Preventing a common infection with
an 'ounce' of rules
If someone were to ask you to name half a dozen things
that Benjamin Franklin invented, could you? You might
get bifocals and the lightning rod on your list, and
perhaps the Franklin stove, maybe the library chair,
and even swim fins and Daylight Saving Time. But there
is another invention, which is commonly used in health
care that might not make your list, but should. The catheter.
The man known for flying a kite in an electrical storm
also is credited with inventing the flexible urinary
catheter to help his ailing brother. Perhaps he was thinking
of that discovery when he coined the phrased: "An
ounce of prevention is worth a pound of cure."
In medicine, a catheter is a tube that is inserted in
the body to remove or to inject fluids, or for access
of surgical instruments. In this case, a catheter is
used to drain urine from the bladder.
Because urinary tract infections are so common, Trinity
Health of which Battle Creek Health System is a part
has worked hard to find a way to reduce those complications
for its patients. That compassionate and innovative spirit
was present during the design of Trinity's latest set
of catheter-associated urinary tract infections (CAUTIs)
rules, slated for activation this spring. This program
is part of Genesis, a state-of-the-art computer system
at BCHS that standardizes clinical information including
physician order entry, online patient documentation,
electronic medical records, and adverse drug event alerts
The CAUTI protocol will help BCHS nurses and physicians
further prevent inpatients from getting catheter-related
infections, a longstanding challenge in the health care
setting.
"Urinary tract problems are the most commonly acquired
hospital infections, with more than 75 percent directly
attributed to urinary catheters remaining in place too
long," says Ann Pelisser Neeld, BCHS vice president
of patient care services and chief nursing officer. "In
fact, recent studies indicate that about 15 percent of
inpatients nationally will develop a CAUTI during some
point of their hospital stay. We think that is too high
and are working on eliminating those infections."
The 'toll' from this includes
occurrences of bacteria in the blood and sepsis (whole-body
infections) in a small percentage of patients, occurrences
of nonbacterial urethral inflammation, and increased
length-of-stay for the patient which translates into
increased costs. For the health care provider, Medicare
and Medicaid is no longer reimbursing them for CAUTIs
acquired in the hospital.
As a result of this new CAUTI process, nurses will be
notified when catheters have been in place longer than
48 hours and they will be directed to consider removing
catheters for patients who meet certain pre-specified
criteria.
"This new protocol will go a long way in aiding
the prevention of CAUTIs," adds Heather West, patient
care services manager and the nurse leader for this project. "It's
exciting to see how our established technology can be
leveraged to increase patient safety and quality of care
here at BCHS."
So the next time you see a picture of Ben Franklin with
his bifocals resting on his nose, or feel the warmth
of a fire coming from that cast iron stove named in his
honor, keep in mind that his inventiveness also helped
provide more than an 'ounce' of comfort for those in
the hospital.
Battle Creek Health System, sponsored by two parent
organizations--Trinity Health (the fourth largest Catholic
health system in the U.S. with 21 hospitals, 9 nursing
homes, 19 senior house facilities, 8 home health care
agencies, and 4 hospices in Michigan alone) and BCHS
Community Partners, is accredited by the Joint Commission
on the Accreditation of Healthcare Organizations. Battle
Creek Health System is a recipient of the 2008 HealthGrades
Orthopaedic Surgery Excellence Award(tm) and 2009 Five
Star rated for joint replacement surgery and total knee
replacement. HealthGrades is a leading health care information
company that provides objective 'report card' ratings
nationwide. BCHS provides excellent health care for the
community and promotes wellness for the whole person
with access and compassion for all. For the latest medical
information, visit the BCHS web site at www.bchealth.com
or call the BCHS Marketing Department at (269) 966-8132.
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Patient Safety Initiatives at BCHS
Patient safety is not a slogan but a commitment to a
way Battle Creek Health System cares for patients.
As a result, BCHS has been recognized over the years
for its many initiatives that make certain every patient
who comes to this hospital is treated with the very
best care possible. Here are some examples.
Blood Glucose Testing
Battle Creek Health System instituted a new policy of
checking the blood sugar of every adult patient that
is admitted to the hospital at least twice during their
stay. Patients are tested once within the first hour
of admittance and again within six hours to compare
readings. Depending upon the results, additional tests
may be administered. The purpose of this new protocol
is for BCHS to help the patient avoid dramatic changes
in their blood sugar levels so the body can heal more
rapidly. Testing helps the patient's health care team
keep blood sugar at safe levels and under control.
Colored Wristbands
Battle Creek Health System is standardizing the use of
color-coded patient-alert wristbands in a statewide
initiative focused on reducing inconsistencies between
Michigan hospitals that can result in medical errors
effective June 1, 2009. The goal of the effort is to
decrease the risk of such errors by standardizing the
colors of five patient-alert wristbands: allergy (red),
fall risk (yellow), do-not-resuscitate (purple), limb
risk (pink), and latex allergy (green).
Falls Program
Patients falling are a growing problem throughout the
U.S. Battle Creek Health System is doing something
about that issue through its 'Falling Star!' prevention
program. BCHS has educated its nursing staff so it
can be aware of the signs that patients exhibit making
them a fall risk. The hospital also uses a color-coded
wristband to identify patients who may be prone to
falling or are in a condition that makes them unsteady
so others will keep an extra eye out for their safety.
Genesis
Battle Creek Health System (BCHS) took a giant leap in
2005 by transitioning to a paperless, electronic health
record. By switching all inpatient nursing and ancillary
documentation from traditional, paper-intensive, medical
charts to an electronic medical record system, BCHS
became one of only a handful of hospitals in the United
States to 'go-live' with comprehensive, new technology
that promises to increase patient safety and cut costs
by reducing the potential for human error.
Keystone Initiative
Partnering with Johns Hopkins University and Michigan
Health and Hospital Association, Battle Creek Health
System joined other select Michigan hospitals to implement
a unique quality improvement project that helps provide
better care for patients in their intensive care units
(ICU). The project, called Keystone ICU, is the largest
patient safety collaborative in the world. Keystone
ICU uses three 'interventions' into normal ICU procedures.
1) A daily goals sheet is created for planning patient
treatments. 2) Elimination of all bloodstream infections
is a priority. 3) Care for patients on ventilators
is improved-the longer a patient is on a ventilator,
the greater the risk for blood clots and pneumonia.
Rapid Response Team
Battle Creek Health System introduced a Rapid Response
Team. This multidisciplinary medical group, composed
of critical care registered nurses and respiratory
therapists, is empowered to act swiftly using physicians'
protocol orders if need be to assess and then treat
a patient who exhibits early signs of clinical deterioration
or distress. It is like a SWAT team that is available
24/7 to offer help at the first sign of an impending
crisis like a heart attack or stroke before it happens. |
