Safety is in the details
Safety in the ICU

Patient Safety in the ICU

march 1, 2018

 

Patient safety has become a major concern in the healthcare industry. To raise awareness for patient safety, the World Health Organisation (WHO) celebrates Patient Safety Day on December 9th every year. WHO estimates that 1 in every ten patients admitted to the hospital in developed countries is harmed due to various conditions and occurrences within the hospital [1]. Patient safety is even more crucial in patients admitted to high pressure departments, such as the intensive care unit.


Blood Loss and Infections due to Blood Sampling Impair Patient safety in the ICU


A specific concern for patient safety in the ICU is related to blood loss and infections associated with blood sampling. These issues are a major concern in the ICU because taking blood samples is a standard and often procedure in ICU treatment. Blood loss and catheter related infections can aggravate the ill health of patients and can complicate their overall condition, which in turn can delay their recovery.


Almost all the patients admitted to ICU have a lower than normal hemoglobin level after a week of admission. Only 5% of patients are an exception to this rule [2]. If the blood sample is taken from the patient’s indwelling catheter, 5 to 10ml of blood is wasted every time before a sample is taken. This can lead to the development of anemia.


A study conducted by Silver et al, compared the blood loss in patients with or without the usage of a conservative device. In a seven-day period, 340ml of blood was saved per patient averaging to 49ml per day when a conservative device is used. [4] Another study conducted by Peruzzi showed a reduction of almost 80 to 90 ml of blood loss per day when a conservative device is used for a four-day trial period. [5]


Infection to the already critically ill patients of the ICU can prove fatal. Many studies show that hospital-acquired infections in intensive care patients are commonly due to an indwelling catheter [6]. Blood draws involve catheter manipulation which can cause catheter-associated infections [7].


Minimizing the frequency of blood draws or using a closed system can reduce consequential blood loss and catheter-related infections and hence can have a positive effect on improvement of the patient.


Elcam’s Clear-ITTM increases patient safety at an affordable price


Closed blood sampling systems help a lot in the reduction of incidence of iatrogenic anemia and catheter-related infections. This equipment is usually expensive.


Few closed systems enable the blood volume to be reinfused into a patient in a safe manner which helps to minimize contamination and also contribute to preventing blood loss. Elcam’s Clear-IT™ closed blood sampling system combines an In-Line Reservoir for waste collection and a Marvelous™ stopcock.


The new Clear-ITTM product form Elcam is a relatively low-cost closed system used for blood sampling taken from the blood pressure monitoring line. Safety is enhanced via reduction of blood loss as the clearing volume is reinfused back to the patient after sampling is completed. With the MarvelousTM stopcock, continuous-flushing ensures minimal blood residues.


The reservoir can be connected to a standard mount piece. It is easy to use and doesn’t require much training. It minimizes the blood waste, thus decreasing the risk of anemia. Continuous line, closed in-line design and syringe clearing all help in reducing microbial contamination.


As Patient Safety Day 2016 is approaching, Elcam is presenting yet another product with the ever continued agenda of enhancing patients and staff safety. As the international medical and healthcare community gets together to raise awareness for patient safety, we are happy to take even a small part in the progress achieved in this field.

 

References:
1. http://www.nhp.gov.in/World-Patient-Safety-Day_pg
2. Anemia in the ICU (Review) Cardiovascular Disease, Critical Care, Review Articles . Sept  2012 PulmCCM
3. World Patient Safety Day | National Health Portal of India. Nhpgovin. 2016. Available at: http://www.nhp.gov.in/World-Patient-Safety-Day_pg. Accessed October 11, 2016.
4. Silver M, Li Y, Gragg L, Jubran F, Stoller J. Reduction of Blood Loss From Diagnostic Sampling in Critically III Patients Using a Blood-Conserving Arterial Line System. Chest. 1993;104(6):1711-1715. doi:10.1378/chest.104.6.1711.
5. PERUZZI W, PARKER M, LICHTENTHAL P, COCHRAN-ZULL C, TOTH B, BLAKE M. A clinical evaluation of a blood conservation device in medical intensive care unit patients. Critical Care Medicine. 1993;21(4):501-506. doi:10.1097/00003246-199304000-00007.
6. Valles JLeon C. Nosocomial Bacteremia in Critically Ill Patients: A Multicenter Study Evaluating Epidemiology and Prognosis. Clinical Infectious Diseases. 1997;24(3):387-395. doi:10.1093/clinids/24.3.387.
7. Tinmouth A, McIntyre L, Fowler R. Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients. Canadian Medical Association Journal. 2008;178(1):49-57. doi:10.1503/cmaj.071298.

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