Clinical Excellence

At Nicklaus Children’s Hospital, we dedicate ourselves daily to offering the best possible care to every child and family who come to us for hope and healing. We understand that quality and safety are the twin pillars of clinical excellence. We continuously evaluate our quality and safety performance to ensure that we meet and exceed national benchmarks and routinely incorporate evidence-based strategies to support a culture of continuous improvement.

Patients and families have an essential role in our quality and safety program. No one knows a patient better than the child’s parents or guardians. We look to parents and extended family members to share insights to enhance care and create a better experience to meet each patient’s needs. 

Measuring Care Quality

As we strive to provide the best care experience possible, we steadfastly track key outcomes and measures that serve as quality and safety indicators.

The measures shown below are only a small sampling of the data we routinely measure and report as part of our commitment to quality and safety. Through measurement over time, we can identify practices that enhance these outcomes and identify opportunities for improvement.


 

Catheter-Associated Urinary Tract Infections

Children receiving care in a hospital sometimes require a urinary catheter, a thin tube that drains urine from the bladder. Catheters are helpful for patients during their care or recovery, but they can also bring risks, including catheter-associated urinary tract infections (CAUTI). Minimizing the incidence of CAUTI contributes to patient safety. Nicklaus Children’s uses multiple strategies to minimize CAUTI, including steps taken by the clinical team before and after the catheter is placed.

Measurement

While patients are in the hospital, we track any urinary tract infections that occur that are associated with the use of a urinary catheter (CAUTI). By measuring such infections over time, we can quickly identify emerging trends that impact infections and adapt quickly to continuously improve our care.

Catheter-associated urinary tract infections rate
Fig 1. 2018-2023 Chart of CAUTI rate per 1,000 catheter days
 

Continuous Improvement

Information about CAUTI are regularly reviewed by our Infection Prevention and Control staff along with other members of the care team to observe trends that may impact these events. Strategies to prevent CAUTI include using proper techniques for inserting and maintaining the urinary catheter. We also emphasize the importance of avoiding unnecessary urinary catheter use and removing the catheter when it is no longer needed. Rounding is done to ensure compliance with these strategies, and family representatives are part of our subject matter expert team to help us identify ways to improve continuously.

Collaboration to Improve Safety

Nicklaus Children’s submits our CAUTI data monthly to the Children's Hospitals' Solutions for Patient Safety (SPS) national collaborative. Hospitals from throughout the U.S. are part of this network that tracks hospital-acquired conditions to share best practices regarding patient safety. The purpose of this is to help hospitals learn from their combined experiences so that all can enhance patient safety.

Central Line Associated Blood Stream Infections

Children receiving care in a hospital sometimes need to have a central line placed into a large blood vessel in their bodies. Central lines are intravenous catheters that are used to provide the patient with fluids, medications and nutrients. This important tool of the medical team can sometimes pose risks, including central line-associated blood stream infections (CLABSI). Minimizing the incidence of CLABSI contributes to patient safety. Nicklaus Children’s uses multiple strategies to minimize these events, including steps taken before and after the central line is placed.

Measurement

While patients are in the hospital, we track any infections that occur that are associated with the use of a central line. By measuring such infections over time we can quickly identify emerging trends that impact infections and adapt quickly to improve our care and reduce future events.

Central line-associated blood stream infections
Fig 2. 2018-2023 Chart of CLABSI rate oer 1,000 central line days.
 

Continuous Improvement

Information about CLABSI are regularly reviewed by our Infection Prevention and Control staff along with other members of the care team to observe trends that may impact these events. Strategies to prevent CLABSI include using proper techniques for inserting and maintaining the central line and the associated dressings. After the line is inserted, we regularly assess the necessity of each central line and remove them when they are no longer needed to support the patient’s care. Rounding is done to ensure compliance with these strategies, and family representatives are part of our subject matter expert team to help us identify ways to improve continuously.

Collaboration to Improve Safety

Nicklaus Children’s submits our CLABSI data monthly to the Children's Hospitals' Solutions for Patient Safety (SPS) national collaborative. Hospitals from throughout the U.S. are part of this network that tracks hospital-acquired conditions to share best practices regarding patient safety. The purpose of this is to help hospitals learn from their combined experiences so that all can enhance patient safety.

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