Hospital-Acquired Condition Reduction Program
Define
The first step in the DMAIC model is to define the problem. In this case, the problem is CLABSI, which is a serious infection that can occur when a central line is inserted into a vein. CLABSI can be life-threatening, and it is estimated to cost hospitals billions of dollars each year.
To define the problem more specifically, we need to collect data on the incidence of CLABSI in our hospital. We can do this by reviewing our infection control data or by conducting a root cause analysis of recent CLABSI cases. Once we have collected data, we need to identify the root causes of the problem.
Measure
The next step is to measure the current state of the process. This involves collecting data on the inputs, outputs, and key performance indicators (KPIs) of the process. For the HACRP, the inputs would include the type of central line, the insertion technique, and the care provided after the line is inserted. The outputs would be the number of CLABSIs that occur. The KPIs would be the incidence of CLABSI, the mortality rate for CLABSI, and the cost of CLABSI.
Analyze
The analysis phase involves using the data collected in the measure phase to identify the causes of the problem. We can use statistical tools such as Pareto charts, fishbone diagrams, and control charts to help us identify the root causes.
Improve
Once we have identified the root causes of the problem, we can develop and implement improvement solutions. The improvement solutions should be based on the best practices for preventing CLABSI. These practices include using aseptic technique during central line insertion, using chlorhexidine for skin preparation, and using dressings that are changed every 7 days.
Control
The final step in the DMAIC model is to control the process to ensure that the improvements are sustained. This involves monitoring the KPIs and taking corrective action if necessary. We can also use statistical tools such as control charts to help us monitor the process.
Here is an example of a specific improvement solution that could be implemented to prevent CLABSI:
- Develop a checklist for central line insertion that includes all of the steps of the aseptic technique.
- Train all staff on the use of the checklist.
- Conduct regular audits to ensure that the checklist is being used correctly.
This is just one example of an improvement solution that could be implemented. The specific solutions that are implemented will vary depending on the specific causes of CLABSI in each hospital.
By following the DMAIC model, hospitals can improve their processes and prevent CLABSI. This will help to improve patient safety and reduce healthcare costs.
In addition to the specific improvement solution mentioned above, here are some other general tips for preventing CLABSI:
- Use a central line only when it is necessary.
- Remove the central line as soon as it is no longer needed.
- Use the smallest possible catheter.
- Secure the catheter properly.
- Monitor the catheter site for signs of infection.
- Follow the manufacturer's instructions for care of the catheter.
By following these tips, hospitals can help to prevent CLABSI and improve patient safety.