Healthcare Associated Infections in PICU

Sustaining reductions in HCAIs in Paediatric Intensive Care

Overview of the Project

Paediatric intensive care is a high risk environment where HCAIs have been viewed as an accepted complication of admission due to the need for invasive devices used for patient monitoring, treatment and support. A robust data collection system was introduced in 2009/10 to monitor central line infections and ventilator associated pneumonia. The aim of the project was to reduce these HCAIs, sustain reductions seen and ultimately promote a sea change in culture amongst all levels of staff to recognise that HCAIs can be readily preventable with appropriate strategies and should not be accepted as a routine complication of PICU admission.

A HCAI Group was created with leaders from different specialities and levels to increase engagement with the whole PICU workforce. This group exemplified the post-heroic leadership model which, involves multiple actors who take up leadership roles both formally and informally and importantly share leadership by working collaboratively (Turnbull 2011).

Results
The results achieved in the project are shown in the charts above. CVC infection rates have been sustained at a low level and VAP rates have also dropped significantly. As well as further planned changes to tackle arterial line infections and urinary catheter associated urinary tract infections, the ultimate challenge is to ensure all these changes are embedded into PICU culture. Staff awareness of HCAIs and their impact has already increased. Continuing to feedback progress, training new staff in the new ways, and connecting the achievements with the changes made will ensure this new ethos is rooted in PICU culture.

Leadership Challenges
These have been significant and have included: the need to engage staff at many different levels and specialities empowering of staff to challenge colleagues if aspects of care bundles not being followed communication of changes, compliance results and HCAI rates continued education of large numbers of staff

Contact Information Dr. Jeff Martin Consultant in Paediatric Intensive Care jeffmartin@nhs.net 07525 641821