Central line-associated bloodstream infections (CLABSIs) contribute to thousands of deaths annually as well as increase the costs for healthcare. CLABSIs are preventable and nurses play an important role in prevention through implementation of evidence-based interventions defined in policy and guidelines. In the electronic health record (EHR), these interventions are not documented in the same place, so it was challenging for nurses to easily tell if an intervention was due or had already been completed. Nurses requested a way to be able to see the overall status of central line interventions so they could see what needed to be done.
A CLABSI dashboard was created in the EHR to display information about central line interventions from existing nursing documentation. Rules for each intervention were created so that only those interventions that were overdue or needed to be done appeared on the dashboard. The dashboard displayed information individually for the different types of central lines, in the event that a patient had more than one central line. Once an intervention was completed, it disappeared from the dashboard. If all interventions were completed, the central line appeared in green so that the nurse could easily tell that nothing more needed to be done. The dashboard was configured to appear for all nurses in their summary reports, so there was no change to their existing workflow and it was easy for them to find the information.
Nurses were very happy with the dashboard and appreciated that there was no change to their documentation or workflows. They felt that the dashboard provided an easy way to tell if an intervention needed to be done. Nurses like to see green on dashboards and checklists and were motivated to ensure that all interventions were completed. The CLABSI Committee believes that the dashboard helped contribute to a decrease in CLABSI numbers. The catheter-associated urinary tract infection (CAUTI) committee has requested a similar dashboard for interventions to prevent these infections.
Dashboards are useful tools for nurses to see patient information in one place. Creating them takes time to understand the requirements, how it will be used, where documentation is done, and the nursing workflows. Thorough testing of the content is necessary to account for variations in nursing documentation practices. Nursing informatics involvement is key to ensure the successful creation and implementation of a dashboard.
Speaker:
Meg Furukawa, MN, RN-BC, CNS, Nursing Informaticist, UCLA Health
ania.org/library
