Infection Prevention Frequently Asked Questions

Frequently Asked Questions

CAUTI

How does the LogicStream Health CAUTI solution help health systems reduce CAUTI?

The LogicStream Health CAUTI prevention solution helps healthcare organizations reduce CAUTI rates by:

  • Unleashing machine-learning algorithms on a health systems’ electronic health record (EHR) databases to highlight gaps in clinical best practices and deliver those gaps to the teams who drive appropriate care
  • Measuring adherence of clinical teams to best-practice care protocols based on CDC guidelines. The solution guides health systems in adjusting workflows so they are aligned with current evidence-based prevention strategies to drive appropriate care standards, then maintains the workflow over time to ensure it remains up-to-date by checking the entire system every night
  • Providing EHR surveillance tools to ensure clinical staff are following the approved processes and highlighting clinicians who might need further education and approved workflows and care delivery
  • Supporting clinical staff in making determinations about how to insert, maintain and remove catheters using core prevention strategies, including:
    • Inserting catheters only for appropriate indications
    • Leaving them in place only as long as needed
    • Ensuring they are properly inserted and maintained
    • Following proper hygiene precautions
    • Documenting these actions
What role does clinical process improvement (CPI) play in the LogicStream Health CAUTI solution?

The LogicStream Health CAUTI prevention solution uses CPI to help health systems:

  • Ensure CAUTI-related electronic health record (EHR) content is up-to-date
  • Measure Foley placement practices and catheter care
  • Rapidly identify which clinicians, departments and hospitals are ordering Foley catheters outside of approved indications
  • Measure catheter utilization by clinician, department, hospital or region to ensure appropriate ordering
  • Automate the assessment of documentation around insertion and removal times
  • Eliminate non-reimbursable cost around CAUTI events
What are some examples of CAUTI workflow standardization?

The LogicStream Health CAUTI prevention solution helps ensure clinical teams are following current evidence-based strategies for leaving catheters in place only as long as needed, including:

  • Periodically reassessing the ongoing need for urinary catheters
  • Clearly communicating when an inserted urinary catheter should be continued (place order to continue or maintain urinary catheter at points of transition of care, such as post-operatively, when present on admission or at discharge)
  • Ordering nurse-driven catheter care protocol with removal parameters at the time of insertion or continuation order
  • Discontinuing urinary catheter order as soon as it is no longer needed
Who are the targeted users of the LogicStream Health CAUTI reduction solution?

The LogicStream Health CAUTI prevention solution is used by clinical leaders, infection preventionists and quality and performance improvement teams focused on reducing HAI rates.

How well does it work? What results can we expect?

Health systems using the LogicStream Health solution have achieved the following results:

  • Outcomes – 30% reduction in CAUTI rate and 75% reduction in average Foley catheter hours per hospital encounter
  • Process standardization – 88% reduction in order sets containing ‘Insert Foley’ orders, thereby reducing content maintenance overhead and improving EHR usability (one health system discovered, using the LogicStream Health solution, they had 88 order sets with ‘Insert Foley’ pre-checked)
  • Documentation – 90% standardization of documentation of catheter care achieved after identification of nursing units with low documentation compliance practices and intervention by nursing leadership
  • Interventions – Identification of outlier providers with excessive urinary catheter use or inappropriate indications and targeted intervention with those providers leading to an immediate and sustained change seen in ordering behavior and documentation of appropriate indications
How does the LogicStream Health solution compare to other solutions in the marketplace?

The LogicStream Health CAUTI reduction solution is the only one of its kind available. Our clinical process improvement and control software is the only solution able to provide near-real-time access to data from any EHR and deliver instant, highly actionable insights for standardizing and controlling clinical processes. These recommendations are delivered to your teams on a daily basis, as a result of machine-learning algorithms scanning your EHR databases nightly. Using our solution, every clinical operator, caregiver, informaticist, analyst and administrator using a simple web browser on any device can sort and view data, identify patterns and track adoption of best practices to reduce CAUTI and address other challenges, including:

  • Prevention of other infections
  • Managing use of opioids
  • Appropriate medical utilization

This gives clinicians the capability of immediate discovery to drive appropriate workflow change and clinician behavior, which is the key to improving patient safety and care quality.

CLABSI

How does the LogicStream Health CLABSI solution help health systems reduce CLABSI?

