REACHING ZERO: Strategies and Tools Utilized to Eliminate Preventable Bloodstream Infections
Lee Steere, RN, CRNI, is a unit manager at Hartford Hospital of a medical infectious disease unit and of the IV Therapy Services Department.
Joyce Sauvé, RN, CIC, works for the Infection Control Department of Hartford Hospital as a Epidemiology Clinician.
Septicemia, an illness caused by bacterial blood infections, was the single most expensive condition treated in U.S. hospitals at nearly $15.4 billion in 2009. The number of septicemia-related hospital admissions more than doubled between 2000 and 2009, reaching nearly 840,000 stays. The in-hospital death rate for septicemia was 16 percent in 2009 — more than eight times as high as for all other hospital stays (AHRQ. Statistical Brief #122: “Septicemia in U.S. Hospitals,” 2009).
One-quarter of a million bloodstream infections occur in U.S. hospitals each year (Klevens, Edwards, et al., Public Health Reports, 2007). Complications resulting from a device, implant, or graft were the most common reasons for these hospitalizations, representing one of every five septicemia-related stays.
Catheter-related bloodstream infections (CRBSIs) in particular are the fourth most common hospital-acquired infections. Approximately 90 percent of CRBSIs occur with central-line catheter placements.
Roughly 80,000 central-line associated bloodstream infections (CLABSIs) occur in U.S. intensive-care units every year, and these infections are fatal in up to 25 percent of cases, claiming up to 20,000 lives annually and adding $296 million to $2.3 billion to the cost of patient care (Mermel. Ann Intern Med. Mar 7, 2000).
Historically, a small number of CLABSIs were considered an acceptable risk of placing central lines.
However, the work by Dr. Peter Pronovost at Johns Hopkins Hospital, The Institute for Healthcare Improvement (IHI), and others has challenged that premise. Today, hospitals across the country are leveraging a wide range of clinical-best practices and implementing new tools to demonstrate that achieving the goal of zero hospital-acquired bloodstream infections should be the standard of care. This paper describes the journey of one such inner city medical center, Hartford Hospital (Hartford, CT) in chasing zero.
- June 1, 2012
- Posted by Jamie