Champions for the Cause: Using the TAP Strategy to Identify Gaps in Preventing HAIsPosted on by
Shannon Davila, MSN, RN, CIC, CPHQ
Director, NJHA’s Institute for Quality and Patient Safety
At the Health Research and Educational Trust of New Jersey, an affiliate of the New Jersey Hospital Association, we are dedicated to helping our members improve patient outcomes. We strive to create a learning environment that promotes evidence-based care by featuring examples of success led by nurses, physicians, pharmacists, infection preventionists, and other healthcare leaders. Sharing their stories and lessons learned is an effective way to spread best practices and create a network that supports interdisciplinary, peer-to-peer learning.
In early 2019, we led a Targeted Assessment for Prevention (TAP) Strategy healthcare-associated infection (HAI) collaborative with 17 member hospitals, working with CDC to administer the CAUTI, CLABSI, and C. difficile TAP Facility Assessments to more than 800 frontline staff. These assessments measure knowledge and perceptions of practices designed to reduce the risk of HAIs. Within each of these assessment types, lack of nurse and physician champions emerged as the greatest opportunity for improvement.
Models for quality improvement, including the Comprehensive Unit-based Safety Program (CUSP), recommend that HAI prevention teams include both a nurse and physician champion. Champions serve as a voice on the frontline to promote and accelerate change; they are the experts and advocates who answer questions and give clarification when it’s needed.
When clearly identified and fully engaged, champions can be a valuable resource to help address interdisciplinary patient safety concerns, including removing unnecessary indwelling urinary catheters during daily rounds and promoting appropriate testing for C. difficile infection. When champions are not visible to staff at the bedside, an important opportunity is missed.
By using the TAP Strategy tools in our New Jersey collaborative, we have seen a more than 20% statewide reduction in C. difficile infection, CAUTI, and CLABSI rates. The TAP Strategy is a powerful approach, driven by unit-level TAP Reports and TAP Facility Assessments, that empowers partners to directly address infection prevention and patient safety within their own facilities, including the full engagement of nurse and physician champions. In New Jersey, we will continue to use this important approach to further drive improvements in patient safety.
Shannon Davila is the director of the New Jersey Hospital Association’s Institute for Quality and Patient Safety and clinical director of the New Jersey Hospital Improvement Innovation Network. With a clinical background in adult critical care nursing, Shannon specializes in infection prevention and healthcare quality improvement. She has provided leadership for several state and national patient safety programs, including the New Jersey Sepsis Learning Action Collaborative, the CMS Hospital Improvement Innovation Network, and On the CUSP: Stop CAUTI. Shannon is certified in infection control and healthcare quality and is a TeamSTEPPS master trainer and High Reliability coach.
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Do they do daily rounding on all their central lines? Those rounding champions, are they picc RNs? What about the doctors? May I ask, on picc insertion, after washing my hands , can I drop and open my syringes and probe covers and the biopatch without a clean gloves being aware that I am not touching the sterile syringe? I want to give a good grip of the plastic cover of each device that I include in my picc insertion. Also, under the sterile field , I put the chlorhexidine under the sterile drape knowing that the sterile drape is water proof. I was dinged by our infection control who was watching me. I am just curious. I am very protective of my sterile field on the actual site. Please advise
So glad to have been able to support this workshop – we’re grateful for the partnerships between NJHA and the NJDOH!
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