The LogicStream Health CLABSI reduction solution helps healthcare organizations ensure the appropriate use of central line care and reduce infections by:

  • Unleashing machine-learning algorithms on a health systems’ electronic health record (EHR) databases to highlight gaps in clinical best practices and deliver those gaps to the teams who drive appropriate care
  • Measuring adherence of clinical teams to best-practice care protocols based on CDC guidelines. The solution guides health systems in adjusting workflows so they are aligned with current evidence-based prevention strategies to drive appropriate care standards, then maintains the workflow over time to ensure it remains up-to-date by checking the entire system every night
  • Providing EHR surveillance tools to ensure clinical staff are following the approved processes
  • Supporting clinical staff in making determinations about when and how to properly insert, care for and maintain central blood lines once they are in place to prevent infection and highlighting clinicians who might need further education and approved workflows and care delivery
What role does clinical process improvement (CPI) play in the LogicStream Health CLABSI solution?

The LogicStream Health CLABSI reduction solution uses CPI to help health systems:

  • Standardize CLABSI protocols and physician workflows to minimize central-line days and infection risk
  • Ensure that central line nursing care procedures consistently adhere to best practices
  • Measure central line-related procedures by provider, department, specialty and hospital
  • Measure the impact that care standardization has on the reduction of CLABSI
What are some examples of workflow standardization?

The LogicStream Health CLABSI reduction solution helps ensure clinical teams are following current evidence-based strategies. For example, dressings and tubing must be changed appropriately (the frequency of tubing change varies based on what is being administered, and changing dressings too frequently can increase opportunity for infection). Workflow examples include:

  • Proper insertion practices:
  • Insert only for appropriate indications
  • Perform hand hygiene before insertion
  • Adhere to aseptic technique
  • Use maximal sterile barrier precautions
  • Choose the best insertion site
  • Prepare the insertion site with appropriate antiseptic
  • Place appropriate sterile dressing at the insertion site

 

  • Appropriate handling and maintenance:
  • Hand hygiene before manipulation of central line
  • Bathe ICU patients with chlorhexidine preparation daily
  • Scrub the access port or hub with friction immediately prior to each use with an appropriate antiseptic
  • Use only sterile devices to access catheters
  • Immediately replace dressings that are wet, soiled or dislodged (or maintain intact dressing)
  • Perform routine dressing changes using aseptic technique with clean or sterile gloves
  • Change gauze dressings at least every two days or semipermeable dressings at least every seven days
  • Change administration sets for continuous infusions no more frequently than every four days, but at least every seven days
  • Change tubing every 24 hours when blood products or fat emulsions are administered through the line or every six to 12 hours or when the vial is changed when Propofol is administered through the line
What is the scope of the CLABSI problem? Why has LogicStream Health developed a solution targeting CLABSI?

Reducing CLABSI and ensuring appropriate central line care is a top priority for healthcare systems across the country. CLABSI are unfortunately common, costly and cause significant harm. In most cases, CLABSI is preventable by following evidence-based care bundles. Health systems need to reduce CLABSI negative impact, which includes:

  • 250,000 CLABSI cases in the United States each year
  • 80,000 CLABSI cases in United States ICUs each year
  • Approximately 33,000 deaths attributable to CLABSI each year in the United States
  • Excess attributable cost per patient of more than $16,000 with a total annual cost of CLABSI in the US of $1 billion, according to the Centers for Disease Control
  • Average CLABSI cost of $70,696 per case as reported in worldwide literature (adult patients only) with a range of $40,412 to $100,980 in 2012 dollars
Who are the targeted users of the LogicStream Health CLABSI reduction solution?

The LogicStream Health CLABSI reduction solution is used by clinical leaders, infection preventionists and quality and performance improvement teams focused on reducing healthcare-associated infection rates.

How does the LogicStream Health solution compare to other solutions in the marketplace?

The LogicStream Health CLABSI reduction solution is the only one of its kind available. Our clinical process improvement and control software is the only solution able to provide near-real-time access to data from any EHR and deliver instant, highly actionable insights for standardizing and controlling clinical processes. These recommendations are delivered to your teams on a daily basis, as a result of machine-learning algorithms scanning your EHR databases nightly. Using our solution, every clinical operator, caregiver, informaticist, analyst and administrator using a simple web browser on any device, can sort and view data, identify patterns and track adoption of best practices to reduce CLABSI and address other challenges, including:

    • Prevention of other infections
    • Managing use of opioids
    • Appropriate medical utilization

This gives clinicians the capability of immediate discovery to drive appropriate workflow change and clinician behavior, which is the key to improving patient safety and care quality.

C. diff

How does the LogicStream Health solution help health systems reduce C. diff?

