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
Central venous catheters (CVC) are essential for treating children with cancer. They reduce the need for multiple needlesticks and the associated pain and anxiety. In addition, they can be used to deliver chemotherapy, parenteral fluids, blood products and analgesics. Despite the positives, children with CVCs are at increased risk for bloodstream infections. Complications associated with CVCs include pneumothorax, air embolism, nerve injury, catheter malposition, infection and occlusion.
A recent study had four objectives:
1. To decrease CVC-related bloodstream infection rates in children with cancer through a comprehensive educational intervention.
2. To determine if the frequency of catheter hub colonization of CVCs in children with cancer would decrease following the educational intervention.
3. To evaluate nurses' knowledge of CVC care.
4. To determine risk factors influencing CVC-related bloodstream infections in children with cancer.
The study was conducted in the cancer center of a large children's hospital and included patients ranging in age from infancy to 18 years. A 45 minute educational program on CDC guidelines, most frequent guideline violations and information on catheter-related infections was presented to all caregivers. Following the educational presentation, catheter-related bloodstream infections were tracked for six months in order to determine the rate of infection. Study findings showed that the educational program increased nurses' knowledge and instances of catheter-related bloodstream infections decreased. You can read the full article in the March 2009 issue of Oncology Nursing Forum or purchase it online here.
Photo Credit: Gulf Coast Regional Blood Center
Each year hospital-acquired infections sicken 1.7 million patients and kill another 99,000. To improve these statistics, hospital staff members across the country are taking action. At Pacific Hospital in Long Beach, California, only dangerous bacteria are targeted. Hospital staff feed patients yogurt to keep digestive bacteria balanced, bathe patients with soap designed to maintain skin's natural pH and use antibiotics only when necessary.
Another bright spot in the infection control fight is the checklist designed by Dr. Peter Pronovost from Johns Hopkins University and Hospitals. Pronovost's checklist protocol is aimed at reducing infections when inserting a central venous catheter. According to his checklist doctors should:
- Wash their hands with soap
- Clean the patient's skin with chlorhexidine antiseptic
- Put sterile drapes over the entire patient
- Wear a sterile mask, hat, gown and gloves
- Put a sterile dressing over the catheter site
In Michigan, more than 1,700 lives and $246 million were saved in the first three years the checklist was adopted, according to the state hospital association. Other hospitals across the United States, the United Kingdom, Spain and Peru are adopting the checklist. To read more about how hospitals are preventing infection, click here.
Photo Credit: @rild
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.
A study published in the March 25, 2009 edition of the Journal of the American Medical Association showed use of a chlorhexidine gluconate (CHG) impregnated sponge in intravascular catheter dressings reduced rates of catheter-related infections (Read study abstract
here.)
The Biopatch* protective disk with CHG is designed to continually release CHG allowing for unsoiled adherent dressing changes to increase from every three days to every seven days.
The Biopatch is available in
Navilyst Medical PICC Convenience Kits. To learn more, click
here.
*Biopatch is a registered trademark of Ethicon.