All Entries Tagged With: "HAI"
CAUTIs still a problem
Bit of a plug, but I think my visitors will find HCPro’s webcast on CAUTIs (catheter-associated urinary tract infections) extremely relevant, especially as CAUTIs cause 35% of all hospital-acquired infections every year, with 38,000 patient infections, and costing hospitals $400 million a year, according to an October 2011 National Quality Forum’s Partnership for Patients/ National Priorities Partnership webinar.
And don’t forget that The Joint Commission named CAUTIs a National Patient Safety Goal to be fully implemented by 2013. The Partnership for Patients also aims to reduce preventable CAUTIs by 50% by 2013.
So join nurse practitioner Mikel Gray, PhD, PNP, FNP, CUNP CCCN, FAANP, FAAN, and chief of infection prevention and 2012 APIC conference speaker Brian Koll, MD, FACP, FIDSA, for a live presentation of proven methods on CAUTI reduction, including how Beth Israel Medical Center reduced the number of CAUTIs by 83% using proven organization-wide catheter best practices such as evidence-based practice, staff education, daily need assessments, multidisciplinary teamwork, monitoring, and root-cause analysis. You’ll also get best practices to educate and train your entire staff.
Just a note that now, you can buy the live audio and download the on demand version free.
Bloodstream infections in pediatric ICUs
A Consumers Report study has found that many pediatric ICUs have high rates of bloodstream infections, often higher than adult ICUs—on average, 20% higher.
As you may recall, Josie King, whose unfortunate story has been made famous by her mother who now advocates for better patient safety, had complications after a central-line bloodstream infection.
Hospitals may want to look at the strategy of 2010 Baldrige-award winner Children’s Hospital at Providence in Anchorage, AK. Children’s cut catheter-related bloodstream infections in the neonatal ICU. Though they didn’t focus on central lines, the strategies might be of interest. They resisted the typical “see one, do one, teach one” method and instead implementing standard teaching methods. The hospital also ensured peace and quiet upon insertion by moving the patient into a quiet room during the procedure. Read more about this in Patient Safety Monitor Journal.
Still, there’s a problem a bit more concerning than the infections: a lot of pediatric ICUs aren’t reporting the data publicly, according to the report::
Of the 423 pediatric intensive-care units in the U.S., information on bloodstream infection rates is publicly available for less than half.
The investigation was left to focus on the 92 pediatric intensive-care units in 31 states plus Washington, D.C. that did report rates.
What can be done? What’s missing? Why aren’t we reporting rates? How can hospitals emulate others that have low rates if we can’t identify which ones they are?
Is it time to stop duplicating reporting efforts?
Interesting turn of events this week. The Cleveland Clinic, Henry Ford Hospital in Detroit, and Parkview Health in Fort Wayne, IN, have all ceased to report hospital-acquired infections to the Leapfrog Group, a nonprofit organization in Washington, D.C.
According to Consumer Reports, the three health systems fall in different spots for bloodstream infections—something Consumer Reports previously analyzed. One did better than average, one about average, on under average.
The hospitals’ reason for the end to Leapfrog reporting was that they now report to CMS on the same or similar measures, and must end duplicate efforts to reduce waste of resources.
What do you think? Do you think the private nonprofit reporting group will soon be a thing of the past?
Can a video really help curb infections?
For quite some time now, hospitals have been creating and posting videos to create awareness about proper infection control protocol for patient caregivers (most focus on hand washing or vaccination).
The Association of Peri-operative Nurses (AORN) and 3M had a contest for nurses to submit videos on hand hygiene. The World Health Organization (WHO) posted a video on hand hygiene, and even the Department of Health and Human Services (HHS) had a contest for people to submit a public service announcement video for preventing flu. And of course, hospitals have created videos on their own to help raise awareness and educate.
Videos are fun—they have the power to get staff out of their daily routine, dancing in sterile hospital hallways and awkwardly singing their newly-crafted lyrics over popular hits (think “I’m Gonna Wash My Hands” or “Pump It”). I also assume that while the video is being made, hospital staff are more focused on proper patient safety protocol. But do videos actually make a lasting effect on ensuring staff wash their hands or get vaccinated?
