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Instructor’s Guide – Putting Safety on the Line
Overview:
This story is about the importance of following protocols, particularly those pertaining to central venous catheters (CVCs). Prevention of CLABSI is mandated by legislation. Therefore, it is every team member’s responsibility to speak up when procedures are incorrectly performed.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- List the five best practice components of the central line bundle for prevention of CLABSI.
- Describe how to apply a central line bundle to prevent CLABSI.
- Explain the importance of identifying and communicating deviations from CLABSI preventative best practices to team members using assertive language.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
Reflection Questions:
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- What are the five best practice components of the central line bundle for prevention of CLABSI?
A: Hand Hygiene, apply a sterile drape, allow the chlorhexidine to dry, use antimicrobial catheters, and disinfect hubs, connectors and injection ports.
- What can we do to ensure that a central line bundle is applied to all patients with central lines?
A: One way is to apply a copy of the bundle to the front of each patient chart that is receiving a central line. Another way is to encourage all staff to use open communication when assisting or inserting a central line.
- What can you do to ‘stop the line’ if central line bundle protocols are not followed by any member of the team?
A: One way is to address the person in charge of the procedure and to note if there is a break in the protocol.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: The patient needs to be the focus of care. In this instance Corrie was looking out for the patient. She addressed her concerns with the doctor and it resulted in a positive response. Patient safety was the top priority.
- What do you think Corrie did well in this story? Why?
A: Corrie demonstrated assertiveness when she addressed Dr. Winters when he had not waited to allow the chlorhexidine to dry completely before continuing with the procedure. She stood her ground and ensured the patient’s safety was a priority.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Make a poster to remind your colleagues of the five best practice components of the central line bundle for prevention of CLABSI.
- Create a step-by-step presentation describing how to apply a central line bundle to prevent CLABSI.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| List the five best practice components of the central line bundle for prevention of CLABSI. |
Student struggles to list the five best practice components of the central line bundle for prevention of CLABSI. |
Student can list some of the five best practice components of the central line bundle for prevention of CLABSI, but needs more practice. |
Student can accurately list the five best practice components of the central line bundle for prevention of CLABSI. |
| Describe how to apply a central line bundle to prevent CLABSI. |
Student struggles to describe how to apply a central line bundle to prevent CLABSI. |
Student can describe how to apply a central line bundle to prevent CLABSI, but needs more practice. |
Student can accurately describe how to apply a central line bundle to prevent CLABSI. |
| Explain the importance of identifying and communicating deviations from CLABSI preventative best practices to team members using assertive language. |
Student struggles to explain the importance of identifying and communicating deviations from CLABSI preventative best practices to team members using assertive language. |
Student can explain the importance of identifying and communicating deviations from CLABSI preventative best practices to team members using assertive language, but needs further practice. |
Student can accurately explain the importance of identifying and communicating deviations from CLABSI preventative best practices to team members using assertive language. |
Additional Story-Specific Resources:
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- Advocacy and Assertion
- Briefs
- Collaboration
- Cross Monitoring
- CUS
- Debriefs
- DESC Script
- Feedback
- Huddles
- STEP
- Task Assistance
- Two-Challenge Rule
- “Speak Up”
- 3Ws – Who I am, What I am Doing, and Why I Care
