Recent medical news regarding catheters and infection

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Recent medical news regarding catheters and infection

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Here is a recent article pertaining the importance of sterile procedures used in hospitals to minimize the risk of infection from catheter insertion :

Evidence-based practice cuts ICU infection
By Ed Susman Dec 28, 2006, 0:32 GMT

BOSTON, MA, United States (UPI) -- The risk of an intensive care unit catheter-related infection was slashed two-thirds when hospital personnel followed evidence-based practices aimed at the well-being of the patient, doctors said Wednesday.

As many as 17,000 deaths a year are caused when tubes that provide easy access for intravenous medicine in critically ill patients become colonized with bacteria and cause lethal bloodstream infections.

'These infections once were considered the `cost of doing business` when dealing with very ill people. We now think these infections are preventable and are not inevitable,' said Dr. Peter Provonost, professor of medicine at Johns Hopkins University in Baltimore.

'We look at infections in the intensive care unit as `defects,` and our goal is to eliminate them much the way Microsoft would develop a `patch` to overcome a bug in its program or General Motors would `recall` an automobile for a manufacturing problem,' Provonost told United Press International.

In a report that will be published in Thursday`s edition of the prestigious New England Journal of Medicine, Provonost reported on a two-year pilot project involving more than 100 hospitals in Michigan. 'We set out to find evidence-based practice changes that were feasible to perform in the intensive care setting and then tried to make it a team approach to reduce infections,' he explained.

The result: The average infection rate fell from 7.7 percent to 1.4 percent after 18 months. 'More than half the hospitals in this study were able to report that they had no infections after implementing the program,' Provonost told UPI.

'Frankly, when I first saw his results, I didn`t believe it,' said Dr. Michael Edmond, professor of internal medicine and hospital epidemiologist at Virginia Commonwealth University in Richmond.

'Now I think we can reduce these infections to a fraction of what we ever thought possible,' Edmond told UPI. 'It may not be possible to get the rate to zero, but there is no question this study will change clinical practice in hospitals.

'This story is compelling and the costs and efforts so relatively minor that the five components of intervention should be widely adopted,' said Edmond, co-author of an editorial in the journal that accompanied Provonost`s report.

'We can no longer accept the variations in safety culture, behavior or systems of practice that have plagued medical care for decades.'

Provonost said no new staff was added to perform the interventions, which basically require:

-- Assuring that participants wash their hands before the procedure.

-- Assuring full barrier protection -- a sterile bed sheet rather than just keeping the insertion site sterile, and having staff wear sterile gloves, gowns, hats and masks.

-- Cleansing the skin surface with chlorhexidine.

-- Placing the catheters in the chest or neck rather than in the groin. Edmond said that the femoral placement in the groin is less technically difficult but is also prone to more infection.

-- Removing unnecessary catheters as soon as possible.

Edmond said his hospital has already adopted the program as outlined in a Johns Hopkins single-institution report two years ago.

'This new paper,' he told UPI, 'shows that you can generalize this work. It can be done in teaching hospital and in community hospitals, in large hospitals and in small hospitals.'

Part of the success of the program, Provonost said, is that it uses a team approach to placement of the catheters and empowers nurses to second-guess or suggest changes in approach to the physicians. Provonost said one of the educational steps in implementing the program is discussing how to make those suggestions in diplomatic ways.

Edmond said that the studies show that the care in inserting the catheter is a key element in preventing infection. 'We want doctors and nurses to consider catheter insertion as a precision procedure, not something that should be considered just routine,' he suggested.

In the study, Provonost said that after recording baseline rates of infections at the hospitals, the hospitals generated reports every three months on infection rates in the intensive care unit. The infection rate dropped 36 percent in the first reporting period and continued to decline in every period after that. At 18 months, the infection rate had dropped by 66 percent.

The program developed at Johns Hopkins and implemented in Michigan using state and federal grants is now being pursued in the operating suite, emergency room and pediatrics departments of the hospitals as the program unfolds.

Provonost told UPI that the state of Rhode Island will be adopting the procedures, and he and colleagues are in discussions with the World Health Organization on establishing the procedures in entire nations.

Copyright 2006 by United Press International
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Sweetpickle
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Re: Recent medical news regarding catheters and infection

Post by Sweetpickle »

This seems to be information about catheters in veins, not urethral catheters.
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