Lisa Zubkoff1, Julia Neily2, Beth J King3, Mary Ellen Dellefield4, Sarah Krein5, Yinong Young-Xu6, Shoshana Boar6, Peter D Mills7. 1. Health Science Specialist, White River Junction Department of Veterans Affairs (VA) Medical Center, White River Junction, Vermont; Assistant Professor of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. Electronic address: Lisa.Zubkoff@va.gov. 2. VA National Center for Patient Safety (NCPS), White River Junction. 3. VA NCPS, Ann Arbor, Michigan. 4. Research Nurse Scientist, VA San Diego Healthcare System; Clinical Professor of Nursing, Hahn School of Nursing and Health Science, University of San Diego. 5. Research Career Scientist, Center for Clinical Management Research, VA Ann Arbor Healthcare System; Research Professor, Internal Medicine, with an adjunct appointment, School of Nursing at the University of Michigan, Ann Arbor. 6. White River Junction VA Medical Center. 7. Director, VA NCPS, White River Junction; Adjunct Associate Professor of Psychiatry, Geisel School of Medicine at Dartmouth.
Abstract
BACKGROUND: In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs). METHODS: During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims. The action phase consisted of educational conference calls, coaching, and monthly team reports. Learning was conducted via phone, web-based options, and e-mail. The CAUTI bundle focused on four key principles: (1) avoidance of indwelling urinary catheters, (2) proper insertion technique, (3) proper catheter maintenance, and (4) timely removal of the indwelling catheter. The HAPU bundle focused on assessment and inspection, pressure-relieving surfaces, turning and repositioning, incontinence management, and nutrition/hydration assessment and intervention. RESULTS: For the 18 participating units, the mean aggregated CAUTI rate decreased from 2.37 during the prework phase to 1.06 per 1,000 catheter-days during the action (implementation) phase (p < 0.001); the rate did not change for CAUTI nonparticipating sites. HAPU data were available only for 21 of the 31 participating units, whose mean aggregated HAPU rate decreased from 1.80 to 0.99 from prework to continuous improvement (p < 0.001). Staff education and documentation improvement were the most frequently implemented changes. CONCLUSION: This project helped improve CAUTI and HAPU rates in the VHA and presents a promising model for implementing a virtual model for improvement. Copyright 2016 The Joint Commission.
BACKGROUND: In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs). METHODS: During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims. The action phase consisted of educational conference calls, coaching, and monthly team reports. Learning was conducted via phone, web-based options, and e-mail. The CAUTI bundle focused on four key principles: (1) avoidance of indwelling urinary catheters, (2) proper insertion technique, (3) proper catheter maintenance, and (4) timely removal of the indwelling catheter. The HAPU bundle focused on assessment and inspection, pressure-relieving surfaces, turning and repositioning, incontinence management, and nutrition/hydration assessment and intervention. RESULTS: For the 18 participating units, the mean aggregated CAUTI rate decreased from 2.37 during the prework phase to 1.06 per 1,000 catheter-days during the action (implementation) phase (p < 0.001); the rate did not change for CAUTI nonparticipating sites. HAPU data were available only for 21 of the 31 participating units, whose mean aggregated HAPU rate decreased from 1.80 to 0.99 from prework to continuous improvement (p < 0.001). Staff education and documentation improvement were the most frequently implemented changes. CONCLUSION: This project helped improve CAUTI and HAPU rates in the VHA and presents a promising model for implementing a virtual model for improvement. Copyright 2016 The Joint Commission.
Authors: Jordan M Harrison; Andrew W Dick; Elizabeth A Madigan; E Yoko Furuya; Ashley M Chastain; Jingjing Shang Journal: Am J Infect Control Date: 2021-12-07 Impact factor: 4.303
Authors: Andrew J Zimolzak; Umber Shahid; Traber D Giardina; Sahar A Memon; Umair Mushtaq; Lisa Zubkoff; Daniel R Murphy; Andrea Bradford; Hardeep Singh Journal: J Gen Intern Med Date: 2021-04-27 Impact factor: 5.128
Authors: Laura J Damschroder; Nicholas R Yankey; Claire H Robinson; Michelle B Freitag; Jennifer A Burns; Susan D Raffa; Julie C Lowery Journal: J Gen Intern Med Date: 2020-09-08 Impact factor: 5.128
Authors: Supriya Mohile; Marie Anne Bakitas; Lisa Zubkoff; Kathleen Doyle Lyons; J Nicholas Dionne-Odom; Gregory Hagley; Maria Pisu; Andres Azuero; Marie Flannery; Richard Taylor; Elizabeth Carpenter-Song Journal: Implement Sci Date: 2021-03-11 Impact factor: 7.327
Authors: Max T Wayne; Sarah Seelye; Daniel Molling; Xiao Qing Wang; John P Donnelly; Cainnear K Hogan; Makoto M Jones; Theodore J Iwashyna; Vincent X Liu; Hallie C Prescott Journal: JAMA Netw Open Date: 2021-09-01
Authors: Daniel H Solomon; Theodore Pincus; Nancy A Shadick; Jacklyn Stratton; Jack Ellrodt; Leah Santacroce; Jeffrey N Katz; Josef S Smolen Journal: Arthritis Care Res (Hoboken) Date: 2022-02-04 Impact factor: 5.178