MAGGIE-ROSE BAYBLISS1, JOAQUIN MARTINEZGARCIA1, JANE WAUGH1, NICHOLAS GRAY1, Prof. RATHIKA KRISHNASAMY1
1Sunshine Coast University Hospital, , Australia
Biography:
Maggie-Rose Baybliss is a Vascular Access Coordinator at Sunshine Coast University Hospital who is leading several quality improvement projects to improve vascular access outcomes.
Aim:
This quality improvement project aimed to assess the environmental impacts, central line-associated bloodstream infection (CLABSI) rates and cost-savings of ANTT transition from a critical aseptic field technique for haemodialysis catheter access.
Background:
Haemodialysis catheter access traditionally involves a large sterile field and gloves, often requiring two clinicians for procedures like an open run-back. This method imposes significant environmental, budgetary, and resource burdens. Applying newer techniques such as ANTT with micro-critical aseptic fields (MCAF) may reduce consumables, comply with manufacturer requirement for an open-run-back, minimise environmental impact and economic burden, all while maintaining high patient safety standards.
Methods:
A multi-phased, nurse-led single centre project was conducted from 2022 to 2024. This included a literature review (to ascertain comparative benchmarking), risk assessment based on established infection management decision-making framework, development of resources, functional testing, consumable and cost analysis, and staff training. The technique was implemented in 2023 and overseen by the Vascular Access Nurse. CLABSI rates were collected quarterly up to one- year post implementation and single-use plastics and cost-associated with consumables were collected during implementation phase.
Results:
13,000 access procedures were performed using ANTT during the implementation phase. This resulted in reduction of waste of 96,000 pieces of single-use plastic. Additionally, there was a 62% reduction in consumable costs per treatment with a saving of $65,500/year. The CLABSI rate averaged at 0.24/1000 line-days prior to commencement of ANTT, with a downward linear trend to 0.18/1000 line-years during and 0.12/1000 line-years one-year post implementation.
Conclusion:
The successful transition to ANTT using MCAF for all haemodialysis catheter access was a nurse-led, evidence-based initiative that resulted in environmental, economic, and patient safety improvements.
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