Electronic central line maintenance audits
Abstract:
Background: Health care systems use auditing processes to monitor compliance with evidence-based practices. The auditing process for a bundle targeting central line-associated bloodstream infection (CLABSI) prevention at a large children’s hospital was suboptimal. The purpose of this project was to implement a revised audit and feedback data collection process. The specific aims of the project were to evaluate: (1) the number of completed audits and, (2) central line maintenance bundle compliance rates before and after implementing a new process.
Methods: An innovative, electronic audit process was developed to allow data entry in real time as CLABSI prevention champions conducted audits. Data were fed into a robust electronic dashboard, allowing units to readily visualize their performance. Data was analyzed over a 52-month period (26-months pre and post-implementation).
Results: The number of central line maintenance bundle audits significantly increased post-implementation from an average of 36 to 64 per month, p=.0001. Central line maintenance bundle compliance scores also increased from an average compliance score of 76.3% to 89.3%, p=.0001. Special cause variation was also noted in the statistical process control charts.
Discussion: This project demonstrated the effectiveness of using an electronic process to capture audit data to assist with quality improvement efforts.
Conclusion: Other institutions may consider implementing a similar electronic audit process to capture infection prevention compliance data.
Reference:
Fritz A, Kalu IC, Candito TL, Krishnan AM, Reynolds SS. Strength in Numbers: Utilization of an Innovative Electronic Audit to Enhance Completion of Central Line Maintenance Audits. Am J Infect Control. 2023 May 31:S0196-6553(23)00379-6. doi: 10.1016/j.ajic.2023.05.009. Epub ahead of print. PMID: 37268018.