Dire rect ctor r WHO IS THE NETWORK? INFE~ DETECTION Network - PowerPoint PPT Presentation

BLOODSTREAM INFECTION (BSI) QUALITY IMPROVEMENT ACTIVITIES Present nted d By: : Dany y Anchi hia a BSN, , RN, , CDN N AUGUST 28, 2019 ------- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- -- Quality y Impr mproveme ment nt Dire rect ctor r

WHO IS THE NETWORK? INFE~ DETECTION  Network 14 is a non-profit organization incorporated in Texas and provides services on behalf of the Centers for Medicare & Medicaid Services (CMS) to kidney patients and their providers. Our r Mission n To support equitable patient- and family-centered quality dialysis and kidney transplant health care through the provision of patient services, education, quality improvement, and information management.

PATIENT ADVISORY COMMITTEE ~ DETECTION Subject 23 3 me memb mber ers s Matter Experts

~ i ~ ► * " 'i S ◄ PATIENT ADVISORY COMMITTEE INFE~ DETECTION Facility’s Patient Clinic Committee members reviewing the Conversation Starter and the Lead Patient Committee member, Juan Morales, demonstrating teach back with the clinic staff. . • - ~ •!,,<i~ END STAGE RENAL DISEASE T . NETWORK OF EXAS

~ BSI NETWORK QIA PROJECTS INFE~ DETECTION  As mandated by the Centers for Medicare and Medicaid Services (CMS), the bloodstream infections (BSI) and INFE ~ long-term catheter (LTC) quality improvement activities DETECTION (QIAs) are aimed at reducing bloodstream infections and TI long-term catheter rates within the State of Texas C atheter O peration (Network 14 coverage territory). R eduction & E limination  Pilot Project: The ESRD Network of Texas has also been directed by CMS to collaborate with 10% of the ~ - outpatient dialysis facilities within the state of Texas to achieve a 2% point decrease in the average rate of overall hospitalizations and a 10% relative decrease in ESRD-related hospitalizations. END STAGE RENAL DISEASE NETWORK OF TEXAS

BSI QIA INFE~ GOALS, PURPOSE, AND ACTION DETECTION  Goal: : Reduce e the e national l rate e of f bloodstream m infections s (BSIs) ) in n dialysis s patients s by y 50%, , to o achieve e the e 5 5 year r national l target t to o improve e health h of f all l ESRD D patients s living g in n the e US. .  Purpose: : The Network is contracted to develop a plan to reduce the rates of BSIs in patients with end stage renal disease (ESRD) because of their increased vulnerability to healthcare -associated infections (HAIs).  Activities s will focus on reducing BSIs by:  Supporting ESRD facilities use of NHSN and the CMS reporting requirements  Assisting facilities with implementation of CDC Core Interventions and increase awareness of resources  Reducing the Long-Term Catheters (LTCs)  Participating in ESRD NCC HAI Learning and Action Network (LAN)  Improving communication between hospitals and dialysis facilities, and encourage facilities to join Health Information Exchange (HIE)

SELECTION PROCESS INFE~ DETECTION  For 2019, CMS directed the Network to work with at least 50% of the facilities in the Network’s service area with the highest excess infection rate and provide an increased focus on the top 20% of the selection .  Goal: : Achieve a 20% or greater relative reduction in the semi -annual pooled mean rate among the 20% cohort at re -measurement (Jan-Jun 2019) compared to the previous year (Jan -Jun 2018). Network 14 facilities Selection of 50% of Selection of 20% 20% of Total number of eligible to report for Network 14 facilities Network 14 facilities facilities remaining in Facilities ranked by all of 2018 with the highest with the highest highest Excess BSI the 30% cohort Excess BSI Rates Excess BSI Rates Rates (N N 171 = 171) ) (N N 573 = 573) ) (N N 286 = 286) ) (N=115 115) ) Baseline Data: Q1/Q2 2018 (January – June) 50% Cohort Facility Average PMR: 0.68 20% Cohort Facility Average PMR: 1.03 3

