Compliance towards decolonisation prescription prior to/at time of CVC insertions

£55.00

Project Title: Compliance towards decolonisation prescription prior to/at time of CVC insertions

Project Type: Questionnaire/Survey

Project Summary: Its a QIP about compliance towards prescribing a skin decolonisation regime for hemodialysis patients at CVC insertion in Ward3 BHH , I have presented results of two cycles in audit departmental meeting in Arden hotel conference room with >20 audiences ,
Background:Bloodstream infections associated with central venous catheters (CVCs) are an important cause of hospitalisations, morbidity, and mortality in patients receiving hemodialysis.
Dialysis patients are frequently exposed to pathogens whilst attending for dialysis or during hospitalisation. The hemodialysis vascular access is a potential entry site for S. aureus, in particular when using a central venous catheter (CVC) which increases the risk of sepsis compared to arteriovenous (AV) fistula.
As part of the process when CVC is inserted, or changed, patients should be routinely given preventative decolonisation treatment to prevent infection.

Project Host: Dr Osama Hendam- ST4 Renal

Specialty: Renal Medicine

I am looking for help with data collection, analysis and write-up

Project summary so far:

Our standard was : Decolonisation regime: Prior/at day of hemodialysis catheter insertion to day 5, to use once a day Octenisan body wash and Mupirocin ointment to be applied for patient’s nostrils three times a day, to follow hospital and NIC guidelines

Aim: Increase awareness of all clinical staff to comply with 100 % decolonization prescription regime to hemodialysis patients with new catheter insertion and subsequently to decrease risk of catheter related infections.
To ensure that all clinical ward staff review medications daily on PICS for hemodialysis catheter patients to make sure that decolonization prescription is prescribed.
1st cycle:We have retrospectively looked at a cohort of 30 patients from Birmingham Heartlands hospital with acute and chronic hemodialysis who had new tunneled and non tunneled hemodialysis catheter insertions from March to June 2022.
Results of 1st cycle: 53% (N=16) were prescribed decolonisation at some point peri-line insertion
and 47% (N=14) were not prescribed decolonisation at all , there was 2 episodes of bacteremia infections of two of the patients who didn't have the decolonisation prescription.
2nd cycle:18 patients had temporary or permanent line insertions at heartlands hospital in August 2022
Results of 2nd cycle: 67% (N=12) were prescribed decolonisation at some point peri-line insertion
and 33% (N=6) were not prescribed decolonisation at all.

2nd cycle outcome has partially improved in compare to 1st cycle , no dramnatuic change as there were a team of new starters from
Our vascular access team were involeved allover t
We have started 3rd cycle in 12/2022 , analysis is pending.
Our ways to improve the decol prescription:
We have created 2 posters for 1st and 2nd cycles results and importance and the correct regimen of decolonisation.
We have conducted formal and informal teachings about decolonisation prophylactic treatment.
To highlight this in the smar meetings of morning ward rounds.
We are planning for optimising PICS(our electronic system to help with compliance towards this prescription).

Project Title: Compliance towards decolonisation prescription prior to/at time of CVC insertions

Project Type: Questionnaire/Survey

Project Summary: Its a QIP about compliance towards prescribing a skin decolonisation regime for hemodialysis patients at CVC insertion in Ward3 BHH , I have presented results of two cycles in audit departmental meeting in Arden hotel conference room with >20 audiences ,
Background:Bloodstream infections associated with central venous catheters (CVCs) are an important cause of hospitalisations, morbidity, and mortality in patients receiving hemodialysis.
Dialysis patients are frequently exposed to pathogens whilst attending for dialysis or during hospitalisation. The hemodialysis vascular access is a potential entry site for S. aureus, in particular when using a central venous catheter (CVC) which increases the risk of sepsis compared to arteriovenous (AV) fistula.
As part of the process when CVC is inserted, or changed, patients should be routinely given preventative decolonisation treatment to prevent infection.

Project Host: Dr Osama Hendam- ST4 Renal

Specialty: Renal Medicine

I am looking for help with data collection, analysis and write-up

Project summary so far:

Our standard was : Decolonisation regime: Prior/at day of hemodialysis catheter insertion to day 5, to use once a day Octenisan body wash and Mupirocin ointment to be applied for patient’s nostrils three times a day, to follow hospital and NIC guidelines

Aim: Increase awareness of all clinical staff to comply with 100 % decolonization prescription regime to hemodialysis patients with new catheter insertion and subsequently to decrease risk of catheter related infections.
To ensure that all clinical ward staff review medications daily on PICS for hemodialysis catheter patients to make sure that decolonization prescription is prescribed.
1st cycle:We have retrospectively looked at a cohort of 30 patients from Birmingham Heartlands hospital with acute and chronic hemodialysis who had new tunneled and non tunneled hemodialysis catheter insertions from March to June 2022.
Results of 1st cycle: 53% (N=16) were prescribed decolonisation at some point peri-line insertion
and 47% (N=14) were not prescribed decolonisation at all , there was 2 episodes of bacteremia infections of two of the patients who didn't have the decolonisation prescription.
2nd cycle:18 patients had temporary or permanent line insertions at heartlands hospital in August 2022
Results of 2nd cycle: 67% (N=12) were prescribed decolonisation at some point peri-line insertion
and 33% (N=6) were not prescribed decolonisation at all.

2nd cycle outcome has partially improved in compare to 1st cycle , no dramnatuic change as there were a team of new starters from
Our vascular access team were involeved allover t
We have started 3rd cycle in 12/2022 , analysis is pending.
Our ways to improve the decol prescription:
We have created 2 posters for 1st and 2nd cycles results and importance and the correct regimen of decolonisation.
We have conducted formal and informal teachings about decolonisation prophylactic treatment.
To highlight this in the smar meetings of morning ward rounds.
We are planning for optimising PICS(our electronic system to help with compliance towards this prescription).

  • References related to projects: Danese MD, Griffiths RI, Dylan M, et al. Mortality differences among organisms causing septicemia in hemodialysis patients. Hemodial Int 2006; 10:56.

    Gorwitz, RJ, Jernigan, DB, Powers, JH, et al. Strategies for clinical management of MRSA in the community: Summary of an experts' meeting convened by the Centers for Disease Control and Prevention. 2006. www.cdc.gov/mrsa/pdf/MRSA-Strategies-ExpMtgSummary-2006.pdf (Accessed on December 13, 2011).

    Pubmed Decolonization to Reduce Postdischarge Infection Risk among MRSA Carriers.

    Huang SS, Singh R, McKinnell JA, Park S, Gombosev A, Eells SJ, Gillen DL, Kim D, Rashid S, Macias-Gil R, Bolaris MA, Tjoa T, Cao C, Hong SS, Lequieu J, Cui E, Chang J, He J, Evans K, Peterson E, Simpson G, Robinson P, Choi C, Bailey CC Jr, Leo JD, Amin A, Goldmann D, Jernigan JA, Platt R, Septimus E, Weinstein RA, Hayden MK, Miller LG, Project CLEAR Trial

    http://uhbpolicies/assets/MrsaControlProcedure.pdf

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