Wednesday, February 26, 2014

Using the Electronic Medical Record and an Electronic Dashboard to Decrease Catheter Associated Bloodstream Infections

I am always on the look out for novel approaches to improve infection prevention practices. Here is an article published in Pediatrics on the use of the electronic medical record (EMR) to decrease the rate of catheter associated bloodstream infections (CLABSI).

CLABSI rates decreased from 2.6 CLABSIs per 1000 line-days before intervention to 0.7 CLABSIs per 1000 line-days after intervention.  There was increased daily documentation of line necessity from 30% to 73% (P < .001), increased compliance with dressing changes from 87% to 90% (P = .003), increased compliance with cap changes from 87% to 93% (P < .001), and increased compliance with port needle changes from 69% to 95% (P < .001). Ironically, decreased compliance with insertion bundle documentation was reported from 67% to 62% (P = .001). 

The EMR may be an important adjunct for the consistent implementation of infection prevention strategies. Linking EMR alerts to rounds and to provider documentation may prompt and enhance compliance with expected practices. A highly visible, real time, unit based dashboard may provide the visual stimulus to maintain an infection prevention effort.

This may be promising.

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