In August 2024, Recuperative Skills Nurse Susane Tiu, BSN, RN, Staff Nurse IV, noticed a pattern she knew the care team could improve: patients arriving from the Emergency Department with peripheral IV phlebitis. Instead of viewing the issue as an unavoidable challenge, Tiu saw an opportunity to strengthen care. She observed recurring factors such as site irritation, frequent dressing changes, inconsistent antimicrobial disc use, and scattered supply availability. Through careful bedside assessment, she identified a key contributor — many IVs arrived from the ED without antimicrobial disc protection, a preventable gap in practice.
When early peer engagement proved limited, Tiu continued her work independently, gathering data and mapping inconsistencies across workflows. Her central question—whether embedding antimicrobial protection inside the IV dressing could simplify care and improve patient outcomes—opened the door to an innovative solution.
What began as one nurse’s curiosity quickly evolved into a systemwide improvement effort. Tiu partnered with ICU Director Charity Shelton, DNP, RN; ED Director Sara Figueroa, MSN, RN; Nurse Manager Rozanne Sherlock, BSN, RN; and Regional Supply Chain Representative Francisco Tijero. Together, the team evaluated IV dressings with integrated chlorhexidine gluconate (CHG), exploring how a single, standardized product could reduce phlebitis, streamline supply use, and eliminate the need for separate antimicrobial discs.
Frontline nurses across the ED, ICU, and Medical-Surgical units became active collaborators, participating in hands‑on trials and education sessions. Their feedback directly shaped the final supply kit configuration—an example of how practical bedside insight can lead to thoughtful, scalable redesign.
The results were both local and far‑reaching. Vallejo successfully transitioned 100% of inpatient units to the new CHG dressings by August 2025. The work also reinforced a culture of continuous learning, with subsequent quality huddles identifying additional CLABSI prevention opportunities, including advances within hemodialysis nursing.
Most notably, a solution sparked at the bedside extended beyond a single hospital. Vallejo’s work helped inform regional supply decisions, influencing practice across multiple Kaiser Permanente Northern California facilities.
Reflecting on the experience, Tiu shared, “It felt empowering to know that a concern from the bedside could change what’s in our kits hospital-wide.” She later learned that her efforts ultimately shaped practice across the entire Northern California region.