STANDARD 4.7 (Study of Quality) and Standard 4.8 (Quality Improvement)

PUBLIC REPORTING OF OUTCOMES 2016

Introduction: Santa Barbara Cottage Hospital has had an accredited Cancer Program in place since 1988. The program undergoes rigorous survey every three years to make sure that we meet standards set forth by several professional organizations under the umbrella of the American College of Surgeons, Commission on Cancer.

 Reducing Central Line Blood Stream Infections (CLABSI) in patients with neutropenia secondary to cancer treatment.

Neutropenia (noo-troe-PEE-nee-uh) is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell important for fighting off infections - particularly those caused by bacteria. For adults, counts of less than 1,500 neutrophils per microliter of blood are considered to be neutropenic. This increases the risk of acquiring a CLABSI in this vulnerable patient population and decreases their ability to fight off an infection.

There are standard set forth by the National Healthcare Safety Network (NHSN) under the oversight of the the Centers for Disease Control (CDC). The benchmark is 0.9 CLABSI per 1000 central line days.

A multidisciplinary team was formed including front line nursing staff, the IPC (Infection Prevention and Control) team, quality improvement and educators. Each CLABSI incident was thoroughly investigated. Once the causes were identified, strategies were developed to decrease the risk of a patient acquiring a CLABSI. 1. Introduction of patient bathing with warm Chlorhexidine Gluconate cloths. CHG has both bacteriostatic (inhibits bacterial growth) and bactericidal (kills bacteria) mechanisms of action. This has the effect of reducing the bacteria on the patient’s body and therefore decreasing risk of bacteria transfer. 2. Blood cultures are often drawn when a patient has a fever or signs and symptoms of infection. The process used to draw blood cultures was enhanced and standardized.

RESULTS: By August 2016, data revealed that CLABSI’s had decreased to 0.2 per 1000 central line days which is a decrease of 80% In summary, the quality of life for the patient and family increases tremendously by not having to endure a hospitalization for antibiotics and other invasive treatments.