572 Integrating Shared Governance Principles with Real-time Technology to Improve Infection Rates in a Large Burn Center with Patients of Varying Acuity Levels

Abstract

Introduction Increased job satisfaction, and nursing retention are outcomes that have been related to nursing empowerment.1 Probably one of the most beneficial results of nursing empowerment is improved patient outcomes.1 Empowering nurses is not always an easy task, but the nursing best practice of shared governance through unit-based councils gives nurses the ability to mobilize resources within their own groups to get things done. Couple this mobilization of resources with real-time technology that provides a true clinical picture of outcomes, and this creates a template for success. Methods This is a nursing Quality Improvement project. Shared governance in the form of unit-based councils created within all of our patient care units has proven to be part of the equation for improved infection rates in all units. Our number of CAUTI AND CLABIS from 2018–2019 were reduced, we significantly reduced the number of device days (hospital-wide) for both foleys and central lines, which was also a goal. Through extensive nursing education, utilizing nurse driven protocol for foley removal, increased use of bladder scanning (each unit now has their own bladder scanner) and teaching about de-escalation of central lines/PICC lines as soon as possible, we have been able to reduce our device days overall. Alongside this nursing best practice, a new nursing data portal that allows for real time data collection to identify breaks in protocol with regards to central line and foley maintenance leading to CAUTIs and CLABSIs was also implemented, which allowed nursing to have direct impact on achieving success. Results Percent Change 2018 – 2019 CAUTI BU = 83% decrease, 3E burn = 100% decrease, 4W burn = 100% decrease Overall decrease = 90% CLABSI BU = 85%, 3E burn = 67% increase, 4W burn = no change Overall decrease = 78% Conclusions Implementation of nursing best practice efforts such as shared governance and unit-based councils, coupled with cutting edge technological resources directly contribute to improved infection rate outcomes. Another result of these efforts is the overall positivity fostered among nursing staff, boosting their sense of empowerment and creating better retention rates in all our units.