Lee health system’s ICUs recognized for blood infection safety
The Florida Hospital Association recognized the Lee Memorial Health System Intensive Care Units for having zero incidences of central line blood stream infections for more than nine months.
Central lines are catheters placed in large veins, which enables caregivers to administer medication or fluid. When a patient is removed from a central line or ventilator as soon as possible, they have less of a chance of developing an infection.
The Lee Memorial Hospital Medical Intensive Care Unit and the Open Heart, Neurosurgical and Medical ICU’s at HealthPark Medical Center were recognized for going nine months or more without having a central line blood stream infection.
“The award recognizes the people who are at the bedside and who are working very hard for those patients,” System Medical Director Marilyn Kole, MD said. “It speaks to our goal of patient safety…it’s about preventing bad things from happening.”
HealthPark ICU Nursing Director Sandra Simmons said the award means that they are keeping their patients safe.
“It means that everything we do is about the patient and that we really made a big difference,” she sad.
Kole, said they worked with the Institute of Health Care Improvement for seven years to improve conditions in the ICU before they began working with the Florida Hospital Association.
The Florida Hospital Association began after a program was originally initiated in Michigan to reduce the number of central line blood stream infections that occurred to patients in ICU. The ultimate goal was to decrease the number of infections to zero, which produced tremendous results. After the association was introduced to Florida last year, Kole said they registered in October 2009 because she wanted the ICUs to get to zero infections in Lee County as well.
Kole said a meeting is held every six to nine months with the other hospitals in Florida to discuss what is being done to keep infections at zero. Meetings are also held at the Lee County campuses for the same purpose.
“We still share ideas across the country with our colleagues,” Kole said. “We will ask for things from anywhere.”
When the HealthPark ICU had bi-monthly occurrence of infections last June, the unit decided to direct its focus on how to decrease the patient infections to zero. Simmons said the infections meant that patients would remain in ICU longer or they could die, so something needed to be changed.
Simmons said when she first began working in ICU in the early 90s they expected ICU patients to get infections. That attitude has changed in Lee County.
A multi-disciplinary approach of having everyone working together, along with a culture change has provided HealthPark with the right tools to make sure zero incidences of central line blood stream infections occur in their patients.
Every morning the team makes their rounds in the ICU to examine each patient’s well-being, along with checking on them. The team discusses how long a central line has been in a patient, what the line has been used for, along with the possibility of eliminating it if it is not accessed on a regular basis.
Another tool the Lee Memorial Health System has implemented is a board that posts how many days the ICU has been without an infection and what kind of infection it was for the staff to see. When an infection occurs the team is debriefed and a discussion takes place of what they missed and what could have been done to receive different results.
Simmons said they use a lot of technology and skills to help prevent the central line blood stream infections from occurring.
“Over and above the technology is the attitude of the zero tolerance,” she said.
Kole said maintaining zero incidences of central line blood stream infections is accomplished because the teams are at the patients bedside every day examining the line and constantly asking the question of when “can that line come out.”
Simmons said three out of the four ICU units have not had any central line blood stream infections in more than a year.
HealthPark ICU has recorded a central line blood stream infection occurrence of .22 per 1,000 central line days for the past 12 months.
Cape Coral Hospital recorded central line blood stream infections of .64 per 1,000 days of patients having central lines during 2009-2010, which is compared to the state average of 1.59 per 1,000 days and the national average of 1.62 per 1,000 days.