(Press-News.org) Using a widely heralded Johns Hopkins checklist and other patient-safety tools, intensive care units across the state of Michigan reduced the rate of potentially lethal bloodstream infections to near zero.
Now, led by the same Johns Hopkins patient-safety expert who spearheaded the Michigan program, researchers in Rhode Island have shown the Michigan results weren't just a fluke.
The new study, published in the December issue of the journal Quality and Safety in Health Care, found that the rate of central-line associated bloodstream infections (CLABSIs) fell by 74 percent across Rhode Island's 23 ICUs over two and a half years. Researchers estimate the interventions prevented 42 CLABSIs, saved 10 lives, reduced ICU stays by 608 days and saved $2 million.
"This study verifies that the Michigan results can be replicated across another entire state," says Peter Pronovost, M.D., Ph.D., a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, director of the Johns Hopkins Quality and Safety Research Group and the study's leader. "We saw an even greater reduction in bloodstream infections in Rhode Island, providing strong evidence that these patient safety initiatives can be successful across the nation."
In 2009, U.S. Health and Human Services Secretary Kathleen Sebelius called for a 50 percent reduction in these catheter infections nationwide by 2012, and interest in the Hopkins system is strong, Pronovost says.
Central lines are thin plastic tubes used regularly for patients in ICUs to administer medication or fluids, obtain blood for tests, and directly gauge cardiovascular measurements such as central venous blood pressure. But the tubes are easily contaminated and each year roughly 80,000 patients with central lines become infected. Some 31,000 are estimated to die — nearly as many as those who die from breast cancer annually — and the cost of treating them may be as high as $3 billion nationally.
"Nearly all of these infections are preventable," Pronovost says. "Unlike breast cancer, we have a cure. Yet some hospital infection rates are 10 times what they should be."
Before heading to Michigan and Rhode Island, Pronovost tested the checklist and other interventions at The Johns Hopkins Hospital in Baltimore, where catheter infections have now been virtually eliminated.
The safety program developed at Johns Hopkins includes the much-heralded, cockpit-style checklist for doctors and nurses to follow when placing a central-line catheter, five basic steps from hand-washing to avoiding placement in the groin area where infection rates are higher. Along with the checklist, the program promotes a "culture of safety," comprised of science of safety education; training in how to identify safety problems and solutions and to measure improvements; and empowering all team members, no matter how senior or junior, to question each other and stop procedures if safety is compromised.
Pronovost and his team have taken the checklist system across the globe, with rollouts in the United Kingdom, Spain, parts of Peru and even Pakistan. They are also in the process of putting it in all 50 states, in partnership with state health departments and hospital associations. In some states, like Rhode Island, all hospitals have signed up for the program, he says. But in other states, the buy-in has come much slower with fewer than 20 percent of hospitals signing up for the program.
In the Rhode Island project, conducted between January 2006 and June 2008, the average rate of ICU bloodstream infections decreased from 3.73 infections per catheter day to .97 infections per catheter day. More than half of the ICUs reported zero catheter-related infections. Pronovost says he expects CLABSI rates to continue to stay low in Rhode Island, just as they have in the more than 100 ICUs in Michigan. A separate study recently published by Pronovost and his team found that Michigan had been able to sustain its results for three years after first adopting these standardized procedures.
INFORMATION:
The Pronovost team worked with the Rhode Island ICU Collaborative, a statewide quality improvement initiative. The research was funded by Blue Cross & Blue Shield of Rhode Island and United Health Care of New England.
For more information:
http://www.hopkinsmedicine.org/anesthesiology_critical_care_medicine/research/experts/research_faculty/bios/pronovost.html
Checklist continues to stop bloodstream infections in their tracks, this time in Rhode Island
Earlier success with Johns Hopkins patient safety tools repeated in 23 intensive care units in the Ocean State
2010-12-04
ELSE PRESS RELEASES FROM THIS DATE:
Beyond nature vs. nurture: Parental guidance boosts child's strengths, shapes development
2010-12-04
Why does a child grow up to become a lawyer, a politician, a professional athlete, an environmentalist or a churchgoer?
