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Published: Friday, 7/8/2011

Hospitals cutting infections

Issues from central-line catheters have dropped

BY JULIE M. McKINNON
BLADE STAFF WRITER

The approach is simple: Prevent patients from getting potentially deadly bloodstream infections from central-line catheters by keeping conditions clean and continually assessing whether they are necessary.

Community Hospitals and Wellness Centers in Bryan learned about the common-sense process developed by Dr. Peter Pronovost of Johns Hopkins University Quality and Safety Research Group and decided to follow it. The hospital has not had a patient acquire a central-line bloodstream infection since November, 2009.

"It's not rocket science," said Phil Ennen, Community Hospitals president and chief executive. "You don't have to have the resources of a giant research hospital to make this happen."

He added: "You just have to keep everything clean."

Community Hospitals is among about 1,100 hospitals nationwide that have joined an effort to lower central line-associated bloodstream infections. A central-line catheter is inserted into a large vein and threaded until it nears the heart, often to give medications.

Quality and safety are top priorities for hospitals, and with Medicare and other insurers halting payments for hospital-acquired conditions, many are focusing on such problem areas. It can cost $84,000 to treat each bloodstream infection associated with a central-line catheter, and up to 30 percent of cases are fatal, according to the Ohio Hospital Association.

Statewide, about 50 hospitals are involved with the two-year project led by the Health Research & Educational Trust, an affiliate of the American Hospital Association. The participating Ohio hospitals have reduced the rate of central-line bloodstream infections by more than a third, from 3.43 per 10,000 patient days to 2.2 per 10,000 patient days, according to the Ohio Hospital Association.

Other northwest Ohio hospitals involved in the effort include Toledo Hospital, Bay Park Community Hospital in Oregon, Flower Hospital in Sylvania, Regency Hospital of Toledo, Blanchard Valley Hospital in Findlay, and Fisher-Titus Medical Center in Norwalk.

At Community Hospitals, caregivers first question whether a central-line catheter really is needed, Mr. Ennen said. If so, then they continue to assess how long one needs to be in place, he said.

The project's checklist allows anyone to stop the insertion of a central-line catheter if there is a breach in the sterile technique, as well as give preferred insertion sites, the protocol for changing dressings, proper cleaning for the line and components, and other steps.

Bay Park has cut the number of central-line bloodstream infection cases in half since joining the project in 2009. The hospital's rate was below 2 per 10,000 patient days, but there is always room for improvement, said Heidi Shank, director of critical care at Bay Park.

"We didn't want those numbers to slide," Ms. Shank said. "If we can reduce one infection, we would consider it a success."

The hospital had a checklist to help prevent bloodstream infections from central-line catheters before joining the project, and now the compliance rate among staff has jumped to 95 percent, Ms. Shank said. The effort has blossomed so that staff also is looking at safety in other areas too, she said.

Contact Julie M. McKinnon at: jmckinnon@theblade.com or 419-724-6087.



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