I-Care
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What is the I-Care Program?
In recent years, a large number of interventions have been developed to prevent healthcare associated intravascular device-related bloodstream infections. The CHRISP I-Care Project consolidated these interventions into one Standard and six Protocols, for the six main types of intravascular devices (IVD). The Standard and Protocols are specifically tailored for the Queensland Health environment. The purpose of the Standard and six Protocols is to provide evidence-based support to healthcare professionals related to the insertion and management of six intravascular devices.
The I-Care standard and protocols were developed by critically appraising the literature including existing guidelines. Not included in the I-Care Standard and Protocols is information associated with the insertion and management of arterial, pulmonary artery and intraosseous catheters or pressure monitoring devices.
By using the acronym I-Care we are reinforcing the key steps healthcare professionals need to take to prevent intravascular device-related bloodstream infections that is - cleaning their hands, using alcoholic chlorhexidine to prepare the insertion site, using single use 70% alcohol swabs to clean injection ports before accessing, reviewing the need for the IVD on a daily basis and removing it when no longer required, and educating everyone about I-Care.
Why is it important?
On 1 July 2011 the Australian Commission on Safety and Quality in Health Care (ACSQHC) commenced as an independent statutory authority under the National Health and Hospitals Network Act 2011. The ACSQHC commissioned the Australian Institute of Health and Welfare to develop a set of safety and quality indicators that reflected the direction of the ACSQHC's Information Strategy.
Subsequently, the ACSQHC introduced mandatory reporting of healthcare associated Staphylococcus aureus blood stream infections. Currently, only infections associated with care provided by acute care public hospitals are required to be monitored and reported by jurisdictions for inclusion in the National Health Care Agreements reporting system.
A key clinical indicator for the ACSQHC and the Australian Council on Healthcare Standards EQuIP5 are Central-Line Associated Bloodstream Infections (CLABSIs) within Intensive Care Units. Therefore, it is necessary that Queensland Health provide evidence based resources focusing on the important role that appropriate intravascular device (IVD) management plays within healthcare facilities.
How to use the I-Care Resources
The Standard and six Protocols of I-Care provide clinicians with resources for the support of evidence-based practice in relation to the prevention of healthcare associated IVD-related BSIs. The Standard and six Protocols shall be reviewed and applied by the facility or practice setting. Healthcare professionals responsible for leading and facilitating practice change will find the I-Care standard and protocols valuable for the development of educational programs, assessments and documentation tools related to IVD management.
How to implement the I-Care Standard & Protocols
- Assess current healthcare practices using the I-CARE Standard and Protocols
- Identify needs or gaps in practices and services
- Systematically develop a plan to implement the Standard and six Protocols using I-CARE associated resources such as the implementation checklist
How to sustain I-Care
In order to ensure sustainability of I-Care a sustainability plan outlining roles and responsibilities has been developed which can be customised for each facility. CHRISP is committed to supporting strategies that minimise or prevent healthcare associated infections, and intravascular device-related bloodstream infection surveillance and analysis will form one of the core components of an Infection Control Management Plan.
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