Published on January 13, 2012

Preventing Central Line Infections

ICUs at Genesis, Davenport earn patient safety award

Patients in the Intensive Care Unit are so sick that caregivers need a way to quickly administer medications, fluids or even blood to them.

That’s the job of the central line, a catheter that is placed into a critically ill patient’s vein to deliver the life-saving goods. Unlike regular IVs, a central line may stay in place for days or even weeks.

The central line’s biggest benefit -- its ability to quickly spread fluids throughout the body -- can become its biggest risk, however. Every time a doctor or nurse touches that line or the skin surrounding it, there’s a risk of introducing bacteria unless the strictest sterile conditions are observed. Bacteria can quickly multiply and cause sepsis, an infection of the entire bloodstream that can kill up to 30 percent of its victims.

Throughout Genesis Health System, central line infections have become a rarity thanks to diligent patient safety initiatives.

The Iowa Hospital Association recently recognized the two Intensive Care Units (ICUs) at Genesis Medical Center, Davenport for going 13 consecutive months without a central line infection. The 13-month mark represents the time Genesis has been submitting data to the “On the Cusp Project,” a landmark initiative to dramatically reduce centralline associated bloodstream infections in hospital ICUs.

“The national average for central line infections is 2.5 per 1,000 line days. For our two ICUs to be at zero for 13 months is truly amazing, but the story is even better,” says Nancy Fier, MSN, RN, CCRN, Assistant Manager of the Intensive Care Units at Genesis Medical Center, Davenport. (Every day the device is in place counts as a line day. One month, for example, the hospital had more than 200 line days.)

“The last central line infection in the Surgical ICU was in August 2010. The last one in the West ICU was in January 2009, or nearly three years without a central line infection.”

Preventing central line infections has been a focus throughout Genesis. At the Illini Campus ICU, for example, the last central line infection was in summer 2009. Genesis, DeWitt doesn’t have an ICU but participated in “On the Cusp” for its inpatient unit.

“We’re proud of our ICU staff, who have really embraced the goal of a zero infection rate,” says Lisa Caffery, BSN, MS, RN, BC, CIC, infection control specialist at Genesis Medical Center, Davenport. “Without their commitment, we wouldn’t be there. They’ve done an outstanding job of doing the right things for our patients.”

The focus has expanded to all units caring for patients with central lines, including medical and surgical floors, she says.

“Medicare is starting to look at central line infections as one of those events that should ‘never’ happen, and soon the government will no longer pay the extra costs associated with those infections.”

In September 2010, the annual Horizon Summit introduced employees to an entertaining video that stressed the importance of eliminating central line infections.

Using a background of karaoke music -- Jay Sean’s “Do You Remember?” -- and the dancing and acting talents of a cast of dozens of employees and Genesis executives, the video “Rub a Dub Dub, Scrub the Hub’’ created a buzz within the health system and on Genesis social media sites.

“When the hub, or port, becomes contaminated with bacteria and the hub is not cleaned, the bacteria is carried into the bloodstream and can be very dangerous. A patient can become septic and die,’’ Caffery says. “We felt if we could get the ‘Scrub the Hub’ message into the heads of caregivers, our patients would benefit.’

At last year’s Horizon Summit, a new music video premiered to remind employees about another patient safety basic: hand hygiene. The video, entitled “Hand Check,” is a Genesis adaptation of Billy Squire’s 1981 hit “The Stroke.” It reminds employees to use the words “hand check” whenever they see a colleague fail to use proper hand hygiene. Both videos were produced by Don Abbott, BSN, Nursing Informatics Liaison at Genesis, Davenport.

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