After watching the APIC Infection Prevention Film Festival winner’s video, I think some might. About forty entries were submitted, but the winner takes a less gimmicky approach and “depicts the tragedy and irony of healthcare-associated infections, transforming the statistics into a story of a patient who gets an infection,” according to the APIC press release. In my opinion, the video directly connects the simple–and sometimes annoying–act of hand washing to the safety of the patient, leaving the responsibility square on the shoulders of healthcare professionals. In fact, I would go as far as to say that the fun, light-hearted videos may be downplaying the danger. But that’s just what I think; I’d love to hear what you think of the video posted below. Over dramatic? Right on target? Play movie critic and share your thoughts below.
New CMS final and proposed rules address HACs, transparency
Last week, The Centers for Medicare & Medicaid Services (CMS) issued the final rule on reducing or prohibiting payments to providers for hospital-acquired conditions (HAC). The new rule will better align Medicare and Medicaid payment policy and give states flexibility to add to the federal list of HACs. This rule specifically prohibits states from making payments to providers under the Medicaid program for HACs, using the current list of HACs under the no-payment Medicare rule already in place.
The final rule is effective July 1, 2011 and gives states the option to implement its effective date July 1, 2012.
View the press release and the list of reduce or no-pay HACs.
In other CMS news, a new proposed rule would allow Medicare and private sector claims data to be used to produce public reports that evaluate the performance of physicians, other healthcare providers, and suppliers. Organizations seeking such Medicare information would have to undergo an application process and be continually monitored by CMS.
To prevent mistakes, the proposed rule requires that any reports generated from the Medicare data be shared confidentially with providers and suppliers before being released to the public. Publicly released reports would contain aggregated information only, meaning that no individual patient/beneficiary data.
“Performance reports that include Medicare data will result in higher quality and more cost effective care,” CMS administrator Donald M. Berwick, MD, said in a statement.
For more analysis, visit HealthLeaders Media.
The proposed rule will be published in the Federal Register on June 8, and the CMS will accept public comments for 60 days. Until June 8 the proposed rule is available here.
HHS recognizes hospitals’ patient safety successes
The U.S. Department of Health and Human Services (HHS) recognized 37 hospital and healthcare facilities for their efforts to prevent – and eventually eliminate – healthcare-associated infections (HAIs), a leading cause of death in the United States.
The organizations are the first to be honored as part of a new national awards program to highlight successful and sustained efforts to prevent healthcare-associated infections, specifically infections in critical care settings. This initial set of awards recognizes critical care professionals and healthcare institutions for their efforts to reduce, and eventually eliminate, ventilator-associated pneumonia and bloodstream infections associated with central intravenous lines.
Awards were conferred on two levels, according to specific criteria tied to national standards. The “Outstanding Leadership Award” went to teams and organizations that sustained success in reaching their targets for 25 months or more. The “Sustained Improvement Award” recognizes teams that demonstrated consistent and sustained progress over an 18- to 24-month period.
Organizational issues for prevention of HAIs and the systemic nature of the problem
Healthcare-associated infections are no doubt a focal point of every patient safety professional. This month’s column by Catherine Hinz in Patient Safety Monitor Journal explores how organizations might lower their rates.
The following is an excerpt of a Patient Safety Monitor Journal column that explores patient safety from the perspective of a newcomer to the patient safety field. Columnist Catherine Hinz, MHA, currently works at PatientSafe Solutions, Inc. Previously, she was the patient safety lead at HealthEast Care System in St. Paul, MN, worked for seven years as an ED health unit coordinator, and has completed a patient safety internship with the Agency for Healthcare Research and Quality.
You can’t read anything about patient safety and quality or health reform without running into the topic of healthcare-associated infections (HAI). The issue tops a list of priorities for many health-related government institutions (e.g., Agency for Healthcare Research & Quality, CMS), nonprofit organizations (e.g., IHI, National Patient Safety Foundation), current research and publications, and patient advocacy groups. Popular media has recently been ¬shining a light on the problem as well as the use of tools, such as checklists, as part of the solution for prevention.
