The Surgical Care and Outcomes Assessment Program (SCOAP) is a physician-led, voluntary collaborative effort of the Washington Foundation for Healthcare Quality. The goal of SCOAP is to improve quality by reducing variation in process of care and outcomes at participating facilities. In addition to defining quality measures most relevant for surgical patients and working to make surgical care more cost effective within hospitals, standardized order sets and checklists are used to create active change in clinical care.
The SCOAP checklist for Inpatient Surgical Safety, adapted from the WHO "Safe Surgery Saves Lives" campaign, includes evidence-based clinical and process measures that are known to improve safety for surgical patients in the inpatient/hospital setting. Likewise, the SCOAP checklist for Ambulatory Care (draft) includes measures that are known to improve safety for those patients having surgery in an ambulatory care/outpatient setting.
Central Line Associated BloodStream Infection (CLABSI) – Central Line Bundle
In the past, the National Nosocomial Surveillance System at the Centers for Disease Control defined catheter lines and central line bloodstream infections. This program has been replaced by the National Healthcare Safety Network (NHSN). They have defined a central line as a catheter whose tip terminates in a great vessel (large blood vessel). One of the ways to reduce or prevent CLABSI is to use the central line bundle, which consists of five care components. These are:
- Hand hygiene
- Maximal barrier precautions
- Chlorhexidine skin antisepsis
- Optimal catheter site selection, with avoidance of using the femoral vein for central venous access in adult patients
- Daily review of line necessity, with prompt removal of unnecessary lines
The “How to Guide: Preventing Central Line Infections” (5 Million Lives Campaign. Getting Started Kit: Prevent Central Line Infections How-to Guide. Cambridge, MA: Institute for Healthcare Improvement; 2008. Retrieved April 11, 2011 from www.ihi.org) describes practical steps for implementing a central line bundle. With permission from Virginia Mason Medical Center in Seattle, WA., we have also included a central line bundle checklist for your use in practice.
