Improving and Standardizing CVC Skills
Central Venous Catheterization (CVC) is one of the most common invasive procedures performed in modern hospitals. Up to 48% of patients in the Intensive Care Unit have a catheter placed, with 15 million CVCs inserted every year. Catheters are also frequently placed in the Emergency Department, the Operating Room, and in Interventional Radiology. Unfortunately, the rate of complications from CVC is quite high, with studies demonstrating a complication rate between 5% to 29%
Case Study Details
less than 0.9 CLABSI/1000 cathedar days
Reduction of 35 line complications per year
- $1,050,000 savings per year
Better Compliance and Documentation
- 100% Compliance Documentation (Critical for proper reimbursements)
- Compliance Errors 3/checklist post intervention (86% improvement)
Design and Implementation of the Technical Skills Simulation
- prior to simulations, self-directed online learning
- Patient Preparation,
- Internal Jugular Needle and Guidewire insertion,
- Subclavian Needle and Guidewire Insertion, and
- Catheter Advancement and Completion.
- Design and Implementation of System-Wide QI Process
$70,000 to $100,000 per year for course/module development
- does not include dedicated Nursing Staff to support the effort
- does not include faculty time
- does not include staffing support
On-going
- Self directed learning
- 4 simulation stations, faculty driven feedback
- Online Learning
- 4 training stations
- ultrasound
- simulator
- 1.8 to 5.2 CLABSI/1000 cathedar days
- CLABSI are now classified as never events (not reimbursable)
- On average, cost is $45,000 per event
- No process for Compliance or documentation
- Compliance Errors 22/checklist upon intervention
$1,050,000 in reimbursable expenses
- estimated 210 bed days lost to treating patients with CLABSI
- inability to care for an estimated 48 additional patients due and their potential revenue
Decision Maker Talking Points
- Reduction of 35 line complications per year
- $1,050,000 savings per year
- 100% Compliance Documentation (Critical for proper reimbursements)
- ablility to care for an estimated 48 additional patients due and their potential revenue
- better avoidance of never events
- $1,050,000 savings per year
- 100% Compliance Documentation (Critical for proper reimbursements)
- ability to care for an estimated 48 additional patients due and their potential revenue
- less than 0.9 CLABSI/1000 cathedar days
- Reduction of 35 line complications per year
- 100% Compliance Documentation (Critical for proper reimbursements)
- ability to care for an estimated 48 additional patients due and their potential revenue
- better avoidance of never events
- need to train medical students with evidence based best practices
- need to have medical students training in an IPE environment to best prepare for current needs in Hospitals
- have students prepared to operate in high risk, time pressured critical environments
- better preparing the medical students given limitations on clinical hours
- practicing in a simulated environment instead of on actual patients
- need to train nursing students with evidence based best practices
- need to have nursing students training in an IPE environment to best prepare for current needs in Hospitals
- better preparing the nursing students given limitations access to clinical placements
- practicing in a simulated environment instead of on actual patients
- 100% Compliance Documentation (Critical for proper reimbursements)
- better avoidance of never events
- ability to retain staffing by showing value for patient satisfaction
- ability to better adjust behavior as teams train together
- making the case will involve a fully engaged staff of passionate educators
- Requires staffing and faculty to properly support the initiative
- support a part of the institutions patient safety initiative to align with mission focus
- focus on capturing the appropriate ROI metrics for you environment