Identifying best practices in electronic health record documentation to support interprofessional communication for the prevention of central line–associated bloodstream infections

• Published in: American journal of infection control 2020-02, Vol.48 (2), p.124-131
• Main Authors: Thate, Jennifer, Rossetti, Sarah Collins, McDermott-Levy, Ruth, Moriarty, Helene
• Format: Article
• Language: English
• Subjects: Adult; Catheter-Related Infections - prevention & control; Catheterization, Central Venous - adverse effects; Central Venous Catheters - adverse effects; CLABSI; Communication; Cross Infection - prevention & control; Delphi technique; Electronic Health Records; Female; Health Planning Guidelines; Humans; Infection control; Infection Control - methods; Informatics; Male; Middle Aged
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2019.07.027

•An expert panel identified 12 information types for CVC management decisions.•For each information type, agreement was reached on best communication channel.•For 10 of the 12 information types an EHR documentation channel was selected.•For 2 information types a preference for oral communication was demonstrated.•Findings reflect best practices for how the EHR ought to support CVC management. There is a paucity of research on best practices for communication through the electronic health record (EHR) to support shared decision-making and to prevent adverse events. To explore this issue, this study focused on interprofessional communication around a specific clinical issue, the prevention of central line–associated bloodstream infections. The Delphi technique was used to describe what information is needed to support decisions regarding central venous catheter (CVC) management, and best practices for communicating this information among the interprofessional team. The expert panel, 4 physicians and 6 nurses, identified 12 information types necessary for decisions regarding CVC management and the removal of unnecessary lines. For each of the 12 information types, the panel reached agreement regarding the best channel to communicate this information, including asynchronous EHR formats and synchronous oral channels. Findings address 2 important aspects of postinsertion CVC practices and a gap in the literature by moving beyond a description of current practices to a description of how the EHR ought to be used to support collaboration and interprofessional communication. Future research should examine how the communication practices identified in this study contribute to a reduction in central line–associated bloodstream infections.