-
psnet.ahrq.gov/node/49657/psn-pdf
July 01, 2012 - catheter insertion.(9,22) Simulation-based mastery learning (SBML) for central venous catheter
insertion … Simulation-based mastery learning
reduces complications during central venous catheter insertion in … Use of simulation-based mastery
learning to improve the quality of central venous catheter placement … Preventing complications of central venous catheterization. N Engl J Med.
2003;348:1123-1133. … Long-term retention of central venous catheter
insertion skills after simulation-based mastery learning
-
psnet.ahrq.gov/issue/just-what-doctor-ordered-missed-ordering-venous-thromboembolism-chemoprophylaxis-associated
September 07, 2022 - Study
Just what the doctor ordered: missed ordering of venous thromboembolism chemoprophylaxis … Just what the doctor ordered: missed ordering of venous thromboembolism chemoprophylaxis is associated … Hospital-acquired venous thromboembolism (VTE) remains a significant source of preventable patient … July 19, 2023
Eliminating central line-associated bloodstream infections: a national … May 10, 2023
Modes of failure in venous thromboembolism prophylaxis.
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/clabsi-event-reporting_revised.docx
April 01, 2022 - flow for therapy such as hemodialysis
☐ Hemodynamic monitoring in critically ill patient
☐ Providing venous … access for placement of a device, such as a pacemaker
☐ Inadequate peripheral venous access
☐ Other … venous catheter (CVC) hub/port (use facility policy if evidence-based) … Do clinicians know which of their patients have central venous catheters? … Meta-analysis of subclavian insertion and non-tunneled central venous catheter associated infection risk
-
psnet.ahrq.gov/web-mm/danger-10-intravenous-calcium-chloride-extravasation
April 24, 2024 - After resuscitation and stabilization, he was noted to have venous congestion and soft tissue damage … venous access is not available. … Erosion of the venous wall may be induced by endovascular inflammation from movement of the catheter … venous catheter, if possible, over an appropriate amount of time. … During infusion of fluids, IV catheters can become dislodged and/or penetrate through the venous wall
-
www.ahrq.gov/topics/simulation.html
simulation-based learning include using simulation to educate, train or assess clinicians inserting central … venous catheters with ultrasound guidance, diagnosing skin cancer, identifying sepsis or performing
-
psnet.ahrq.gov/issue/explaining-matching-michigan-ethnographic-study-patient-safety-program
August 20, 2018 - Matching Michigan program attempted to replicate the success of the Keystone ICU study at preventing central … October 21, 2020
Families’ experiences of central-line infection in children: a qualitative … 1, 2013
'Matching Michigan': a 2-year stepped interventional programme to minimise central … venous catheter-blood stream infections in intensive care units in England. … September 20, 2011
Elimination of central-venous-catheter-related bloodstream infections
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/clabsi-learning-from-defects-revised.pdf
April 01, 2022 - Learn From Defects Tool Worksheet: Central Line-Assoiated Bloodstsream Infection (CLABSI) … Program for Intensive Care Units:
Preventing CLABSI and CAUTI
Learn From Defects Tool Worksheet:
Central … (Select all that apply)
� Hemodynamic monitoring
� Poor venous access
� Long-term antibiotics
� Vesicants … Yes No Uncertain
10) Was the blood culture drawn from this central line? … If yes how frequently:
Type fo line: Off
Insertion site: Off
Hemodynamic monitoring: Off
Poor venous
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/standalone_pdi_casestudy.pdf
December 01, 2015 - tools from the Pediatric QI Toolkit – which
are all included in the QI Toolkit as well - to reduce
central … had
made some progress in the past by implementing
CLABSI reduction programs, such as the use of
central … venous catheter maintenance bundles. … Venous
Catheter (CVC)-Related
Bloodstream Infections (Tool
D.4x)
• Gap Analysis (D.5) … Two tools were critical to gaining physician support: Best Practices for Central Venous Catheter
(CVC
-
www.ahrq.gov/sites/default/files/publications/files/10-tips-for-hospitals.pdf
December 01, 2009 - Prevent central line-
associated blood stream
infections. … Be vigilant
preventing central line-
associated blood stream
infections by taking five steps
every time … a central venous
catheter is inserted: wash
your hands, use full-barrier
precautions, clean the skin … Prevent venous
thromboembolism. … Eliminate
hospital-acquired venous
thromboembolism (VTE), the
most common cause of
preventable hospital
-
www.ahrq.gov/hai/cusp/clabsi-neonatal/nclabsi4.html
January 01, 2013 - Central Lines
Central lines were classified as: peripherally inserted central catheter (PICC), umbilical … artery catheter (UAC), umbilical venous catheter (UVC), Broviac (a surgically placed, tunneled central … venous catheter), or "other" (all other percutaneously placed central lines). … To date, 17,212 central lines have been placed ( Table 2 ) with 16,067 of these lines having both insertion … Central lines placed by type
Catheter Type
N (%)
Other
185 (1.1)
Broviac
577
-
psnet.ahrq.gov/node/49765/psn-pdf
August 21, 2016 - Bedside cannulation of the central circulation for measurement of central
venous pressure and for vasopressor … venous insertion has declined from its initially reported rate of 2% to below 1%. … Relative value of central-venous-pressure monitoring and blood-volume measurement in the
management … Preventing complications of central venous catheterization. N Engl J Med.
