Featured Research

from universities, journals, and other organizations

Road Map For Elimination Of Central Line-associated Bloodstream Infections

Date:
March 27, 2009
Source:
University of Pennsylvania School of Medicine
Summary:
Central line-associated bloodstream infections fell by more than 90 percent during the past three years at the Hospital of the University of Pennsylvania due to a novel, multi-pronged approach.

Central line-associated bloodstream infections (CLABSI) fell by more than 90 percent during the past three years at the Hospital of the University of Pennsylvania due to a multi-pronged approach combining leadership initiatives, electronic infection surveillance, checklists to guide line insertion and maintenance, and implementation of the Toyota Production System to encourage best practices in line care.

The findings, which Penn physicians say provide a road map for cutting the deadly, costly toll of hospital-acquired infections nationwide, will be presented on Friday, March 20 at the 19th Annual Meeting of the Society for Healthcare Epidemiology of America (SHEA).

"We were only able to see a sustained reduction in infections when we took a multifaceted approach throughout the entire hospital. There are many procedures, many steps and many personnel that are involved in the placement, care and maintenance of central venous catheters. We have learned that a successful program to reduce CLABSI must take all of these factors into consideration," says Neil Fishman, MD, director of Healthcare Epidemiology and Infection Prevention and Control at the 735 bed Philadelphia hospital and president-elect of SHEA. "Central line-associated bloodstream infections can add up to $40,000 to the cost of a hospitalization and take their toll in human lives. The mortality rate of CLABSI has been reported as high as 30 percent. Our program ultimately makes the hospital a safer place to receive medical care."

Previous studies on CLABSI reduction efforts have focused only on intensive care units. But since the majority of CLABSI cases occur on other hospital floors that care for acutely ill, high-risk patients who require the long-term venous access for delivery of IV medications or nutrition, the Penn investigators sought to identify ways to eliminate all preventable infections of this kind. When the campaign began, in the fall of 2005, more than 30 patients with central lines developed bloodstream infections in the hospital each month. Over time, however, a series of process, technology and equipment improvements has cut the number of infections to less than five each month. Only one case was reported in February of 2009.

Key early components of the effort called for strict adherence to hand hygiene, chlorhexidine to clean the skin prior to procedures, and sterile techniques during line insertion, access and dressing changes. Checklists helped prompt staff adherence to the guidelines. New technology to improve management of catheter insertion sites also played an important role in battling the infections. When the authors identified problems with the handling of the line dressings – they were poorly placed or falling off, leaving room for bacteria to enter the line – they introduced a more adherent bandage and began using a new chlorhexidine (CHG) sponge. The sponge contains an antiseptic that can kill bacteria before they gain access to the bloodstream.

When the staff learned that a special cap that had been used to keep blood from clotting inside the lines was associated with increased bloodstream infections, its use was eliminated, leading to another drop in CLABSI rates.

The University of Pennsylvania Health System also began using an electronic surveillance program, TheraDocฎ, at a cost of more than $1 million, to help quash infections. This state-of-the-art-system allows hospital unit leadership teams to monitor hospital-acquired infection data in real time, and to rapidly identify problems and trends and intervene to stop them. Fishman believes that ready access to this data along with a hospital administration that understands the importance of preventing these infections and provides the resources to do so are the cornerstones of fighting healthcare-associated infections. He notes that the hospital system has used this model to attack other hospital-acquired infections such as ventilator-associated pneumonias and catheter-associated urinary tract infections.

More recently, several HUP units implemented the Toyota Production System, which applies processes honed in the auto manufacturing industry to reduce variation in practice and to streamline and improve hospital care. The hospital has also begun an active central line surveillance program to help identify problems that could result in a bloodstream infection and take action before an infection develops.

"Our goal is to provide the very best care for our patients," says Patrick J. Brennan, MD, chief medical officer and senior vice president for the University of Pennsylvania Health System, "and we will not rest until we eliminate bloodstream infections from our hospitals."


Story Source:

The above story is based on materials provided by University of Pennsylvania School of Medicine. Note: Materials may be edited for content and length.


Cite This Page:

University of Pennsylvania School of Medicine. "Road Map For Elimination Of Central Line-associated Bloodstream Infections." ScienceDaily. ScienceDaily, 27 March 2009. <www.sciencedaily.com/releases/2009/03/090321103805.htm>.
University of Pennsylvania School of Medicine. (2009, March 27). Road Map For Elimination Of Central Line-associated Bloodstream Infections. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2009/03/090321103805.htm
University of Pennsylvania School of Medicine. "Road Map For Elimination Of Central Line-associated Bloodstream Infections." ScienceDaily. www.sciencedaily.com/releases/2009/03/090321103805.htm (accessed September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Snack Attack: Study Says Action Movies Make You Snack More

Snack Attack: Study Says Action Movies Make You Snack More

Newsy (Sep. 2, 2014) — You're more likely to gain weight while watching action flicks than you are watching other types of programming, says a new study published in JAMA. Video provided by Newsy
Powered by NewsLook.com
U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) — The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Doctors Fear They're Losing Battle Against Ebola

Doctors Fear They're Losing Battle Against Ebola

AP (Sep. 2, 2014) — As a third American missionary is confirmed to have contracted Ebola in Liberia, doctors on the ground in West Africa fear they're losing the battle against the outbreak. (Sept. 2) Video provided by AP
Powered by NewsLook.com
Tech Giants Bet on 3D Headsets for Gaming, Healthcare

Tech Giants Bet on 3D Headsets for Gaming, Healthcare

AFP (Sep. 2, 2014) — When Facebook acquired the virtual reality hardware developer Oculus VR in March for $2 billion, CEO Mark Zuckerberg hailed the firm's technology as "a new communication platform." Duration: 02:24 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins