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|Newsletters: Back-to-Basics Plan Saves Lives in ICUs|
Back-to-Basics Plan Saves Lives in ICUs
This excerpt was first published in the Detroit News on October 14, 2005. The staff at Oley felt it contained a very important message for those on HPN. A copy of the complete article can be obtained by contacting Cathy at the Oley office for a copy (800-776-OLEY or HarrinC@mail.amc.edu). In conjunction with this article we have included a Keep Me Safe flyer in the newsletter for your use when hospitalized. Additional copies are available free of charge from the Oley office (contact information above).
Steps as simple as ensuring doctors wash their hands have sharply reduced the rates of two potentially fatal complications for intensive care patients in Michigan, researchers said Thursday as they outlined the results of a two-year project to curb medical errors.
The project included the vast majority of Michigan’s intensive care units. Since it began in 2003, they were able to lower the rate at which patients suffered infections after receiving “central line” IV’s more than 80 percent and cut the rate of pneumonia 45 percent, the researchers said. Both conditions are frequently linked to mistakes by doctors and nurses.
“What we have shown here is the vast majority of those cases are preventable,” said Dr. Peter Pronovost of Johns Hopkins University, who was one of the project leaders.
The project was part of a broad effort to lower the toll of medical mistakes nationwide. A study published in May found up to 98,000 Americans are killed by medical errors each year. The rate has scarcely budged in the five years since a landmark study showed mistakes were the nation’s eighth-leading cause of death. The news pushed physicians and the government to focus on improving safety.
Few of the steps the researchers recommended are complicated. To keep intravenous lines from causing infections, they urged doctors to wash their hands and asked nurses to check up on them; they recommended that doctors wear caps and downs when inserting the line and asked that doctors use a different type of disinfectant before inserting the IV, among other steps. To keep patients on ventilators from developing pneumonia, researchers urged that their heads be kept elevated – a standard instruction in nursing school.
“It’s those back-to-basics that can really impact the patients’ quality of care,” said Maria Palleschi, a registered nurse who has worked in Harper University Hospital’s intensive care unit for 29 years. “When you’re in an environment that’s high-tech and you have a reduction in nursing hours, when you have so many things that are going on with the patient, the basic things sometimes have a tendency to get away from you.”
The project, by Johns Hopkins and the Michigan Health and Hospital Association, included 127 intensive care units at 77 Michigan Hospitals.
It focused only on bloodstream infections linked to “central line” IV’s, which let doctors deliver drugs and fluids to a main artery instead of the smaller vessels in patients’ arms; and on pneumonia among patients on ventilators. Both complications can prove fatal. It did not include a variety of other safety problems, such as medication errors, because they are more difficult to measure, Pronovost said.
Researchers estimated the changes have prevented 1,500 deaths and saved nearly $166 million in health-care costs, though they were unable to precisely measure either. Sixty-eight of the ICU’s that participated in the project have not had any cases of bloodstream infections or ventilator-associated pneumonia in at least six months.
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