By Marie McAden
Zip. Zero. Zilch. Not one patient in the last 30 months has developed a bloodstream infection in Beaufort Memorial Hospital’s Intensive Care Unit.
It has taken a concerted effort by staff and physicians to win the battle of the bugs — a problem that continues to plague hospitals across the country.
Bloodstream infections are introduced through central lines, an intravenous catheter used to deliver medication, nutrition and fluids to a patient. The thin, flexible tube is inserted into one of the large veins deep in the chest near the heart.
“When you break the skin to insert these devices, you’re making it easier for organisms to enter the body,” said Beverly Yoder, RN, Beaufort Memorial’s Infection Prevention Coordinator.
According to the Centers for Disease Control and Prevention, an estimated 248,000 bloodstream infections occur in U.S. hospitals each year, leading to longer hospital stays, higher costs and an increased risk of death.
“With central line infections, germs are transmitted throughout the body via the bloodstream,” said Diane Razo, RN, director of critical care for BMH. “It’s a very serious condition that can affect vital organs.”
To reduce the number of infections caused by central lines, the Institute for Healthcare Improvement developed a series of evidence-based practices physicians and nurses should follow when inserting and maintaining a central line. Beaufort Memorial implemented the recommendations in 2006.
The hospital purchased special central line kits that contain everything needed to insert the catheter in a sterile environment, including the prescribed antiseptic, full-body sterile drapes, sterile mask, cap, gloves and gown, as well as a checklist to follow. The staff was trained on how to use the kits, where to insert the lines to minimize the risk of infection and how to properly change the dressings.
In 2009, BMH went a step further and joined the “On the Cusp: Stop BSI” campaign, a national initiative endorsed by the South Carolina Hospital Association, to stay abreast of any changes to the multi-faceted interventions.
“We used to change the dressings every day, but now they’re recommending every seven days and sooner if needed,” Razo said. “It’s based on evidence that has proven to reduce the risk of introducing infections.”
The hospital’s infection preventionist performs random spot checks to ensure compliance of the practices. In addition, daily reviews are conducted by staff to determine the necessity of each central line.
“The longer a catheter stays in, the greater the risk of infection,” Yoder said. “We want to be sure they are removed as soon as possible.”
In the past, Beaufort Memorial’s Intensive Care Unit had gone as long as nine months without a patient developing a bloodstream infection. It’s now been two-and-a-half years the ICU has maintained a clean record.
“Bloodstream infection rates have come down across the country,” Yoder said, “but going this long without an infection is rare.”