Input needed for unit Quality Improvement Initiative

[SteveNNP, MSN, NP]

Hi all,

Last year in our unit, the staff (MD/RT/RN/PT/OT/ST/nutrition) decided to form committees to develop interventions to attack a few problem areas in our unit:

1. Breastfeeding rate: Abysmal 40%...... now >85%

2. Chronic Lung Disease: Abysmal 40%.....now

3. IVH: Abysmal 75th percentile in Vermont-Oxford network for III/IV IVH rates in infants

Needless to say, we're ecstatic, not only because so many babies were helped by this, but because this is proof that a staff-level (NO MANAGEMENT) grassroots effort could be so effective in only one year!!

Anyway, enough tooting my unit's horn!!

This year, we are choosing 3 more areas to attack while continuing to improve on last year's. Here are the staff's top 3:

1. Decrease infection rate

2. Improve noise levels in the unit

3. Improve parent satisfaction

As we start to form groups and begin research:uhoh3: , have any of you had any luck with one of these areas? Any ideas as far as staff involvement techniques, protocols, equipment, educational resources, etc that you've found effective in your own units would be greatly appreciated. I really appreciate the help you all have offered over the last few years...there are many great minds at work in the NICU forum!!!:bowingpur

Stephen

[Jolie, BSN]

Congratulations to your unit ans staff for such great work!

As far as infection rates go, I have worked in 2 units that focused on PICC line infections, and dramatically reduced them by implementing improved standards of care on insertion, maintenance, repair, and discontinuation of PICC lines. I don't know if this is a major concern in your unit, but it might be worth investigating.

Good luck!

[RainDreamer, BSN, RN]

Wow Steve, that's awesome progress that you guys are making!! Good job on pulling together and taking charge!

I don't have numbers, but I do know we had a big infection problem about a year ago. So they made some changes and our infection rate has indeed gone down, and I can't remember the percentage, but I know it was quite a difference.

We started doing sterile line changes for ALL deep lines. Any time you break into a line for any reason, you do it under sterile technique. Anytime anyone (docs, x-ray techs, etc) touches a baby, they wash and wear gloves. And we've had 100% compliance with that according to our infection control dept.

As far as noise levels, we have lights in each room that will light up if the noise gets to a certain level. Sometimes you don't realize how noisy it is until that light goes off! It's a good reminder to us to help keep it quieter.

Parent satisfaction increased in our unit, but it was right before I started working there, so I'm not sure what they are doing different now than they did before. It might be a good idea to give the parents a "survey" of some kind, that can be anonymous, just asking what you (as a unit) can do to help better meet their/their baby's needs.