The Impact of Replacing Peripheral Intravenous Catheters when Clinically Indicated on Infection Rate, Nurse Satisfaction, and Costs in CCU, Step-Down, and Oncology Units.

BACKGROUND: A practice change of replacing peripheral intravenous (PIV) catheters when clinically indicated was implemented concurrent with a new PIV chlorhexidine (CHG) securement dressing and existing IV care bundle to prevent the risk of infection. PURPOSE: The aim of this study was to examine the impact of replacing PIV catheters when clinically indicated on infection rates, nurse satisfaction, and costs in three high-risk, vulnerable hospital populations (Critical Care, Step Down, and Oncology units). METHODS: A retrospective review of 473 medical records, 737 peripheral IV sites, and two nursing surveys were completed after the practice change. Data was gathered related to PIV 1) catheter dwell times, 2) phlebitis rates, 3) catheter-related bloodstream infection (CR-BSI) rates, 4) skin tears related to the new PIV dressing, 5) costs, and 6) a nurse satisfaction survey. RESULTS: The average PIV dwell time was 7 days with a 3% phlebitis rate. Findings showed no CR-BSIs and 2 (0.27%) skin tears. Cost savings of $17,100.00 in PIV supplies occurred one year after the practice change. Nurse satisfaction with the new dressing was 94.2%, with a 17- month sustainment of satisfaction. CONCLUSION: The impact of the practice change and new dressing had positive quality outcomes on infection rate, nurse satisfaction, and costs in three vulnerable hospital populations

Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients.

BACKGROUND: In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment. OBJECTIVES: To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic. METHODS: A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas. Zones were designated as hot (highest risk), warm (moderate risk), or cold (lowest risk). Caregivers working in the safety zones were invited to complete a survey regarding their perceptions of safety, caregiver well-being, workflow, and teamwork. Each question was asked twice to obtain caregiver opinions for the periods before and after implementation of the zones. RESULTS: Significant improvements were seen in perceptions of caregiver safety (P \u3c .001) and collaboration within a multidisciplinary staff (P \u3c .001). Significant reductions in perceived staff fatigue (P = .03), perceived cross contamination (P \u3c .001), anxiety (P \u3c .001), and fear of exposure (P \u3c .001) were also seen. Teamwork (P = .23) and workflow (P = .69) were not significantly affected. CONCLUSIONS: Safety zone implementation improved caregivers\u27 perceptions of their safety, their well-being, and collaboration within the multidisciplinary staff but did not improve their perceptions of teamwork or workflow