EVIDENCE-BASED IMPROVEMENT PROJECT PROSPECTUS IMPROVING MAMMOGRAPHY SCREENING SCHEDULING THROUGH COVID-19 VACCINE CLINICS UTILIZING AN ONLINE POPULATION MANAGEMENT SYSTEM—A TEAM APPROACH

Abstract Problem: The recent Covid-19 Pandemic led to delays in necessary cancer screening procedures, such as Breast Cancer Mammography Screening (BCS). Suboptimal mammography screening rates persisted at 11% compared to the regional goal of 30% of eligible women in a primary care setting. Context: Covid-19 Vaccination Clinics are part of a private HMO health plan that participates in quality accreditation and data benchmarking utilizing Healthcare Effectiveness Data and Information Set Measures (HEDIS). In this managed care health system, primary care clinics offer appointments and referrals for screening tests similar to mammography. Interventions: Change ideas such as standardized scheduling scripting, standard work process for clinic registration staff, and team education related to population health management were incorporated to foster a Quality Improvement (QI) culture to increase breast cancer screening scheduling for eligible women 40-74 years of age. Measures: The primary outcome measure addressed increasing breast cancer screening mammography scheduling, following organizational guidelines for the population of average risk eligible women aged 40-74. From a baseline of 11% to a target quarterly goal of 25% or more excellent by July 15, 2022. One process measure aimed for 90% of clinic staff to receive breast cancer screening scheduling training by June 8, 20222. Results: For two months, 90% of clinic staff (N=15) received 1 to 1 real-time hands-on training related to scripting, scheduling, and same-day mammography scheduling. Conclusion: Healthcare restrictions resulting from Covid-19 had unintended consequences that resulted in late cancer diagnoses and missed opportunities for life-saving cancer screening mammography. Clinical nurse leaders are encouraged to employ evidence-based practices in the microsystem setting

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN