Impact of a Hospital-wide Daily Interdisciplinary Safety Huddle on Device Utilization and Device-related Hospital Acquired Infections

Abstract

Background

Implementation of interventions to increase provider awareness of central venous catheters (CVC) and indwelling urinary catheters (IUC) and indications can impact device utilization rates. Device utilization rates (DUR) correlate with device-associated complications. We implemented a Daily Interdisciplinary Safety Huddle (DISH) involving all hospital units. Devices were reported and plans for removal reviewed. Barriers identified were addressed within 24 hours. The purpose of this study was to evaluate the impact of DISH on DUR and HAI at a 151-bed urban, community hospital.

Methods

This is a retrospective review of DUR for IUC, CVC and the relationship to HAI. DISH is a daily 15-minute meeting at 8am. Key participants include the chief nursing officer (CNO), infection control practitioner (ICP), and managers of all hospital units. CVC and IUC usage are reported by nurse managers. The ICP reviews indications, duration, and plans for device removal. When barriers for removal remain, such as provider preference, the CNO, Medical Director of Infection Control or Chief Quality Officer are involved. Data before and after implementation of DISH was compared. Paired T-test was used to assess for differences between DUR means of both groups.

Results

Mean DUR for CVC was reduced from 0.2858 to 0.178 (device days/patient-days, P <0.001, CI 95%). For IUC, there was reduction from a mean of 0.586 to 0.176 (device days/patient-days, P <0.001, CI 95%). There was a significant reduction for IUC DUR in intensive care units (ICU) and non-ICU settings. The decrease in CVC DUR was significant in only the non-ICU setting.

Conclusion

Hospital-wide reductions in DUR and HAI occurred after DISH. A 90% reduction in HAI occurred with estimated cost savings of $498,000. The impact of DISH was more profound in non-ICU settings, where devices may remain without indication or awareness. DISH may help mitigate this behavior. To our knowledge, a hospital-wide safety huddle with infection control components and its effect on DUR and HAIs has not been reported in the literature. DISH is a forum that promotes device removal, accountability and promotes a culture of safety.

Figure 1.

ICU IUC DUR

Figure 2.

Non-ICU IUC

Figure 3.

ICU CVC DUR

Table 1.

HAI

	CAUTI	CLABSI
Before	5	12
After	1	1

Disclosures

All authors: No reported disclosures.