According to the Centers for Disease Control and Prevention, there are an estimated 30,100 central line-associated bloodstream infections (CLABSA) in U.S. health care facilities each year. These are serious infections that cause the prolongation of hospital stays and increased risk of death. These infections are preventable through the use of proper insertion techniques and the management of the central line.
In an article by Sarah Kliff on vox.com, Do no harm, the author tells the story of little Nora Borstrom, who died just a few days before her fourth birthday from a series of central line infections. Kliff writes about the changing attitudes towards central line infections, which in the mid-1990s, doctors viewed as an unavoidable side-effect of modern medicine. Between the years 1990 and 2010 patients contracted about a half a million central line infections.
Central line infections can be prevented
In the mid-2000s, researchers showed doctors how they could significantly reduce and eventually eliminate central line infections by following a short safety checklist. Between 2008 and 2013, central line infections fell 46 percent, which was a big victory for the public health system.
Dr. Peter Pronovost, a critical care doctor at Johns Hopkins University developed the 5 point checklist after the death of 18-month-old Josie King, a burn victim who died from a central line infection. Once Dr. Pronovost’s protocol was adopted at Johns Hopkins’ surgical intensive care unit, central line infections fell by 50 percent within the first three months, and by 7 months infections were down 70 percent.
This startling reduction in the number of central line infections shows that it is possible to get to zero, and when one does occur it can most likely be traced back to not following the five-step protocol that helped to stem the tide of these once prevalent infections.
Central line infections are just one type of hospital-acquired infection, which cause early 100,000 deaths per year. The 1.7 million infections include staph, pneumonia and surgical site infections, urinary tract infections and bloodstream infections. Hospital-acquired infections (HAIs) can be caused by a variety of pathogens including:
The CDC reports that approximately 1 in every 20 hospitalized patients will develop an infection.
Which hospitals have the worst scores for hospital-acquired infections?
On an interactive map on the Healthcare IT News website, Healthcare Finance has used data from the Centers for Medicare & Medicaid Services to create a searchable map where hospitals who scored worse than the national average on infections metrics could be identified. Now, the federal government is beginning to tie a hospital’s infection metrics with Medicare payments. If a hospital continues to have high HAI rates, they will see their Medicare payments reduced. Last December, according to Healthcare IT News, 721 hospitals were going to be penalized for their high rates of hospital-acquired infections.
We go to the hospital because we are ill or injured and we expect to leave having been healed or cured, not with a life-threatening infection from being in the hospital. When hospitals learn from past medical errors change their procedures and train staff, it can make a significant difference in the outcomes for their patients.