Our Goal of Zero Harm
Catholic Health is working diligently to eliminate facility-acquired infections across our organization. Through the use of evidence-based practices such as observing hand hygiene, eliminating non-essential devices in patients, and preventing inappropriate antibiotic usage, we are closer to our goal of Zero Harm in the Journey to High Reliability.
Catheter-Associated Urinary Tract Infection (CAUTI) Reduction Initiative
Urinary tract infections (UTIs) are traditionally among the most common hospital-acquired infections, and are most often associated with the presence of a urinary catheter. UTIs can increase complications and prolong hospitalization.
Beginning in 2009, Catholic Health developed a care team tasked with decreasing the frequency of catheter infections by using evidence-based guidelines from authorities such as the Centers for Disease Control to standardize catheter insertion techniques, catheter maintenance and early discontinuation to prevent infection. As we progress on our Journey to High Reliability, the team has been successful in significantly decreasing UTIs.
Catholic Health will continue to work to reduce both catheter usage as well as any associated infections as we approach our Goal of Zero Harm.
Hospital Acquired C-Difficile Infection Reduction Initiative
Clostridioides difficile (also known as C. diff) is a type of bacteria that can cause symptoms ranging from diarrhea to more serious intestinal conditions. The infection can range from mild symptoms to those resulting in patient death.
The most common risk factor for C. diff is the extended use of antibiotics, or the use of antibiotics that treat broad ranges of conditions. This type of antibiotic use may disrupt the balance of this bacteria in your intestines and thus lead to infection. C. diff bacteria is contagious and can therefore be spread from person to person. It is one of the most frequently reported organisms acquired in the health care setting.
Catholic Health identified an elevated C. diff infection rate, which peaked at 10.4 per 10,000 patient days in the 2nd Quarter of 2015. As part of our Journey to High Reliability and Zero Harm to our patients, the organization dedicated resources to address this trend and put forth a concentrated effort to reduce the rate. Team members modified policies and procedures, re-educated caregivers on appropriate hand hygiene techniques, improved methods for cleaning patient rooms and equipment, and tackled the appropriate use of antibiotics within the organization.
Interventions were extremely successful and resulted in a significant reduction in our C. diff infection rate as noted below. The organization continues to monitor these rates with the hope of decreasing them even further.
Central Line-Associated Bloodstream Infections (CLABSI) Reduction Initiative
A central line (also known as a central venous catheter) is a larger IV catheter that is placed in the larger veins of the chest, neck, or legs in order to provide medicine or fluids. It is usually placed because of the medical needs of the patient (often in the intensive care unit), or because of difficulty placing the larger IV in the peripheral veins. They may remain in longer than a traditional peripheral IV.
Unfortunately, these catheters can sometimes become infected, which may become a serious issue. We are working aggressively as a system to prevent these infections through a combination of sterile insertion technique, meticulous hand hygiene, and prompt removal when clinically appropriate.
As we progress on our Journey to High Reliability, the team has been successful in significantly decreasing CLABSI. Catholic Health will continue to work to reduce both central line usage as well as any associated infections as we approach our Goal of Zero Harm.
Eliminating Colon Surgical Site Infections
The colon is another name for the large intestine, which is located in the lower part of your digestive tract. Its function is to process waste products from the body and prepare them for elimination. Each year, many patients undergo colon surgery as treatment for a variety of conditions such as colon cancer, Crohn’s disease, diverticulitis, and colon polyps.
As with any surgery, sometimes post-operative complications occur. One such complication is a post-operative surgical site infection.
As part of Catholic Health's journey toward Zero Harm for patients, the organization has embarked on an initiative to help eliminate surgical site infections after colon surgery. Healthcare providers at Catholic Health utilize a “Colon Bundle,” which is a checklist of items that should be performed before, during, and after colon surgery. Clinical evidence has shown that completing items on the checklist may help decrease the occurrence of colon surgical site infections.
In 2016, a care team was created to educate providers on bundle parameters, develop workflows in the electronic health record to facilitate implementation of the items on the checklist, and monitor physician-specific compliance with bundle elements. The work effort has yielded the results depicted below. The team continues to work on developing ideas to help providers reduce the number of infections and achieve Zero Harm.