2003;348:1123-1133. … Delayed pneumothorax after central venous
access: a potential hazard. Am Surg. 1993;59:587-589.
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/updatedhacrateinfo.pdf
June 01, 2014 - Infections
370,000 11.30 350,000 10.58
CLABSI MPSMS Blood Stream
Infections Associated
With Central … Venous
Catheters
17,000 0.52 17,000 0.51
https://admin.ahrq.gov/professionals/quality-patient-safety … 2.51
VAP MPSMS Ventilator-Associated
Pneumonia
35,000 1.07 34,000 1.02
VTE MPSMS Postoperative
Venous … 2012 PFP
Measured
HACs per
1,000
Discharge
s
MPSMS Mechanical
Complications
Associated With
Central … Venous
Catheters
130,000 3.84 120,000 3.74
MPSMS Postoperative
Cardiac Events for
Cardiac and
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/a4_pdi_casestudy.pdf
December 01, 2015 - the hospital chose to use, as well as several of the key actions it took to improve
performance on central … Lurie Children’s Hospital
used the Pediatric QI Toolkit to reduce central line-
associated bloodstream … venous catheter maintenance bundles. … Venous
Catheter (CVC)-Related
Bloodstream Infections (Tool
D.4j)
• Gap Analysis (D.5)
1 … Two tools were critical to gaining physician support: Best Practices for Central Venous Catheter
(CVC
-
www.ahrq.gov/hai/cauti-tools/phys-championsgd/refs.html
October 01, 2015 - Teamwork and Communication Definitions and Tools
Peripheral and Central Venous Catheters … Peripheral venous catheter care in the Emergency Department: Education and feedback lead to marked improvements … Sustained improvements in peripheral venous catheter care in non-Intensive Care Units: A quasi-experimental … Strategies to prevent central line- associated bloodstream infections in acute care hospitals. … Consensus conference on prevention of central line-associated bloodstream infections: 2009.
-
www.ahrq.gov/hai/clabsi-tools/appendix-3.html
March 01, 2018 - Guidelines to Prevent Central Line-Associated Blood Stream Infections
Tools for Reducing Central … Guidelines to Prevent Central Line-Associated Blood Stream Infections
Guidelines to Prevent Central … Use full-barrier precautions during central venous catheter insertion. … venous catheter. … Selected patients with suspected blood stream infections and limited venous access may have their catheter
-
psnet.ahrq.gov/web-mm/cognitive-overload-icu
June 01, 2005 - Bedside cannulation of the central circulation for measurement of central venous pressure and for vasopressor … venous insertion has declined from its initially reported rate of 2% to below 1%. … Relative value of central-venous-pressure monitoring and blood-volume measurement in the management of … Preventing complications of central venous catheterization. N Engl J Med. 2003;348:1123-1133. … Delayed pneumothorax after central venous access: a potential hazard. Am Surg. 1993;59:587-589.
-
psnet.ahrq.gov/issue/10-state-project-study-methods-reduce-central-line-associated-bloodstream-infections-hospital
October 23, 2019 - Press Release/Announcement
10-State project to study methods to reduce central line-associated … Citation Text:
10-State project to study methods to reduce central line-associated bloodstream infections … This announcement highlights a program in 10 states that will test methods of reducing central-line–associated … Cite
Citation
Citation Text:
10-State project to study methods to reduce central … May 25, 2011
Elimination of central-venous-catheter-related bloodstream infections from
-
qualityindicators.ahrq.gov/Downloads/Modules/V2023/AHRQ_QI_Indicators_List.pdf
October 01, 2023 - Surgical Item or Unretrieved Device
Fragment Count
• PSI 06 - Iatrogenic Pneumothorax Rate
• PSI 07 - Central … Venous Catheter-Related Blood
Stream Infection Rate
• PSI 08 - In-Hospital Fall-Associated Fracture … Po stoperative Respiratory Failure Rate
• PDI 10 - Postoperative Sepsis Rate
• PDI 12 - Central … Venous Catheter-Related Blood
Stream Infection Rate
Area-Level Indicators (e.g., County, State)
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a4b_combo_pdi_casestudy.pdf
December 01, 2015 - It also
describes several of the key actions the hospital took to improve performance on central line … tools from the Pediatric QI Toolkit – which
are all included in the QI Toolkit as well - to reduce
central … venous catheter maintenance bundles. … Venous
Catheter (CVC)-Related
Bloodstream Infections (Tool
D.4x)
• Gap Analysis (D.5)
1 … Two tools were critical to gaining physician support: Best Practices for Central Venous Catheter
(CVC
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/natlhacratereport-rebaselining2014-2016_0.pdf
January 01, 2016 - National HAC Rates
Adverse Drug Events (ADE)
Catheter-Associated Urinary
Tract Infections (CAUTI)
Central … Preliminary 2016 vs. 2014 Baseline
Adverse Drug Events
Catheter-Associated
Urinary Tract Infections
Central … -800 -1,800
Catheter-
Associated Urinary
Tract Infections
$419,140,000 $82,800,000 1,100 200
Central … like all rates in the sample, uses all patients in the denominator, not just the patients
who had a central … difficile Infections 85,558 2.88
CLABSI MPSMS Blood Stream
Catheters
Infections Associated With Central