Intense process improvement and research efforts in Michigan ICUs have gained a lot of ¬attention for demonstrating significant reductions (and subsequent sustainability of those reductions) of HAIs. The work of Peter Pronovost, Atul Gawande, and others is quickly gaining traction. One of the troubling aspects of HAIs is the systemic nature of how they occur, the complex contributing factors, and the organizational issues of detecting and preventing them (not to mention their breadth of type and severity). HAIs are a problem wrought with cost and reimbursement pressures, challenges in allocating organizational resources, and care team performance factors.
To read Catherine’s full column on HAIs, see the May issue of Patient Safety Monitor Journal (a part of your Patient Safety Monitor subscription for those blog readers out there who are also subscribers.)
CMS to invest $1 billion toward patient safety initiative
Health and Human Services Secretary Kathleen Sebelius, and Centers for Medicare & Medicaid Services (CMS) Administrator Donald Berwick, MD, along with other leaders in the healthcare and patient safety field announced today that the government will invest up to $1 billion toward Partnership for Patients, a new initiative that aims to reduce hospital-acquired conditions (HAC) by 40% and hospital readmissions by 20% by 2013.
The funding would be made available under the Affordable Care Act. More than 500 hospitals, as well as physician and nurses groups, consumer groups, and employers have pledged commitment to the initiative. The CMS Innovation Center will help hospitals adapt evidence-based care to prevent HACs and test different methods of improving care.
“We will provide hospitals with incentives to improve the quality of health care, and provide real assistance to medical professionals and hospitals to support their efforts to reduce harm,” said Berwick in an HHS press release.
Kentucky hospitals may soon be reporting HAIs to the state
In the United States, 27 states require state-level reporting of hospital-acquired infections (HAIs), but not Kentucky.
Senate Bill 72 was filed mid-January before the state legislature. If passed, all Kentucky hospitals will be required to report all HAIs to the state Cabinet and Health and Family Services and execute infection prevention programs beginning July 1, 2012, reported WPSD of Paducah, KY.
Kentucky’s hospitals oppose the bill, saying there is already a similar requirement by the federal government, and having another one would be oppressive and costly.
However, Sen. Denise Harper Angel (D-Louisville) agrees with the bill. She tells WPSD that the number of infections contracted during hospital stays is high, and something needs to be done to improve patient safety while saving money for patients and healthcare systems. Close to 1,400 deaths a year in Kentucky could be the result of HAIs, according to WPSD.
If the bill passes, facilities that fail to report HAIs could face a fine of up to $20,000 depending on the violations.
C. diff in children on the rise, guidelines for MRSA, and what’s up your nose
There’s been quite a bit of infection control news out there, so here’s a summary:
From 1997 to 2006, the number of children with Clostridium difficile (C. diff) rose about 15% each year, according to a new study published in the Archives of Pediatrics and Adolescent Medicine. According to The Los Angeles Times, these pediatric patients had longer hospitalizations, higher death rates, and more surgeries to remove portions of colon compared to patients who did not contract the disease.
In other infection control news, the Infectious Diseases Society of America (IDSA) has published guidelines to treat methicillin-resistant Staphylococcus aureus (MRSA). These are the first guidelines IDSA has issued for treating the multi-drug resistant organism. The guidelines include personal hygiene, wound care, and antibiotic therapy. They are published in the February 1 issue of Clinical Infections Diseases and have been endorsed by Pediatric Infectious Diseases Society, the American College of Emergency Physicians, and the American Academy of Pediatrics.
If you’re wondering how to find MRSA in patients, and to what severity they are infected, a new study at Rhode Island Hospital found that you might want to check your patient’s nose first. MRSA was more likely to be found in the nose than under the arms, the groin, or the perineum, reports HealthDay News. People with high levels of MRSA in the nose were also more likely to have MRSA in three other locations on the body.
