| Description |
Traditional strategies to mitigate central line-associated bloodstream infections (CLABSIs) in intensive care units (ICUs) often involve retrospective chart audits, self-audits, or staff re-education through e-learning and skills days. This quality improvement project explored the feasibility of using Kamishibai cards (K cards), an innovative tool that provides immediate feedback and education to nursing staff, enhancing compliance with evidence-based protocol. Methods: A qualitative approach was employed to assess the practicality of K card implementation in a large urban hospital with high CLABSI rates. Survey data from 23 ICU leaders examined their existing knowledge and perceptions of K cards. Collaboration with the Medical ICU led to the development of a unit-specific K card prototype. Over a four-week pilot, 30 K card audits were conducted to observe staff adherence to CLABSI bundle protocol, identify trends, address knowledge gaps, and provide recommendations to leadership staff. Results: K card interactions highlighted key areas for improvement in bundle protocols. While there was 100% compliance with timely dressing changes, gaps in knowledge were observed regarding chlorhexidine gluconate (CHG) drying time, the proper duration for insertion site cleaning, and the appropriate use of clean gloves instead of sanitizing existing gloves. Compliance with daily CHG bathing was 90%, indicating room for improvement. Although the short duration of the project limited the assessment of long-term impacts on CLABSI rates, the K card audits provided valuable insights into staff practices and educational needs. Conclusions: K cards are a highly practical and evidence-based tool for promoting adherence to CLABSI prevention protocols. Their simplicity, adaptability, and easy integration into routine workflows make them a sustainable solution for long-term compliance. They also offer potential for broader applications, such as patient falls and catheter-associated urinary tract infection prevention. Continued use of K cards is recommended to maintain improvements in clinical practice, but additional research would help clarify guidelines for implementation. |
