Safety is in the details
Safety in the ICU

Infections in the ICU, Part 2

June 09, 2015

 

In Part One of this series, we highlighted “Designing a Hospital to Better Fight Infection,” a Wall Street Journal article that profiled a Chicago hospital study designed to better understand the factors that influence bacterial population development in healthcare environments. The study is mapping “where hospital germs linger and what causes them to take root.”

 

Along similar lines, a USA Today article we profiled, titled “Deadly bacteria on medical scopes trigger infections,” revealed how a pattern of hospital illnesses linked to bacteria called carbapenem-resistant Enterobacteriaceae (CRE) has become a significant concern at several US hospitals, resulting in several deaths.

 

As promised, here in Part Two of this three-part series, we’d like to focus on another device-assisted infection: central-line associated bloodstream infections (CLABSIs). As we briefly mentioned last time, according to InfectionControlDaily.com, healthcare institutions spend an estimated $9.8 billion every year treating the assortment of healthcare-associated infections (HAIs) that currently exist. CLABSIs are included in the group that falls into the top five most expensive HAIs to deal with.

 

As InfectionControlDaily points out, ventilator-associated pneumonia (VAP) and CLABSIs combine to make up $3.3 billion and $3.1 billion, respectively, of the aforementioned $9.8 billion.  

 

While these numbers are alarming, the good news is that progress is being made, thanks to the intense focus and efforts on the part of hospitals across the country to deal with the problem. The article quotes infection prevention consultant Kelley Boston as saying: “We’ve nearly cut CLABSI rates in half.”

 

The key to prevention for CLABSIs is through, as the Healthcare Infection Control Practices Advisory Committee of the CDC has stated in its Guidelines for the Prevention of Intravascular Catheter-Related Infections, proper insertion techniques and the management of the central line.

 

Case in point: the April edition of HealthCanal.com reported on a study conducted by researchers at Johns Hopkins that utilized these techniques to significantly reduce bloodstream infections in several Abu Dhabi hospitals (proving also that this is not a problem solely affecting US providers). Through a mix of evidence-based infection-prevention practices, safety culture and teamwork, researchers were able to achieve “an overall 38 percent reduction” in these types of infections, with the number of ICUs achieving a quarterly CLABSI rate of less than one infection per 1,000 catheter days increasing by nearly 40 percent.

 

“Our results suggest that ICUs in disparate settings around the world could use this program and achieve similar results, significantly reducing the global morbidity, mortality and excess costs associated with CLABSIs,” the article quotes the study’s lead author Asad Latif as saying. “In addition, this collaborative could serve as a model for future efforts to reduce other types of preventable medical harms around the world.”

 

These infections have rightly caused concern among US healthcare officials and hospital leaders across the globe. As the results outlined above reveal, progress is being made thanks to the implementation of sound prevention strategies and techniques. We’ll take a look at some of those techniques more closely in future blogs. In the upcoming, final installment of this series, we’ll take a look at catheter-related bloodstream infections (CRBSIs), and the toll these deadly and costly infections are taking on healthcare.

 

See you next time.

Ilana Engel-Regev, MD

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