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DOI
https://doi.org/10.63853/BKJW5706
Description
QUALITY IMPROVEMENT
Background: Hospital-acquired conditions (HACs) pose a dual challenge to pediatric organizations, compromising patient safety while creating substantial financial burdens, with a single central line-associated bloodstream infection (CLABSI) costing an estimated $48,108 and delaying discharge (Forrester, 2022; Li, 2024). While prior studies have focused on reducing individual HACs through standardized rounding, our pediatric intensive care unit (PICU) adopted a broader, integrated approach.
Methodology: In 2022, we launched a nursing-led initiative to reduce multiple HACs—catheter-associated urinary tract infections (CAUTI), CLABSI, hospital-acquired pressure injuries (HAPI), and peripheral intravenous catheter infiltration and extravasations (PIVIE)—simultaneously. The program empowered Quality Champions (QCs), specially trained bedside nurses, to promote evidence-based practices, reinforce policy adherence, and conduct routine quality-focused rounds. A 2024 program redesign introduced structured QC onboarding, standardized data tracking, and targeted coaching strategies for frontline staff.
Outcomes: During the six months following redesign, QCs conducted more than 4,600 patient rounds, enabling early intervention and enhancing compliance with safety bundles. Since program inception, the PICU has achieved a 45.9% reduction in HACs over two years, with rates declining from 75.74 events per 10,000 patient days in 2023 to 40.97 in 2025. Additionally, the initiative fostered broader improvements in staff knowledge, bundle compliance, and interdisciplinary communication. Leveraging quality-minded nurses as QCs proved effective in driving culture change and achieving sustained reductions in HACs within a high-acuity pediatric setting. This model demonstrates the potential of nurse-led quality improvement programs to simultaneously improve patient outcomes and reduce organizational costs.
Publication Date
11-24-2025
Disciplines
Pediatric Nursing
Recommended Citation
Tyree-Lee, Chasity; Smith, Krystan; Gaines, William; Frederick, Samantha; and Richards, Kendel, "A Quality Attack on HACs" (2025). 2025. 2.
https://scholarlycollection.childrens.com/nursing-anf2025/2
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
