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University of Ottawa Heart Institute To Clip or Not Clip… How to Change an Organizations Practice Brainstorming with a

University of Ottawa Heart Institute To Clip or Not Clip… How to Change an Organizations Practice Brainstorming with a Multidisciplinary Team. Who we are . University of Ottawa Heart Institute (UOHI) is a 134 bed institution Part of The Ottawa Hospital Cardiology/Cardiac Surgery Patients

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University of Ottawa Heart Institute To Clip or Not Clip… How to Change an Organizations Practice Brainstorming with a

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  1. University of Ottawa Heart Institute To Clip or Not Clip… How to Change an Organizations Practice Brainstorming with a Multidisciplinary Team QHN Fall Forum 2008

  2. Who we are • University of Ottawa Heart Institute (UOHI) is a 134 bed institution • Part of The Ottawa Hospital • Cardiology/Cardiac Surgery Patients • Cardiac Rehab • Ambulatory Care QHN Fall Forum 2008

  3. Background • Appropriate hair removal on all patients in the University of Ottawa Heart Institute • To prevent surgical site infections in Coronary Artery Bypass Graft (CABG) patients by implementing the Safer Healthcare Now (SHN) Surgical Site Infection (SSI) bundle components as appropriate at the UOHI • Brainstorming with a multidisciplinary team was the quality improvement tool used. This tool enabled the SSI committee to generate many proactive ideas and measures in an effort to successfully implement a change in practice in our organization QHN Fall Forum 2008

  4. Team Members • Dr. Paul Hendry (CHAIR), Department ofCardiac Surgery • Heather Sherrard, Vice President, Clinical Services • Dr. Kathy Suh, Infection Control • Dr. Michael Bourke, Department of Anaesthesiology • Natalie Bruce/Jenn Johnson, Infection Control • Erika MacPhee, SHN Project Facilitator • Sharon Ann Kearns, Manager Quality and Performance Measurement • Karen Charron, Clinical Manager H3 • Elaine Vandenberg, Clinical Manager CSICU • Cynthia Holm, Clinical Manager COR/ • Gloria Prendergast, Team Leader CSICU • Carol McKissock, Resource Nurse CSICU • Debbie Hubble, Manager Perfusion • Bob Boxell, Anaesthesia Tech • Dave Cecillon, Manager Pharmacy QHN Fall Forum 2008

  5. Responsibilities of SSI Team • Identify and address areas for improvement in preventing Surgical Site Infections and to support the transfer of knowledge to improve patient care at The University of Ottawa Heart Institute • Advocating for policies and systems to be in place to reduce the rate of surgical site infections • Facilitating the development of a patient safety culture through education and other initiatives QHN Fall Forum 2008

  6. Measures Used • Brainstorming with a multidisciplinary team • Reviewed entire process at UOHI to identify current practice • Identified practice concerns • Performed Chart Audits • Performed Surveys QHN Fall Forum 2008

  7. Intended or Achieved Outcomes • Hair removal • Identified process issue here • to clip or not to clip…or just do whatever the heck you feel like!!! • Removal of all razors in building • More clippers in building • Re education/ in-services • Revise pre-op checklist • Policy and Procedure developed for hair removal at UOHI QHN Fall Forum 2008

  8. Lessons Learned • Assembling a team is not as easy as one would think • Identify a champion or 2 (physician and one other health care team member). • Persistence with the physicians…face to face contact to get them to commit to meetings • Assign tasks to your team members and hold them accountable • Make the meetings formal • Establish Terms of Reference • Agendas • Minutes • Don’t Take it all on yourself!!!! QHN Fall Forum 2008

  9. Key Success Factors/Enablers • Once a physician champion was enlisted, the key to the success of this initiative was the all or none principle • Every patient who sets foot in our institution is a potential surgical patient, therefore ALL razors were removed from the building • The clipper rep invited in for a 2 day blitz of in-services on clipper use • A designated manager ordered all the replacement clipper heads and policy drafted for appropriate hair removal QHN Fall Forum 2008

  10. Potential or Actual Barriers • Staff reluctant to change • Referring centers don’t necessarily have the same practice as the UOHI • Physician buy in and compliance • Preconceived notions of who should get what kind of hair removal QHN Fall Forum 2008

  11. Next Steps • All referring hospitals were notified by letter about the hair removal policy and this is a standard order on the transfer to UOHI documents • Ongoing audits to ensure compliance • Spot checks on units to ensure no razors • Social work will look after ordering of facial razors for our long term patients • Share the UOHI Policy and Procedure for Hair Removal with our colleagues at The Ottawa Hospital QHN Fall Forum 2008

  12. Contact Information Erika MacPhee RN, MHScN University of Ottawa Heart Institute Clinical Nurse Educator/Project Facilitator 613-798-5555 x15450 emacphee@ottawaheart.ca Sharon Ann Kearns RN,BScN, CPHQ University of Ottawa Heart Institute Manager Quality and Performance Measurement 613-761-4322 sakearns@ottawaheart.ca QHN Fall Forum 2008

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