The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

COMMON CANNISTER PROCESS FOR DELIVERING AEROSOL MEDICATIONS: THE FINAL STEPS TO ASSURE PATIENT SAFETY

H. D. Mantz1, Linda Radke2, Jeanine Gunn3; 1Respiratory Care, Salina Regional Health Center, Salina, KS; 2Department of Pharmacy, Salina Regional Health Center, Salina, KS; 3Infection Control Department, Salina Regional Health Center, Salina, KS

BACKGROUND: Financial savings, improved staffing efficiency and prevention of cross contamination (utilizing appropriate infection control methods) of the Common Canister (CC) process for delivering aerosol medications have been established and published 1, 2. Also well defined is the variable compliance of clinical staff members with infection control methods, even as simple as performing proper hand hygiene 3. OBJECTIVE: To assure that our CC protocol is safe for our patients; our staff remains compliant with the infection prevention process defined in our protocol and to confirm cost savings in our institution. METHODS: We developed a protocol that assured the hands of the respiratory therapist (RT) did not contaminate the patient’s Valved Holding Chamber (VHC) or other surfaces. The protocol is specific to the point of outlining which hand to use to pick up each item involved in the process. We implemented CC in July 2008. Utilizing a multidisciplinary approach, we provided specific training, periodic validation of competence, unannounced observation of aerosol medication administration and patient interviews to identify the techniques used by the RT. We validated our protocol utilizing a florescent dye and black light to show if there was contamination during a mock CC process. Infection rates pre and post implementation of CC were followed by our Infection Control team using standard methods. MRSA rates were used to confirm that cross-contaminating was not occurring between isolated patients and patients receiving CC. Our departmental compliance is managed by making expectations clear and promoting staff accountability. Non-compliance is identified and the disciplinary process is utilized as needed. RESULTS: Our protocol proved to be valid. Since July 2008 we have delivered over 9,000 CC aerosol medication treatments while maintaining our hospital MRSA infection rate at 0.298% compared to the national average of 2.0% 4. For the most recent quarter in FY 2009, we had a zero infection rate for MRSA infections. We confirmed average cost savings to be near 30% and saw substantial time savings over standard nebulizer therapy after implementation of the CC process. CONCLUSION: CC delivery does provide cost-saving, efficient, effective and safe aerosol medication delivery with our proven protocol and methods to assure staff compliance. Sponsored Research - None

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