Caregivers on the medical telemetry unit (T6) at Intermountain Medical Center haven’t let COVID-19 disrupt their safety processes. In fact, they’ve recently been recognized by the Centers for Disease Control and Prevention (CDC) for preventing hospital acquired infections this year.
Intermountain Medical Center was asked earlier this year to participate in a national collaborative sponsored by the CDC and the American Hospital Association to reduce hospital acquired infections. These infections, such as Clostridium difficile (C. diff), can lead to longer hospital stays, higher readmission rates, increased mortality, and higher costs.
Intermountain Medical Center had already reduced the number of C. diff infections by more than half since 2018, but they’ve continued to trend downward in 2020, thanks to consistently using best practices.
Kylie Brown, patient care tech, monitors patient’s telemetry rhythms
On the medical telemetry unit (T6), which is the hospital’s COVID-19 medical floor, there hasn’t been a single hospital acquired infection the entire year — something the CDC finds very impressive, especially during a pandemic and while treating COVID-19 patients.
“This is really incredible for us,” says Mindi Dellinger, RN, nurse manager on medical telemetry, who says the unit averages more than 20 COVID-19 patients a day. “While hospital acquired infections are a very small percentage during a normal year, our goal is to have none. So, for us to have zero this year is remarkable.”
Mindi says about 20 percent of the COVID-19 patients on the unit have Foley catheters or central lines, which can lead to hospital acquired infections if safety processes aren’t consistently followed.
“What we’ve done is stay on track in spite of a whirlwind of challenges,” Mindi says. “We’ve never deprioritized patient safety or put it on the backburner. This success is a result of strategies and a culture put in place long before COVID hit.”
"We took a hands-on approach to the Foley catheter skills pass off with our CNAs. This was all before COVID-19 began."
How has the unit stayed on track during such a difficult year? Mindi says the reasons include consistency in communication, education, and caregiver engagement.
She says, “The charge nurses talk about their safety protocols with catheters at the beginning of every shift during huddle. They discuss which patients have catheters, why they have them, and what we can do to get them removed. We want to know if we can deliver effective patient care without these devices. Our caregivers are also reminded of protocols, which includes Foley catheter care: cleaning the area where the catheter is inserted at least once per shift.”
The unit also participates in a yearly pass-off for insertion of catheters to make sure caregivers follow best practices.
Otgo Carter, nurse educator on medical telemetry, says, “For the first quarter of 2020 we took a hands-on approach to the Foley catheter skills pass off with our CNAs. This was all before COVID-19 began. During the pass off, I’d join each CNA in the patient’s room as an observer and afterward I’d let them know what they did right or wrong, and I’d mention something they could improve upon. It has had the benefit of keeping everyone on the same page all year long.”
In addition, the floor’s health unit coordinators audit the process daily, making sure each patient has had their catheter area cleaned in the past 24 hours. “If for some reason it hasn’t happened, they’ll let the CNA know,” Otgo says.
“The quality and safety really comes through when you realize they’ve had a significant number of COVID-19 medical patients. The CDC were very impressed.”
“These are just a few ways we’ve prioritized consistency and safety during an incredibly chaotic year,” Mindi says. “Everyone has helped us keep up with the standard and stay on track.”
Karen Singson, an infection preventionist at Intermountain Medical Center, says, “The quality and safety really comes through when you realize they’ve had a significant number of COVID-19 medical patients.”
She says, “When we met with the CDC at the completion of the national collaborative, we learned that only 50 percent of the hospitals who agreed to participate in the collaborative were able to accomplish their goals due to COVID-19. We then ended up presenting our successes. The CDC let us know they were very impressed.”
“These caregivers should be recognized and their efforts applauded,” says Karen. “They’ve kept up their trainings and best practices during COVID. They’ve never used it as an excuse.”
She adds, “We’re so grateful for everyone on this team. You take care of the little things every day. You’re still watching over the details for our patients, and it’s making a difference. Thank you for all that you do.”