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Critical Care Indicators Critical Care Indicators (CCI)(CCI)
MRSA, VRE, C-Diff and MDRO MRSA, VRE, C-Diff and MDRO NotificationNotification
Presented by: Presented by: Janice Lisee, RNC, BSNJanice Lisee, RNC, BSN Frederick Memorial Healthcare Frederick Memorial Healthcare SystemSystemSenior Systems AnalystSenior Systems Analyst Frederick, MarylandFrederick, Maryland
Previous ProcessPrevious Process
Reports from MicrobiologyReports from Microbiology Reports based on nurses Admit HXReports based on nurses Admit HX Relied on registration/bed Relied on registration/bed
management to contact nursing unitmanagement to contact nursing unit Used comment line on VIP screenUsed comment line on VIP screen
• Inconsistent wordingInconsistent wording• Used by more than one deptUsed by more than one dept• Does not inform nurses, doctors or Does not inform nurses, doctors or
departments who treatdepartments who treat
Goals For New ProcessesGoals For New Processes
Gather information at patient’s point Gather information at patient’s point of entryof entry
Notify staff as soon as possibleNotify staff as soon as possible Notify treating departmentsNotify treating departments Bring information forward to next Bring information forward to next
registration/admissionregistration/admission Keep access to ENTER information Keep access to ENTER information
limitedlimited
Points of EntryPoints of Entry
Emergency Room Emergency Room Same Day SurgerySame Day Surgery Direct AdmissionsDirect Admissions
ED RN – View and/or EnterED RN – View and/or Enter
Info Screen from F8Info Screen from F8
FCL1=%MIS.SCREEN.display.doc("NUREDAS.0000010","EDCCI_INFO")}
Pre-Admission and General Pre-Admission and General Nursing Staff on Admit HistoryNursing Staff on Admit History
Display ONLY
These go to Follow-Up Reports
CCIs Available in Reg RoutinesCCIs Available in Reg Routines
Not Seen In Transfer Routines
Information is seen in PCIInformation is seen in PCI(but not easily in Clinical Review) (but not easily in Clinical Review)
Information Shared on Reports & Information Shared on Reports & RequisitionsRequisitions
Daily Follow-Up Report for IC StaffDaily Follow-Up Report for IC Staff Same Day Surgery Standing OrdersSame Day Surgery Standing Orders Nursing Shift ReportsNursing Shift Reports 24 Hour Summary (SBAR)24 Hour Summary (SBAR) Admission Report (Admit Interventions)Admission Report (Admit Interventions) Radiology RequisitionRadiology Requisition Wound Center OE ConsultWound Center OE Consult Request for Bed (admit or transfer)Request for Bed (admit or transfer)
Infection Control Staff AccessInfection Control Staff Access
ImplementationImplementation
Started with MRSA and VREStarted with MRSA and VRE Added C-Diff and MDROAdded C-Diff and MDRO
• Edited 11 reportsEdited 11 reports• Edited Allergy FragmentEdited Allergy Fragment• Edited 16 screensEdited 16 screens
Post Live ReviewPost Live Review
Well received by staffWell received by staff IC pleased with reportsIC pleased with reports Need to “fix” Clinical ReviewNeed to “fix” Clinical Review Would like to flag MDs during POMWould like to flag MDs during POM
Knowledge Base ArticlesKnowledge Base Articles
410 (MRI)410 (MRI) 14568 (PCI)14568 (PCI) 17450 (MIC)17450 (MIC) 24652 (NUR)24652 (NUR) 31686 (PCI)31686 (PCI) 11816 (PCI)11816 (PCI)
Questions??Questions??
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