By COLIN M. STEWART
By COLIN M. STEWART
Tribune-Herald Staff Writer
Hilo Medical Center has joined hospitals across the state and the nation in greatly reducing over the last few years some of the healthcare-related infections its patients experience.
And in the case of one especially dangerous variety, the hospital has held its number of infections to zero since June of 2009.
Healthcare-associated infections, or HAIs, are infections that patients acquire during the course of receiving treatment for other conditions at hospitals. The infections can be “devastating and even deadly,” according to the Centers for Disease Control and Prevention HAI website, http://www.cdc.gov/hai/.
Such infections “are on everyone’s hit list,” adds Carolyn M. Clancy, director of the Agency for Healthcare Research and Quality, and are considered among the leading causes of preventable death in the U.S.
“As they should be, because no patient should get sicker from a preventable infection they pick up in a hospital or other health care facility,” she wrote last year in an article printed in the American Journal of Medical Quality.
In particular, recent research has found that deadly blood stream infections caused by the insertion of catheters — known as central lines — into a patient’s large veins can be prevented if doctors and nurses will follow a simple checklist of procedures to minimize a patient’s exposure to infectious agents.
An estimated 41,000 central-line associated bloodstream infections occur in U.S. hospitals each year, according to the CDC, and can typically prolong hospital stays, as well as increasing costs and the risk of mortality.
But a 2006 study by Johns Hopkins University researcher Peter Pronovost found that the average among 108 intensive care units in Michigan was able to reduce its instance of central line infections from 4 percent to zero using the checklist, according to The New England Journal of Medicine. It was estimated that in the study the checklist saved more than 1,500 lives and about $200 million.
Since then, hospitals across the country have been implementing those procedures and having great success. In 2009, U.S. Department of Health and Human Services Secretary Kathleen Sebelius challenged hospitals around the country to reduce central line-associated blood stream infections by 75 percent over three years.
In 2010, which is the most recent data available, the CDC reported that nationwide hospitals saw a 33 percent reduction in central line infections. That same year, Hawaii hospitals reported a total of only 15 infections.
Hilo Medical Center has experienced similar results, said Dan Brinkman, Hilo Medical Center’s regional chief nurse. He added that the preventative methods may seem simple, but their introduction represented a “culture change” for hospitals.
“Any time you introduce a foreign body into the bloodstream, it has access to your entire body. Obviously, that can be very dangerous and kill you, and it is very, very expensive to treat,” he said. “In the old days, people were routinely given central lines … and it was accepted that a certain percentage (of patients) will get infections and there’s no way to prevent it. But then they started asking, what if you treated the insertion (of a catheter) with the same attention as you do in the operating room?”
By ensuring that doctors’ and nurses’ hands are thoroughly washed, they are wearing sterile gowns and masks, and making sure that the site of the insertion of the catheter is properly disinfected, Brinkman said, the risks for infection are tremendously minimized.
“If you follow that every single time, very rigorously, you won’t necessarily have the infections,” he said. “We’ve found in our ICU that that’s very true.”
Hawaii Health Systems Corp. Regional CEO Howard Ainsley said he was thrilled with the fact that Hilo Medical Center hadn’t seen a case of a central line infection for nearly three years.
“The fact that HMC’s ICU team has reduced central line infections to zero since June of 2009 is a tremendous representation of the quality of this hospital,” he said via a Tuesday email. “This critical gain for our patients and our community owes to the dedicated efforts of ICU Chief Dr. (Mouhamed) Kannass and our nurses who are incredibly mindful of this aspect of quality and patient care.”
Among HMC’s preventative measures, the hospital has instituted an aggressive hand-washing policy that has resulted over the last two years in an increased rate of compliance from 40 percent to 80 percent, said Director of Marketing Mary Stancill.
According to Brinkman, the hospital measures such compliance using a variety of methods, including “secret shopper”-like observers. The hospital also monitors how much soap and alcohol gel it is purchasing, to make sure there is no drop-off in its use.
HMC also holds annual training sessions, Stancill said, to teach proper hand-washing technique. Employees can see how successful their technique is by putting a glow-in-the-dark substance on their hands and then washing them. Then they place them under a black light to see how much residue remains. The same training mechanism has been shared with school children and other members of the general public.
“While we’re doing that with our own staff, we also feel as community health advocates it’s important to bring that message to the community, as well,” she said.
Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.