Take a Look in the Discharge Book

Project Topic:

Reduction of left ventricular assist device (LVAD) driveline infection readmission rates

Hospital Unit:

Cardiothoracic Intensive Care Unit (CTICU)

CSI Participants:

• Leo Clayton, BSN, RN, PCCN, CCRN-CSC
• Lauren Grip, BSN, RN, CCRN, PCCN, ECMO
• Shavonne Sanchez, BSN, RN
• Jeanette Vereecke, BSN, RN, CCRN-CSC-CMC, PCCN

Project Goals/Objectives:

1. Reduce driveline infection rates 20% in 12 months
2. Implement LVAD bundle (driveline dressing process)
3. Improve education of bedside nurses and patients

Project Outcomes:

1. Reduced driveline infections 44% (from 25 to 14), which resulted in a 16% decrease in readmission rates
2. Implemented LVAD bundle
3. These outcomes resulted in a positive estimated annual fiscal impact of $709,500.

Project Overview:

Readmission rates related to LVAD driveline infections lead to an average of 25 excess hospital days, $43,000 in excess costs and 60 excess antibiotic days per patient in our CTICU. To help decrease readmission rates related to driveline infections, our CSI team implemented a project to improve driveline dressing and educate bedside nurses about driveline care and promote standardized patient education.

First, we surveyed the staff to assess their knowledge of the LVAD dressing procedure and patient discharge education. Next, our team hosted a kickoff event where we educated staff about appropriate LVAD dressing supplies and what information to provide patients prior to discharge. We then began auditing LVAD dressing changes and patient education documentation compliance.

As a result of our project, driveline readmissions rates decreased from 31% to 18% and there were 44% fewer patient LVAD infections.