BSI QIA GOAL INFE~ DETECTION INFECTION DETECTION QIA: 2016-2019 SEMI-ANNUAL POOLED MEAN RATE (20% GROUP) 1.54 Project Goal: 20% reduction 1.25 1.25 in the semi- 1.03 annual pooled 0.80 mean rate of 0.63 0.59 the 20% cohort = 0.82 BASELINE REMEASURE BASELINE REMEASURE BASELINE REMEASURE BASELINE REMEASURE 2015 2016 2016 2017 2017 2018 2018 2019 JAN-JUN JAN-JUN JAN-JUN JAN-JUN JAN-JUN JAN-JUN JAN-JUN JAN-JUN

PROJECT COMPONENTS INFE~ DETECTION CDC C Core e NHSN N Intervent ntion ions s Monthly ly Audits ts Coalit ition ion NCC C HAI I LAN N Pa Patient nt & HIE & E Engage gement ment

PROJECT COMPONENTS INFE~ DETECTION CDC C Core e NHSN Inter ervent entions ions Monthly Audits Coalition lition NCC HAI LAN Patient & HIE Engagement

~ ~ C ■ nulalon ~ CDC COALITION INFE~ DETECTION Making Dialysis Safer for Patients Coalition Materials - For Order Via CDC -INFO  The e Coalition ’s Goals:  Facilitate adoption and implementation of .,, All checklists are laminated for repeated use. CDC’s core interventions  Increase awareness about infection rates and bloodstream infection prevention  Collaborate with other coalition members to Hemod lalysts Cathet« Exit AV Fl s tua./Gtatt H~odlatysls Central Conven.at10t1 St a,tt • r to P rh'M l ~te Care ChKk li lt cannulatlon Checklist Yenou1 cau,ete-r Infections 1n O uil-,s~ P atient, Scrub•the•Hub Protocol :Z22J8t 222117 10000 share findings, stories or experiences related 300031 Catheter Exit AV Flltu&a/Grah De-cannulaUon ChKkllst Memodlalvsh C&theter Site Care Audit Tool ConnecUon ChKklb:t ll:ZH6 (On. r-r pad with JO she.W to bloodstream infection prevention 222112 222114 AV Flstua./Gratt and Hemodlalvsts CAlheter Dec:aMulaUon Olsconrwcllon ChKk lst A.udit Tool 222H1 ~NM~w1tlt.$0s11Nt-, Cathetef ConMCt J on I 222117 ~ ~1; :- 1 oi.conl'\Ktlon Audit Tool tv (0Mt-p.Mlri1t.SOR1 .. 222JH  Joining the Coalition as a member is FREE, and includes access to free resources and ·--- education! H~":d~Y-?!r• O~!~~:t\:,~'°;h:~~::• Hemodlafysls lnJ•cUon Safety HedlcMlon 222390 Pt..,.rtiuon Cheddltl to-.1-,»d 222311 llrlthS0.,,_1-.1 01a1vs11 StaUOn Routine You Can Order 222111 Disinfection Audit Tool Hemod lalysls Injection  Members s include: : (O,w tNr pad With .SO ..,,..ti) S•f•tv Medication 2 Ways Adrnlnln,atlon Checldlst 222315 300040 Envltonmental 5urface D11Ulfec:tlon In Dialysis tnJ@Ctlon Safety  Nephrologists and nephrology nurses FaCJldles; Notes fot Hedlc.allon Preparation a Cllnk• Manag..-s Administration Aud it Tool PMI IWffl JO .,,_ti) JOOOJI (0.. ,_ 222JIJ CDC Dialysis lnfectM>n  Dialysis technicians and other clinic staff ~'lefltion A .. OUN:=ff CD CLICK (l1Ktto11lcW1Solcwts olallt"-~ www . cdc . gov / pubs 222171  Dialysis educators and leaders si,/i,ct ·01.iys/J S•fety• r,om thi, Pr-or,,,•ms drop down mll!'n11 M'!dCIIC.lt •Go•  Patients and caregivers Pt'ewntlng BIOOdlhHffl Put Together the Pieces Days Since Lall E lnfKtlons In 0u1-,.1i.nt to Prewnt Infections lntedJoft Poster He,nocO•IY'SI• PaUents; s a.s- x 11 " 300111 In OlalvMsPatlenll Bfft Pr.1ctlc.1 for l:ngll1h 221571 11 " x 17" 100200 D'-lvsJs SUN DVD Spanl1h JOOOJ7 221510