The Intensive Care Unit (ICU) staff of the Montreal Neurological Hospital’s (the Neuro) at the McGill University Health Centre (MUHC) have reached a milestone in patient care and infection control. The team started off the New Year by breaking their own record in the Be Line Wise Program by maintaining zero central venous line (CVL) related infections for a period of three years.
Such an achievement is significant, because of all the hospital-associated infections, Central Line-Associated Blood Stream Infections (CLABSIs) are among the deadliest and costliest – each infection has a mortality rate of 15 to 20 per cent and costs over $25,000 to treat. Many units from our various hospitals are involved in the program.
Nurses, key to success
Nurses are key to the success of the program. As Carol Monette, an MUHC nurse of 35 years explains, the meticulous work of the nurses with each patient, and the communication that comes with it, are major parts of the puzzle that is maintaining an infection free ICU.
“We’re all on the same page; all being trained the same way and using the same efficient techniques,” she says.
“I look back 35 years, and I’m very proud of the progress and innovation being made in nursing across the MUHC,” Carol, who is retiring at the end of the year, adds.
Neuro’s winning recipe
At the Neuro, each member of the nursing staff, as well as physicians, keep track of every movement by logging it through a government online platform. The team has been using can.can.muhc.mcgill.ca for about a year. Every time a dressing is changed, or a port is checked, it is noted to ensure that everyone is on the same page on details about type of catheter, solution and dressing used, site selected, complications, and more. The logging of this information facilitates patient care on a day to day basis.
In addition, information is also gathered through clinical indicator sheets filled out by nurses daily. This is a task usually set aside for an auditor. This information is valuable when studying the quality of care in the ICU.
“This device utilization data is used when calculating infection rates and device use for comparison with other Neurosurgical ICUs. This is made possible in the Neuro ICU by the willingness of the nurses to log this data and to highlight clinical clues such as fever, which alerts me to review the chart for hospital acquired infections,” explains Infection Control Practitioner Sue Rachel.
Leadership and management
Central lines have many benefits, including the ability to administer medication quickly and efficiently. However, they do come with their risks.
With the support and leadership of their Nurse Manager Siva Moonsamy, the team is encouraged to use the tools at their disposal, as well as their expertise, to speak out if something doesn’t seem right. A huge part of the success of the program has to do with management being hands on and leading by example.
“We have a very caring and engaged team,” Siva says.
ICU Nurse Rocio Ramirez explains that if ever someone is concerned about a line, even if the concern is minor, it is addressed and investigated promptly.
“It’s this commitment and continuation of care from patient to patient, nurse to nurse, that allows us to succeed as a team, along with the protocols we have implemented. We work hard, we have a lot of rules, but it’s nice to see results come from it,” says Rocio, who has been a nurse for 16 years.
Both Rocio and Carol agree that such an achievement is not only encouraging for the team, but also aids in gaining the trust of the patients. It’s part of the reason why they chose to dedicate themselves to the field of nursing. ICU patients are often fragile, and therefore more prone to infection, and the number one goal for the team is to ensure the best care possible for those who need it most.
Congratulations and thank you to the Neuro ICU team for their hard work and dedication to patient care!