Hospitals in Michigan lowered the rate of bloodstream infections in their patients by following a five-step checklist. The study published in the
New England Journal of Medicine found that implementing the checklist reduced the rate of bloodstream infections related to catheter use by 66%. Despite this success, utilization of the checklist remains limited. The checklist itself isn't complicated:
- Wash hands
- Clean patient's skin with chlorohexidine
- Wear protective cap and gown and use a surgical drape during the procedure
- Avoid catheter insertion through the groin if possible
- Remove unnecessary catheters
Peter Pronovost, the patient-safety expert who led the study, spoke with The Wall Street Journal to share insights on why more hospitals haven't benefited from using the checklist. To read excerpts from his interview, click here.
Photo Credit: Adesigna
A study published in the May 29 Online First issue of Critical Care found that evidence-based catheter-
care procedures regarding hand hygiene may significantly reduce the rate of catheter-related bloodstream infections (CRBSIs).
A total of 499 patients with 6,200 catheter days were studied in the baseline period and 500 patients with 7,279 catheter days were studied in the intervention period. A total of 3.9 CRBSIs per 1,000 catheter days in the baseline period decreased to 1.1 per 1,000 catheter days in the intervention phase.
To read more specifics on the study, click here.
According to the Centers for Disease Control and Prevention, from 1997-2005 MRSA (methicillin-resistant Staphylococcus aureus) central line associated bloodstream infections declined by 50 percent in intensive care units except pediatric units where rates of incidence remained the same.
The specific cause of the decline is unknown but CDC researchers acknowledge that numerous steps have been taken to improve the safety of catheter insertion and care. Successful hospitals are utilizing a collaborative approach forming teams including medical directors, nurse managers, infection control and others involved in central line placement, access and maintenance. These teams are responsible for creating protocols and processes as well as making recommendations for implementation.
One step hospitals have taken to help eliminate infections is utilization of prepackaged kits for catheter insertion. For more information on other strategies for infection prevention, continue reading here.
Photo Credit: Interplast
A safety initiative to reduce bloodstream infections in intensive
care units was implemented in 30 states this past February. The program could save an estimated $3 billion dollars and 30,000 lives on an annual basis. The program has also been launched globally in Spain and the United Kingdom.
"We ran this program in 77 hospitals and 103 intensive care units in Michigan for 18 months, and infection rates dropped 66 percent," said Peter Pronovost, M.D., Ph.D., director of the Johns Hopkins Quality and Safety Research Group (QRSG) in a press release. "As a result, $200 million and an estimated 2,000 lives were saved. I'm confident we'll see a similar result nationwide."
The program is based on a checklist containing five important steps that should be followed when placing a central line catheter. These catheters are typically used for patients in the Intensive Care Unit to administer fluids or medications, obtain blood and directly take measurements such as central venous blood pressure. For more information on the study, read the press release
here.
Photo Credit:
Hokkey