Excellence in reducing central line-associated bloodstream infections and a whole hospital approach to team healthcare have earned Verde Valley Medical Center in Cottonwood, Ariz., two Amerinet Healthcare Achievement Awards.
Ten hospitals among health centers of all sizes across the nation were recognized by Amerinet this year, and 99-bed Verde Valley was deemed outstanding twice in the quality/patient care delivery category.
Glenn Marks, RN, BSN, a vascular access nurse at Verde Valley, was instrumental in developing Verde Valleys plan to reduce central line infections. Six years ago he questioned why central lines were inserted only by the radiologists at the hospital. Waiting for the line to be inserted by a physician was holding up the discharge process for days, causing patient frustration and resulting in expensive extended stays for the hospital, he said.
He proposed creating a vascular access service, transferring the insertion of peripherally inserted central catheters to the nursing staff and starting to assess what kind of IV would be needed for longterm care at the admission stage rather than discharge.
Key to the programs success, he said, was that hospital administration gave the vascular access team the authority to recommend, based on best practices, which products are best for particular uses, even if they are more expensive.
The vascular access team continues to train other nurses and physicians on measures such as using ultrasound to find veins for every needle stick so that its a single stick instead of several, which can increase the odds of infection. Nurses also developed a better tracking system after the patient leaves the hospital so that the lines are removed as soon as they no longer are necessary, which decreases the chance of infection.
Marks said the program has had a direct result. The hospitals central line-associated bloodstream infection rate went from 3.7% to 4.6% from 2004-2008. The vascular access service program started in 2008, Marks said, and since that time, there have been no infections.
“We should always be changing policies to keep up with the information we have,” Marks said.
Breaking down silos
Working together to enact change is at the root of the Team VVMC approach for which the hospital was recognized.
Susanne Maiden, RN, MBA, who is CNO and president of nursing for Verde Valley, said departments had become very good at working together within their departments, but not between departments. “We were comfortable in our zones,” she said.
Changing the culture took considerable education. One part of the team approach was instilling accountability, Maiden said. Nurses came up with a code of ethics and behavior, and they hold each other accountable to it. If a nurse doesnt document fully after seeing a patient and that makes more work for the next nurse, the first nurse will be accountable for that in a nonpunitive way, she said.
Customer service was another hospitalwide priority that benefited from a team approach. Healthcare providers learned to introduce themselves to the patient and family any time they walked into a patients room whether their role was transportation tech, nurse or physician. The feedback from patients consistently was positive, Maiden said.
Departments also learned to work together to organize the equipment room. Nurses, pharmacists, biomed technicians, physicians, physical and occupation therapists and anyone else who used the room previously organized their items according to what made sense for their needs. Now everyone who walks into that room knows exactly where to go, Maiden said.
“This became an expectation and then it became a reality and then it was just habit,” she said. “This isnt about hitting people over the head. This isnt about bringing out the whip. This is about wanting our patients to have the best possible experience in the most efficient way.”
For information, visit www.VerdeValleyMedicalCenter.com.