Strength in numbers: Utilization of an innovative electronic audit to enhance the completion of central line maintenance audits

Abstract

Healthcare systems use auditing processes to monitor compliance with evidence-based practices. The auditing process for a bundle targeting central line-associated bloodstream infectionprevention at a large children's hospital was suboptimal. The purpose of this project was to implement a revised audit and feedback data collection process. The specific aims of the project were to evaluate(1) the number of completed audits and, (2) central line maintenance bundle compliance rates before and after implementing a new process. An innovative, electronic audit process was developed to allow data entry in real-time as central line-associated bloodstream infection prevention champions conducted audits. Data were fed into a robust electronic dashboard, allowing units to readily visualize their performance. Data was analyzed over a 52-month period (26 months pre- and post-implementation). The number of central line maintenance bundle audits significantly increased post-implementation from an average of 36 to 64 per month, P=.001. Central line maintenance bundle compliance scores also increased from an average compliance score of 76.3% to 89.3%, P=.001. Special cause variation was also noted in the statistical process control charts. This project demonstrated the effectiveness of using an electronic process to capture audit data to assist with quality improvement efforts. Other institutions may consider implementing a similar electronic audit process to capture infection prevention compliance data.