Using the MTCT to Your Advantage
Jill Marsteller PhD, MPP
And On the CUSP: STOP BSI Participating Sites
On the CUSP: Stop BSI
Tuesday, April 20, 2010
1
Learning Objectives
• At the end of this session you should be able
to
– Discuss patterns of CUSP activity and barriers
faced in MTCT data for sites across the Nation
– Describe ways you can use the MTCT to help your
local project roll-out
– Recount ways other teams collect, enter and use
MTCT data
22
Ways you can use the MTCT
• Use the form as a project management tool (e.g., a
checklist)
• Check in with your team about what they think
• Report your activity upward to management
(highlight needs)
• Monitor your progress in CUSP steps and CLABSI
reduction steps
• Identify barriers in teamwork and communication to
guide corrective action
• Identify activities of other teams; compare pace of
your project
3
Other ways the MTCT can help you
• State Leads and National Faculty can use to
respond to educational needs of teams
• Society and science can learn from the
elements of team context that influence
performance
4
Participation in CUSP Activities (1)
%
100
Aug-09
90
Nov-09
80
Feb-10
70
60
50
35
40
31
29
30
20
21
13
34
41
23
14
10
0
Science of Safety Video
AM Briefing
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
Daily Goals
5
Participation in CUSP Activities (2)
%
100
90
Aug-09
80
Nov-09
70
Feb-10
60
47
50
37
40
30
23
20
10
4
21 21
14
10 10
0
Culture Debriefing
Observing Rounds Staff Safety Assessment
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
6
Activities undertaken to teach unit
staff about preventing BSI (1)
%
100
Aug-09
90
80
Nov-09
70
Feb-10
60
50
32 35
40
30
22
20
10
6
10 10
29
35
17
0
Internal seminar
IC visit/talk
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
In-services/demos
7
Activities undertaken to teach unit
staff about preventing BSI (2)
%
100
90
Aug-09
80
Nov-09
70
Feb-10
60
50
40
31
30
19
20
10
8
19 22
9
9
15
10
0
New written policy
Posted steps Put protocols on clipboards
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
8
Partnership with Senior Executive (1)
No. of Meetings
0.98
1
0.76
0.83
Aug-09
Nov-09
Feb-10
0
Average no. of meetings with senior executive partner
n=34, 199, 164 for Aug 09, Nov 09 and Feb10, respectively
9
Partnership with Senior Executive (2)
No. of Meetings with Senior Executive Partner
4.3%
2.4%
9.8%
No meeting
32.3%
Once
Twice
Three times
Four times or more
51.2%
Data on Feb 2010 (n = 164)
10
Partnership with Senior Executive (3)
Types of Data Shared with Senior Executive
%
100
90
78
80
70
Aug-09
63
60
Nov-09
50
Feb-10
40
36
30
20
20
6
10
11
8
10
12
0
Infection rates
Findings from the Staff
Safety Assessment
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
Data from the ICU
culture assessment
11
Partnership with Senior Executive (4)
Activities Senior Executive Partner Participated
%
100
Aug-09
90
80
Nov-09
70
Feb-10
60
50
40
47
34
38
44
51
42
30
20
10
0
Safety rounds
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
Prioritizing of safety issues
12
Usage of BSI-prevention Procedure (1)
3.9
All 4
3.5 3.4 3.4
3.7 3.8
3.7
3.5 3.6
3
Aug-09
Nov-09
2
Feb-10
Few 1
0
Appropriate hand
hygiene
Chlorhexidine skin
preparation
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
Full-barrier
precautions
during line insertion
13
Usage of BSI-prevention Procedure (2)
All
4
3.2
3.3
3.4
3.2
3.2
3.2
3
Aug-09
Nov-09
2
Feb-10
Few 1
0
Avoid femoral site for
placement
n=78, 273, 191 for Aug 09, Nov 09 and Feb10, respectively
Removing unnecessary lines
14
Top Five Progress Barriers (1)
%
100
Aug-09
90
80
Nov-09
70
Feb-10
60
50
59
52
49
40
53
47
32
30
20
10
0
Not enough time
n=34, 199, 164 for Aug 09, Nov 09 and Feb10, respectively
Confusion about how to proceed
with CUSP activities
15
Top Five Progress Barriers (2)
%
100
90
Aug-09
80
Nov-09
70
Feb-10
60
50
40
30
41 41 43
38
38
31 30
31 28
20
10
0
Not enough buy-in Not enough buy-in Not enough buy-in
from physician staff from nursing staff from staff members
n=34, 199, 164 for Aug 09, Nov 09 and Feb10, respectively
16
Work Distractions
%
Aug-09
100
90
Nov-09
80
70
Feb-10
60
50
40
30
26
28
25
20
10
0
any event in your unit that has distracted staff from
this work
n=34, 199, 164 for Aug 09, Nov 09 and Feb10, respectively
17
How do other teams use the
MTCT?
18