutes for disinfection. Nurses only remove the old disinfectant cap and do not need using alcohol swab with friction over 15 seconds.
Objectives :
To reduce clinical workload and improve nursing care of central venous catheter by implementation of new disinfectant cap.
Methodology :
Evidence Based Practice The effectiveness of disinfectant cap was supported by many high quality research studies. Infection control team and pharmacy were consulted to achieve other disciplinary support. Staff Engagement: Three advanced practice nurses and four registered nurses were recruited as project team members. Meetings were organized to introduce this project and let all members understand the rationale of the product. Staff Empowerment: Debriefing sessions were organized in small group to teach nursing staffs. We prepared samples to demonstrate the technique and step in procedure. Environmental Support: The disinfectant cap was installed in the drawer of injection trolley and store room. Product information sheet and practice guideline were available and ready on nursing station for documentation support. Implementation Small pilot was started in March and then extended to all patients in May. Start with small pilot was more acceptable for frontlines and we also monitor the implementation easily.
Result & Outcome :
We carried out evaluation by interview, test nurse competency and audit compliance in April and May. 22 numbers of nurses were interviewed and gave valuable feedback. 15 numbers of nurses were observed with the audit form. All of audit items achieved 100% compliance rate. Five patients with Hickman catheter comment were positive because the disinfection technique was constant. Conclusion This project truly achieves to reduce nurse time consuming in disinfection before injection from 15 seconds to zero and nurse can access to adequate equipment, supplies and support staff. This project was highly accepted by ward nurses with high compliance rate. They felt this project considering their working challenge. This project also improved patient health by reducing the risk of CRBSI.
Co-location with:
