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Central line associated bloodstream infection (CLABSI) are one of the most prevalent hospital-acquired preventable infections experienced by patients, prolonging admissions and costing hospitals thousands of dollars per case. Oncology patients are at a considerably higher risk of developing central line infections due to their neutropenic status and disease process. In December 2020, a blended oncology and stem cell transplant unit, 10 North, experienced a cluster of 3 central line infections in a one month period after not having a CLABSI for 16 months. The purpose of this project was to reduce the total number of central line infections on 10 North by 15% and improve overall nurse competency on central line maintenance. Nursing leadership devised a central line validation checklist based on the organization's policies to assess and provide mentorship to nurses on the following domains: PICC, Broviac, Mediport dressing changes, blood culture and lab specimen collection, and chlorhexidine gluconate (CHG) treatment process. To provide consistency, the clinical manager and program coordinator validated all nurses. Validation highlighted 2 pivotal areas of opportunity for 10 North nurses: blood culture and lab specimen collection process and CHG treatment process and pertinent patient education. Nursing leadership provided one-on-one mentoring for each nurse and provided them with the resources needed to care for central lines using evidence based practice. Nursing leadership collaborated with unit champions to develop education and huddle messages presented weekly. After the validation period, unit champions audit their peers monthly on central line best practice, with at least 10 audits per month. All 10 North nurses were validated within 1 month, completed by the end of January 2021. After the validation period, there have been no new central line infections on 10 North, resulting in a 100% reduction in CLABSI for this unit. Continued mentorship, education, and auditing of best practice will ensure we continue to minimize our incidence of central line infections on 10 North, with the overarching objective to maintain a zero harm environment. This initiative has been replicated the dedicated transplant unit with 68% reduction in CLABSI events. [ABSTRACT FROM AUTHOR]

Falls are one of the most common adverse events that occur to hospitalized patients. Oncology patients, in particular, have a 50% higher chance for falls in the inpatient hospital setting than non-oncology hospitalized patients. Because of sequelae related to their underlying disease, such as pancytopenia, bony metastases, and side effects from chemotherapy, they are also at risk for serious injuries as a result of those falls. In 2020, there were 67 falls on the inpatient oncology units at New York Presbyterian: Weill-Cornell. In 2021, there have been 51 falls (39 unassisted) to date. The purpose of this project was to reduce total number of falls on the inpatient oncology service line (10 North, 10 Central, 10 South, and 10 West) by 15%. Nursing leadership coordinated bi-weekly interdisciplinary fall meetings, during which we discussed practice, gaps, and trends. Led by the medical director of quality and patient safety, the following teams participated: nursing, leadership, medical providers, nursing support staff, quality, nutrition, and environmental services. Two units (10 South and 10 Central) completed fall rapid-cycle peer validation audits, which included proactive rounding practice, documentation, education, and provider-led patient education. Additionally, each unit's fall champions and nurse leaders audited Fall TIPS (tailored interventions for patient safety) compliance, providing feedback to staff in real time. 2 main areas of opportunity were identified as a result of these audits--education delivery and consistent use of fall TIPS. In addition, nursing adopted a collaborative interdisciplinary approach to implementing these interventions. Nursing spearheaded education for the providers, environmental services, nursing support staff, and nutrition, educating >80% of staff. Leadership rounds (at least 40 per month) focused on fall prevention and responsiveness. During the education period, all units implemented standardized door signage, highlighting the patient's risk level based on the Morse score. Adopting an interdisciplinary team approach to fall prevention resulted in an 85% decrease in falls in 2021 YTD. Total falls peaked in January 2021 (13 falls) and has been trending down. Involving all members of the oncology patient care team and implementing sustainable measures is essential to ensuring patient safety. Continued auditing and education will ensure a decrease in falls, striving towards the organization's goal of zero harm. [ABSTRACT FROM AUTHOR]