It's determined by our inherited genes, say some researchers. Still others say the driving force is our upbringing and the nurturing we get from our parents.
But a new child-development theory bridges those two models, says psychologist George W. Holden at Southern Methodist University in Dallas. Holden's theory holds that the way a child turns out can be determined in large part by the day-to-day decisions made by the parents who guide that child's ...
People with a university degree fear death less than those at a lower literacy level
2010-12-04
People with a university degree fear death less than those at a lower literacy level. In addition, fear of death is most common among women than men, which affects their children's perception of death. In fact, 76% of children that report fear of death is due to their mothers avoiding the topic. Additionally, more of these children fear early death and adopt unsuitable approaches when it comes to deal with death.
These are some of the conclusions drawn from a research entitled Educación para la muerte: Estudio sobre la construcción del concepto de muerte en niños de entre ...
Polluted air increases obesity risk in young animals
2010-12-04
COLUMBUS, Ohio -- Exposure to polluted air early in life led to an accumulation of abdominal fat and insulin resistance in mice even if they ate a normal diet, according to new research.
Animals exposed to the fine-particulate air pollution had larger and more fat cells in their abdominal area and higher blood sugar levels than did animals eating the same diet but breathing clean air.
Researchers exposed the mice to the polluted air for six hours a day, five days a week for 10 weeks beginning when the animals were 3 weeks old. This time frame roughly matches the toddler ...
New insights about Botulinum toxin A
2010-12-04
A new study by researchers at the Faculty of Kinesiology, University of Calgary, is raising questions about the therapeutic use of botulinum toxin A.
The study found that animals injected with Clostridium Botulinum type A neurotoxin complex (BOTOX, Allergan, Inc., Toronto, Ontario, Canada) experienced muscle weakness in muscles throughout the body, even though they were far removed from the injection site. The study also found that repeated injection induced muscle atrophy and loss of contractile tissue in the limb that was not injected with the Toxin.
"We were surprised ...
Pattern of drinking affects the relation of alcohol intake to coronary heart disease
2010-12-04
A fascinating study published in the BMJ shows that although the French drink more than the Northern Irish each week, as they drink daily, rather than more on less occasions, the French suffered from considerably less coronary heart disease than the Northern Irish. Ruidavets and colleagues compared groups of middle aged men in France and Northern Ireland, who have very different drinking cultures and rates of heart disease.The authors found that men who "binge" drink (drink =50 g of alcohol once a week) had nearly twice the risk of myocardial infarction or death from coronary ...
Research provides better understanding of long-term changes in the climate system
2010-12-04
For more than a decade, Dr. Joseph Ortiz, associate professor of geology at Kent State University and part of an international team of National Science Foundation (NSF)-funded researchers, has been studying long-term climate variability associated with El Niño. The researchers' goal is to help climatologists better understand this global climate phenomenon that happens every two to eight years, impacting much of the world.
El Niño is the periodic warming of central and eastern tropical Pacific waters. The last El Niño occurred in 2009, Ortiz said, and its impact was ...
Hospital perks: How much should hospitals be rewarded for the patient experience?
2010-12-04
From hotel-style room service to massage therapy to magnificent views, hospitals are increasingly touting their luxury services in a bid to gain market share, especially those in competitive urban markets. An important new article, published today in the New England Journal of Medicine, raises crucial questions about the role of amenities in hospital care, explaining that how we decide to value the patient experience can have a significant effect on health care costs.
"Though amenities have long been relevant to hospital competition, they seem to have increased in importance ...
Urban youth cope with neighborhood violence in diverse ways
2010-12-04
Experiences with violence cause teens growing up in dangerous neighborhoods to adopt a range of coping strategies, with notable impact whether the violence takes place at home, among friends or during police incidents, a University of Chicago study shows.
