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.
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A hospital in Scotland has introduced a nurse-led vascular access service to reduce waiting times for patients needing long term venous access for treatments including chemotherapy, long-term antibiotics and renal dialysis. The nurses who are part of the service insert central venous catheters and are also responsible for the training and education of other healthcare professionals. Since implementation of the service the hospital has seen a reduction in complications. For more information on the service and the process the hospital followed to implement it, click here.
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Certain illnesses and conditions require patients to have frequent blood draws or multiple infusions of medication. In these cases, a central line is often the recommended course of action. Peripherally inserted central catheters (PICCs) and ports are two types of central lines. Read more about PICCs and ports and some risks and benefits here.
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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.
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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.
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Hokkey