Sepsis Prevention in the Emergency Department: Optimizing Line Access Cleaning Compliance

Disciplines

Nursing

Abstract (300 words maximum)

An increase in the occupancy of the intensive care unit (ICU) has resulted in a significant increase in emergency department (ED) length-of-stay. This results in an increased need for ED nurses to be trained in and compliant with strict infection prevention protocols as the incidence of caring for more complex patients with central and arterial line accesses increases in order to maintain low central line associated bloodstream infections (CLABSI). The Joint Commission mandates port cleaning prior to central line access based on ample research that this reduces the risk and prevalence of CLABSIs. Due to the unique workflow and pace of the ED, compliance with various sanitation practices can be lower than in other units of the hospital. Although there is more research needed to determine rising rates of bloodstream infections associated with longer ED stays, this project proposal is aimed specifically at increasing compliance with line cleaning prior to accessing central and arterial line ports in the ED and how this might affect bloodstream infection rates throughout a patient’s length-of-stay. Presence of bloodstream infections can be measured by monitoring for signs and symptoms of sepsis such as elevated temperature, white blood cell count, c-reactive protein, and blood cultures throughout the patient’s hospital stay. These laboratory samples must be documented to have been collected according to Joint Commission guidelines. Compliance will be measured and evaluated for significance by providing antimicrobial scrub caps with a barcode that must be scanned prior to accessing a central or arterial line port to give medications, draw blood, or flush the line and this data will be compared with a control group that has access to, but does not require the scanning of antimicrobial scrub caps with bar codes.

Academic department under which the project should be listed

Nursing

Primary Investigator (PI) Name

Dr. Christie Emerson

Additional Faculty

Bridget Kayser, Practicum Instructor, btk6917@students.kennesaw.edu

Leslie Narain, Practicum Instructor, lnarain2@kennesaw.edu

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Sepsis Prevention in the Emergency Department: Optimizing Line Access Cleaning Compliance

An increase in the occupancy of the intensive care unit (ICU) has resulted in a significant increase in emergency department (ED) length-of-stay. This results in an increased need for ED nurses to be trained in and compliant with strict infection prevention protocols as the incidence of caring for more complex patients with central and arterial line accesses increases in order to maintain low central line associated bloodstream infections (CLABSI). The Joint Commission mandates port cleaning prior to central line access based on ample research that this reduces the risk and prevalence of CLABSIs. Due to the unique workflow and pace of the ED, compliance with various sanitation practices can be lower than in other units of the hospital. Although there is more research needed to determine rising rates of bloodstream infections associated with longer ED stays, this project proposal is aimed specifically at increasing compliance with line cleaning prior to accessing central and arterial line ports in the ED and how this might affect bloodstream infection rates throughout a patient’s length-of-stay. Presence of bloodstream infections can be measured by monitoring for signs and symptoms of sepsis such as elevated temperature, white blood cell count, c-reactive protein, and blood cultures throughout the patient’s hospital stay. These laboratory samples must be documented to have been collected according to Joint Commission guidelines. Compliance will be measured and evaluated for significance by providing antimicrobial scrub caps with a barcode that must be scanned prior to accessing a central or arterial line port to give medications, draw blood, or flush the line and this data will be compared with a control group that has access to, but does not require the scanning of antimicrobial scrub caps with bar codes.