The LogicStream Health C. diff infection testing and reduction solution helps healthcare organizations ensure use of appropriate testing and reduce infections by:

  • Unleashing machine-learning algorithms on a health systems’ electronic health record (EHR) databases to highlight gaps in clinical best practices and deliver those gaps to the teams who drive appropriate care
  • Measuring adherence of clinical teams to best-practice care protocols based on CDC guidelines – the solution guides health systems in adjusting workflows so they are aligned with current evidence-based prevention strategies to drive appropriate care standards, then maintains the workflow over time to ensure it remains up-to-date by checking the entire system every night
  • Providing EHR surveillance tools to ensure clinical staff are following the approved processes
  • Focusing on three key areas: minimizing patient risk for infection; infection control and preventing spread of C. diff infection; and appropriate testing to minimize false positives (some tests produce more false positives, so workflows must indicate the approved testing sequence to avoid over-diagnosis and unnecessary treatment)
What role does clinical process improvement (CPI) play in the LogicStream Health C. diff solution?

The LogicStream Health C. diff prevention solution uses CPI to help health systems:

  • Ensure C. diff-related EHR content is up-to-date
  • Identify and streamline C. diff order sets to control and eliminate inappropriate content
  • Measure C. diff testing and compare to appropriate criteria to reduce over-testing and high false-positive rates
  • Examine patient groups to determine use of appropriate criteria for ordering tests
  • Put in place best-practice workflows and measure the impact of care standardization on C. diff rates
  • Identify clinicians and groups not following best practices to drive targeted interventions
What are some examples of C. diff workflow standardization?

The LogicStream Health C. diff infection testing and reduction solution addresses workflow across three areas: 

  • Minimizing patient risk:
  • Minimize the frequency and duration of antimicrobial therapy and the number of antimicrobial agents prescribed
  • Minimize unnecessary proton pump inhibitor use

 

  • Infection control and prevention:
  • Use full-barrier precautions for contact with C. diff patients and for contact with their body substances and environment; single room preferred
  • Perform environmental decontamination of rooms of patients with C. diff
  • Implement a laboratory-based alert system to provide immediate notification to Infection Prevention Control and clinical personnel about newly diagnosed C. diff patients
  • Conduct C. diff surveillance and analyze and report C. diff data
  • Educate healthcare personnel, environmental service personnel, hospital administration, patients and their families abut C. diff

 

  • Appropriate testing:
  • Only perform testing on unformed stool
  • Do not perform stool testing as a test of cure
  • diff toxin testing is clinically important. In most clinical circumstances, toxin testing should be performed as the initial test of choice. Exclusive reliance on molecular tests for C. diff diagnosis is likely to result in over-diagnosis, unnecessary treatment and increased healthcare costs
What is the scope of the C. diff problem? Why has LogicStream Health developed a solution targeting C. diff reduction?

Healthcare systems need to reduce C. diff infection rates as well as inappropriate testing and over-diagnosis that lead to organizational over-reporting of C. diff cases, diversion of needed infection prevention and quality improvement resources, and false positives resulting in unnecessary treatment. C. diff impact is significant:

  • diff, the causative organism of antibiotic-associated colitis, is the most common infectious cause of healthcare-associated diarrhea
  • diff infection is associated with increased length of hospital stay, cost, morbidity and mortality in adult and pediatric patients
  • Attributable costs of inpatient C. diff infections in 2008 dollars have been estimated to be $3,006 to $15,397 per episode
Who are the targeted users of the LogicStream Health C. diff reduction solution?

The LogicStream Health C. diff infection testing and reduction solution is used by nursing leaders, infection preventionists and hospital leaders who are focused on reducing healthcare-associated infection rates and other clinicians who are responsible if an infection occurs.

How well does it work? What results can we expect?

Health systems using the LogicStream Health solution have achieved the following results:

  • Outcomes – 50% reduction in C. diff infection rate
  • Process standardization – Significant decrease in ordering of C. diff testing and inappropriate provider ordering habits (decrease from average of 90 incorrect order paths per month to less than five per month)
  • Adoption – Decrease in ordering C. diff testing in patients who do not meet criteria
How does the LogicStream Health solution compare to other solutions in the marketplace?

The LogicStream Health C. diff infection testing and reduction solution is the only one of its kind available. Our clinical process improvement and control software is the only solution able to provide near-real-time access to data from any EHR and deliver instant and highly actionable insights for standardizing and controlling clinical processes. Using our solution, every clinical operator, caregiver, informaticist, analyst and administrator using a simple web browser on any device, can sort and view data, identify patterns and track adoption of best practices to reduce C. diff and address other challenges, including:

  • Prevention of infections
  • Managing use of opioids
  • Appropriate medical utilization

This gives clinicians the capability of immediate discovery to drive appropriate workflow change and clinician behavior, which is the key to improving patient safety and care quality.