The responses to violence include seeking out non-violent friends, avoiding trouble, becoming resigned to the situation, striving to do well in school, or for some, retaliating physically, the authors said.
"Exposure to community violence is pervasive among youth in many urban neighborhoods. We found in one study that ...
Sows ears and silk purses: Packing more flavor into modern pork
2010-12-04
Perhaps you can't make a silk purse out of a sow's ear, but scientists are reporting progress in pulling off the same trick with the notoriously bland flavor of pork. They are reporting new insights into the biochemical differences in the meat of an Italian swine renowned for its good flavor since the ancient Roman Empire and the modern "Large White" or Yorkshire hog, whose roots date back barely 125 years. Their study appears in ACS' Journal of Proteome Research.
Lello Zolla and colleagues note that modern lean pork's reputation as bland and tasteless — "the other white ...
Heat helped hasten life's beginnings
2010-12-04
CHAPEL HILL, N.C. -- There has been controversy about whether life originated in a hot or cold environment, and about whether enough time has elapsed for life to have evolved to its present complexity.
But new research at the University of North Carolina at Chapel Hill investigating the effect of temperature on extremely slow chemical reactions suggests that the time required for evolution on a warm earth is shorter than critics might expect.
The findings are published in the Dec. 1, 2010, online early edition of the Proceedings of the National Academy of Sciences.
Enzymes, ...
LAST 30 PRESS RELEASES:
‘Chronic lung-transplant rejection has been a black box.’ New study gives answers, drug targets.
Neutrino experiments in US and Japan join forces
Hunting for the chromosomal genes that break the heart
Trial enrollment and survival disparities among patients with advanced epithelial ovarian carcinoma
Adverse pregnancy outcomes and long-term risk of atrial fibrillation
Study: Dangerous E. coli strain blocks gut’s defense mechanism to spread infection
No benefit of ketamine for patients hospitalised with depression, clinical trial reports
Ants use a genetic 'bulldozer' to achieve a hyper-specific sense of smell
Scientists pinpoint a key gene behind heart defects in Down syndrome
$6.2M grant will launch UC San Diego REACH Center for Translational Science on Whole Person Health
Bay Area Lyme Foundation opens applications for 2026 Emerging Leader Awards and research grants
A new post-processing route to improve tensile strength and ductility in 3d-printed alloys
JMIR Publications’ Journal of Medical Internet Research invites submissions on Navigating AI-Enabled Uncertainty
Small changes in alcohol intake linked to blood pressure shifts
Natural Japanese and Taiwanese hinoki cypresses genetically differentiated 1 million years ago
GemPharmatech announces research collaboration with leading cancer center to advance antibody discovery
Deciding whether a breathing tube is best for a child
A ‘dead’ 1800s idea rises again... with clues to the mystery of the universe’s missing antimatter
Roboticists reverse engineer zebrafish navigation
FAU historian traces the transformation of U.S. nursing homes into big business
CABI study reveals major inequalities in global One Health research
Reptiles ‘pee’ crystals, and scientists are investigating what they’re made of
Drug prevents congenital heart block recurrence in a high-risk pregnancy
Wiley announces winners of Advanced Science Young Innovator Award
Towards new ionic liquid-modified zeolite membranes for efficient CO2 conversion
UK Capital's ULEZ quickly cut air pollution —high vehicle compliance may have left little room for further gains after expansion
Retreating glaciers may send fewer nutrients to the ocean
Scientists develop a way to track donor bacteria after fecal microbiota transplants
Telescope hack opens a sharper view into the universe
ASU’s new School of Medicine receives preliminary accreditation, gift and new name
[Press-News.org] Checklist continues to stop bloodstream infections in their tracks, this time in Rhode IslandEarlier success with Johns Hopkins patient safety tools repeated in 23 intensive care units in the Ocean State