Program Seeks to Reduce ICU Infections

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Oct. 1 (HealthDay News) -- U.S. health officials are giving nearly $3 million to the American Hospital Association to help reduce so-called central line-associated bloodstream infections in hospital intensive care units.

Each year, an estimated 250,000 intensive care unit (ICU) patients suffer these infections, and 30,000 to 62,000 of them die, according to the U.S. Centers for Diseases Control and Prevention. The grant from the U.S. Agency for Healthcare Research and Quality (AHRQ) will be used over three years to roll out a program designed to reduce these infections nationwide.

"When we go to a hospital, we expect to leave healthier, not sicker," Dr. Carolyn M. Clancy, AHRQ's director, said during a Wednesday teleconference. "Unfortunately, it does not always work out that way. Too often, care provided in a hospital leads to infection. These infections are among the greatest risk that patients face."

These infections are largely preventable, Clancy said. "We are simply not doing nearly enough to prevent them. Changing behavior in health-care settings is challenging and isn't as simple as handing clinicians a checklist," she said.

Although infections occur in other parts of hospitals, concentrating on the ICU is a first step in trying to bring down infection rates throughout hospitals, Dr. Peter J. Pronovost, a professor at Johns Hopkins University School of Medicine, said during the teleconference.

The program was started by Johns Hopkins University in Baltimore and the Michigan Health & Hospital Association. It's designed to be a comprehensive unit-based patient safety program to help prevent infections related to central line catheters. Central line catheters, also called central venous catheters, are tubes placed into a large vein in the neck, chest or groin to supply medications or fluids or to collect blood samples.

When the safety program was tested in more than 100 Michigan intensive care units, infection rates dropped dramatically -- over three months, more than 50 percent of the participating hospitals saw their ICU infection rates drop to zero.

"Far too many people suffer preventable harm, suffering and death, and excess costs as a result of our health care system," Pronovost said. "The public deserves much safer health care than they are currently getting."

Using the program in Michigan has saved 1,500 to 1,800 lives a year and $200 million in costs, Pronovost said. "We now have the bold idea to spread the program throughout the rest of the country," he said.

The program is designed to survey and improve ICU safety by changing the "culture" of the ICU. It includes tools to help identify opportunities to reduce infections and policies to make care safer.

The grant program will involve hospitals in 10 states, with at least 10 hospitals in each state participating, Pronovost and Clancy said.

SOURCES: Oct. 1, 2008, teleconference with Carolyn M. Clancy, M.D., director, U.S. Agency for Healthcare Research and Quality; Peter J. Pronovost, M.D., Ph.D., professor, Johns Hopkins University School of Medicine, Baltimore

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