Heroes of Infection Prevention 2019
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Tackling CLABSI by Changing Culture
Jayme Townson, RN
University Hospitals Cleveland Medical Center
Jayme Townson leveraged best practices and back-to-basics education to create a culture shift that reduced central line-associated bloodstream infections (CLABSI) among particularly vulnerable patients.
In 2017, Townson became the infection preventionist for the University Hospitals Cleveland Medical Center’s (UHCMC) Seidman cancer center, which includes an adult hematologic stem-cell transplant (HSCT) unit. While new to infection prevention and control, Townson had heightened urgency around patient safety because of her background as a pediatric hematology oncology nurse. “My kids were always so vulnerable,” she said.
When Townson joined UHCMC, the HSCT unit was struggling to manage CLABSI rates. “CLABSI is particularly challenging in transplant patients, and there was a mindset that ‘our patients are so sick, we can’t change this,’” said Townson. “We needed to shift the culture.”
Townson and colleagues started by spending a day at Johns Hopkins Medical Center, exploring best practices for central line care and CLABSI prevention. “The Johns Hopkins team proved we could reduce infections in HSCT patients, and this helped us convince those who were skeptical,” said Townson.
Based on a literature review following the visit, the UHCMC team transitioned to using antimicrobial catheters. Next, they focused on central line care and maintenance. “The Johns Hopkins team stressed that all the bells and whistles – including the antimicrobial catheters – aren’t going to reduce infections if the basics aren’t getting done,” said Townson.
Townson and her colleague began weekly rounding on every patient with a central line to assess for bundle compliance and provide feedback and real-time education. This interaction helped establish important relationships. “Now the nurses see us coming and say, ‘Can you help me?’ or ‘Tell me what you think,’” said Townson.
In one year, Townson and her team generated a 76 percent CLABSI reduction. “It’s proof that persistence and education can create change that protects our patients,” said Townson.