Spotlight:
Preventing hospital-acquired infections in our ICUs
Preventing hospital-acquired or nosocomial infections is a major focus of the patient safety initiative at Children's Hospital Boston. As a tertiary care center, Children's often manages very sick patients, most of whom are cared for in one of our three intensive care units—the Cardiac ICU, the Medical/Surgical ICU or the Neonatal ICU. Many of these children require intensive and invasive monitoring with central venous catheters to provide medications or nourishment, are on ventilators to help them breathe, or have fresh wounds from having undergone surgery. All these factors make them extremely vulnerable to hospital-acquired infections.
To help prevent these infections, Peter Laussen, MBBS, director of Children's CICU, and the interdisciplinary staff of the CICU, MSICU and NICU are working together to roll out a new patient safety initiative across all Children's ICUs. "Infections in these patients can lead to more days in the ICU and poor outcomes," says Laussen. "It's important to make sure our patients receive care in the safest possible environment."
Laussen has convened a joint Nosocomial Infection Oversight Committee, comprised of representatives from each of the three ICUs, including medical directors, nurse managers and surgical staff, as well as members of Infection Control, Respiratory Therapy and Finance (nosocomial infections also increase the cost of care).
The group has set an ambitious goal: to reduce the rates of bloodstream infections, ventilator-associated pneumonias and surgical-site infections. It is currently working to establish baseline infection rates for each unit; to create an educational program, including NetLearning modules and teaching packets; to evaluate established systems and practices within each unit; to formalize "best practices" and create consistent policies across the units; and to establish databases and links between all units to ensure reliable data collection and analysis. Debra Morrow, RN, of the CICU, Michelle Rufo, RN, of the MSICU, Judy Carter, RN, of the NICU and Gail Potter-Bynoe, RN, from Infection Control will lead these initiatives in their respective areas.
Children's is also mounting a national effort as part of the Child Health Care Corporation of America's Blood Stream Infection Initiative and is committed to the Institute for Health Care Improvement's 100,000 Lives campaign.
"This is not something that only affects our ICU clinicians," says Laussen. "You'd be surprised how many other people interact with ICU patients. From the clinicians that come up to the ICUs for consults, to nurses in the operating room who hand off patients to the ICU, to parents at the bedside, there's something we all can do to help."
