Peter Pronovost, MD, a Johns Hopkins University researcher made famous by his checklist study, has been named to Time magazine's 100 list. Pronovost, 43, began investigating hospital-acquired infections at Johns Hopkins' hospital in 2001 and concluded that arming physicians with a chart reminding them of each step in routine procedures drastically reduces the medical errors that lead to such infections. Pronovost says the checklist protocol could be rolled out nationwide within two years for less than $3 million.
A New Hampshire man has developed a device that could help healthcare professionals tackle the increasing scourge of drug-resistant infections, saving billions of dollars and countless lives. He has developed the technology to kill Noroviruses, C. diff, MRSA and other problem viruses and bacteria using a section of the ultraviolet light spectrum to bombard them with killing high-energy photons.
Despite their large populations, Georgia's DeKalb and Fulton counties reported relatively few cases of serious, drug-resistant staph infections to the state health department for the past three years. Experts are now wondering if Fulton and DeKalb doctors are failing to report MRSA cases in those counties. Fulton County health department officials already said they'll be taking a closer look at reporting.
C. diff has long been a common, usually benign bug associated with simple, easily treated diarrhea in older patients in hospitals and nursing homes. About 3 percent of healthy adults harbor the bacteria with no problem, but overuse of antibiotics has allowed the germ to develop resistance in recent years, creating the toxic new type that stumps traditional treatment. The potentially deadly bacteria responsible for at least 300,000 infections a year in U.S. hospitals, and experts now rank C. diff on par with MRSA as one of the top two infections acquired in hospitals.
The economic slowdown has swelled the ranks of people without health insurance, and now it is also threatening people who have insurance but find that the coverage is too limited or that they cannot afford their own share of medical costs. Higher premiums, less extensive coverage, and bigger out-of-pocket deductibles and co-payments are causing many of the 158 million people covered by employer health insurance to struggle to pay for medical expenses. Many doctors say the soft economy is even making some insured people hesitant to get care they need.
There are more than 250,000 cases of catheter-related blood stream infections among American hospital patients each year, the CDC says. That's why, when your hospital goes 26 months without one, people notice.
Sutter Roseville Medical Center in Roseville, CA, is another one of the "zero heroes" I was introduced to recently. Under the leadership of Sophie Harnage, RN, BSN, clinical manager of infusion services, nurse-driven specialty teams have taken the facility's CRBSI rate from 11 in 2005 to zero during the last two-plus years.
The secret to SRMC's success is a bundle created by Harnage and documented in the Journal of the Association for Vascular Access in December 2007. Its steps include using peripherally inserted central catheters, ultrasound to select insertion sites, surgical-like coverage of both the patient and caregiver, a two-step cleansing and disinfection process, disinfection of the IV connector septum, and daily monitoring of the catheter line.
SRMC's nurses used to use traditional methods to determine where on the arm to insert a catheter, Harnage says. "But two years ago, we went 100% ultrasound . . . It was a big move to make that rule."
Before nurses are allowed to administer the PICC lines they must take a course on the ultrasound-guided technology and demonstrate they are competent in the procedure. Members of the team must also commit to following the steps included in Harnage's bundle.
The result, Harnage says, is an infection rate that hasn't moved from zero in more than two years and a nurse-driven team that is engaged and involved in keeping patients free from infection. "It empowers the team and excites the team," Harnage says. "They're very proud of their high success rate and the skill that they possess."
To come up with her bundle and the specialty team approach, Harnage says she spent a lot of time talking with her colleagues from hospitals all over the country. "I did my homework by asking various medical centers from around the country to ascertain best practices," she says. She gives credit to the many nurses who gave her an inside look at how their hospitals are working to fight infection.
The success that her team has experienced at SRMC gives Harnage hope that other hospitals can also become "zero heroes." She advocates for hospitals empowering nurses to lead the way in infection control.
"We have to take control of lines through assessment, insertion, and removal," she says. "Only specially-trained nurses offer this kind of consistency."