Infection rates reduced by low-cost safety measures

AORN Journal, March, 2007

By using inexpensive, common-sense measures such as consistent hand washing and removing unneeded catheters in a timely manner, hospitals may reduce the rate of common, costly, and potentially lethal central venous catheter-related bloodstream infections in their intensive care units (ICUs), according to a Dec 27, 2006, news release from Johns Hopkins Medicine, Baltimore, Md. An estimated 80,000 bloodstream infections occur each year in the United States as a result of central venous catheters; these infections cost the health care system an average of $45,000 per patient for treatment.

Researchers conducted a review of 103 ICUs in the Michigan hospital system before, during, and after implementing a variety of simple and low-cost measures designed to reduce catheter-rerated bloodstream infections. The measures included

* training physicians and nurses about infection control;

* using standardized, central-line supply carts designed for one-time use;

* using a checklist to track infection control practices such as hand washing;

* avoiding catheter placement through the femoral artery in the groin, an area that is difficult to keep sterile;

* wearing and changing gloves, gowns, and masks for each procedure;

* cleaning patients' skin with chlorhexidine; and

* removing catheters as soon as possible, even if they may be needed again.

Based on data collected quarterly for up to 18 months and representing 375,757 ICU catheter days, researchers found that the median rate of catheter-related bloodstream infections per 1,000 catheter days decreased from 2.7 at baseline to zero after the safety measures were implemented. In addition, the mean rate of catheter-related infections decreased from 7.7 at baseline to 1.4 at 16 to 18 months after the safety measures were implemented.

Safer ICU's: Cheap, Simple, "Low-Tech" Steps Work [news release]. Baltimore, Md: Johns Hopkins Medicine; December 27, 2006. Available at: http://www.hopkins medicine.org/Press_releases/2006/12_27_06.html. Accessed January 8, 2007.