Preventing infections is one of the ways we help keep our patients safe. At ChristianaCare we are committed to protecting our patients and reducing the number of infections our patients experience.
Infections that occur in hospitals, known as hospital-acquired infections, target a vulnerable patient population. Often patients come to hospitals with different chronic illnesses as well as the acute illness that brought them to us. In addition, they may have a weak immune system from an underlying illness or treatment such as chemotherapy. Procedures and surgery that break the skin barrier also present opportunities for infections.
All hospitals have an obligation to reduce risk to patients, and we track measures related to hospital-acquired infections as part of our patient quality and safety work.
Specifically we report to the state of Delaware data on infections, including central-line associated bloodstream infections.
What are central-line associated bloodstream infections?
At times, patients in the hospital may have a tube delivering vital fluids and medicines during their stay. When placed in a large, central vein, most often in the chest, they are called central lines. Every year in the United States, between 5 million and 7 million central lines are used to save lives. Nearly half of patients in intensive-care units (ICU) receive central lines to assist with their care.
While central lines save lives, they can cause certain problems in a small fraction of cases. Having a central line can lead to bacteria getting into and growing in the blood. This is known as central-line associated bloodstream infection or CLABSI. In the United States, there are about 250,000 CLABSIs each year, nearly 80,000 of them in ICUs. These can lead to longer stays in the hospital, higher health care costs and even death.
What we’re doing about central-line infections
As far as we’re concerned, one infection is too many. So we’re working aggressively to prevent and control infection. We have set priorities, and established procedures and measures to track how well we’re doing. Our focus is on increasing transparency and accountability by sharing information throughout our health care system.
We’re reducing infections by:
- Using proper hand hygiene. Everyone who touches a central line must wash his or her hands with soap and water or an alcohol cleanser.
- Taking maximum barrier precautions. Professionals who insert central lines wear sterile clothing including a mask, gloves and hair covering. Each patient is fully covered with a sterile drape, except for a very small hole where the line is inserted. We also use special central-line catheters that have an antimicrobial coating.
- Cleaning the patient’s skin. We use a special soap that contains chlorhexidine, an antibacterial chemical.
- Using the best vein to insert the line. Inserting a central line in certain veins, such as a vein in the chest, is less likely to cause an infection.
- Checking for infection every day. Health care professionals monitor every line in every patient every day to look for signs of infection.
- Reviewing the need every day. When a line is no longer needed, we take it out right away.
- Using a simulation laboratory. In a special laboratory, our health care professionals practice and sharpen their skills for inserting central lines and maintaining sterility.
- Participating in the Comprehensive Unit-Based Safety Program (CUSP) sponsored by the Agency for Healthcare Research and Quality, a part of the U.S. Department of Health & Human Services. CUSP is a nationwide patient safety program to dramatically reduce certain hospital-acquired infections.
What you can do
Patients and their families can play a big role in preventing CLABSIs. If you or a family member were to become a patient in any hospital and a central line is required, here’s what you can do:
- Ask questions before the line goes in. Before you agree to the insertion of a central line, ask the healthcare professionals lots of questions. Which vein will you be using? How will you clean the skin before it goes in? What steps will you take to lower the risk of infection?
- Remind anyone who comes into the room to wash his or her hands before and after touching your loved one.
- Make sure doctors and nurses check every day for signs of infection. They’ll be looking for redness, pain or swelling near the insertion site, pain or tenderness along the path of the line, drainage from the skin around the line, sudden fevers or chills. You should, too.
- Watch visitors. Ask your friends and relatives not to visit if they feel ill.