HHS Releases New Online Patient Safety Training Resources for Clinicians and Patient Advocates

Partnering to Heal is a computer-based, interactive learning tool for clinicians, health professional students, and patient advocates.

The training highlights effective communication about infection control practices and what it means to help create a “culture of safety” in healthcare institutions.

From the press release

The HHS Office of the Assistant Secretary for Health released Partnering to Heal: Teaming Up Against Healthcare-Associated Infections, an interactive learning tool for clinicians, health professional students, and family caregivers.  The training videos include information on basic protocols for universal precautions and isolation precautions to protect patient, visitors, and practitioners from the most common disease transmissions.  The training promotes six key behaviors: teamwork, communication, hand washing, vaccination against the flu, appropriate use of antibiotics, and proper insertion, use, and removal of catheters and ventilators.  Learn how five characters can contribute to—or prevent—risk of several healthcare-associated infections, including surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections,clostridium difficile and methicillin-resistant Staphylococcus aureus.  These resources support the new Partnership for Patients, a new national public-private partnership with hospitals, medical groups, consumer groups, and employers that will help save lives by preventing millions of injuries and complications in patient care over the next 3 years.  Select to read the HHS press release.

Related articles

• Partnering to Heal: Teaming Up Against Healthcare-Associated Infections (thielst.typepad.com)
• Patient Safety Resources (aa47.wordpress.com)
• CDC issues updated bloodstream infection prevention guidelines (physorg.com)

Landmark Initiative to Reduce Healthcare-Associated Infections Cuts Deaths Among Medicare Patients in Michigan Intensive Care Units

Landmark Initiative to Reduce Healthcare-Associated Infections Cuts Deaths Among Medicare Patients in Michigan Intensive Care Units

From the January 31, 2011 AHRQ (Agency for Healthcare Research and Quality) press release

Older Americans who were treated in Michigan intensive care units (ICUs) saw larger decreases in their likelihood of dying while hospitalized than similar ICU patients in other Midwestern hospitals, according to a new study evaluating an innovative quality improvement initiative funded by HHS’ Agency for Healthcare Research and Quality (AHRQ). The initiative, known as the Keystone Project, targeted ways to reduce the number of healthcare-associated infections (HAIs). Previous research has shown that targeted quality improvement programs can reduce HAI rates. This study, “Impact of a Statewide Intensive Care Unit Quality Improvement Initiative on Hospital Mortality and Length of Stay: Retrospective Comparative Analysis,” published in today’s British Medical Journal, is the first to link these programs to reduced death rates. “This study gives us assurance that investing in large-scale, evidence-based quality improvement programs can save lives—the most important outcome for patients and doctors,” said AHRQ Director Carolyn M. Clancy, M.D. “AHRQ and others have already initiated work to expand this project nationwide to other ICUs across the country.” Researchers led by Allison Lipitz-Snyderman, Ph.D., of The Johns Hopkins Bloomberg School of Public Health, analyzed Medicare data for ICU patients in Michigan hospitals and 364 hospitals in 11 other Midwestern states. They looked at data before the project was initiated, while it was being phased in, and up to 22 months after implementation. The researchers found that overall a person’s chance of dying decreased by about 24 percent in Michigan after the program was implemented compared to only 16 percent in surrounding Midwestern states where the program was not implemented. “We knew that when we applied safety science principles to the delivery of health care, we would dramatically reduce infections in intensive care units, and now we know we are also saving lives,” says Peter J. Pronovost, M.D., Ph.D., a professor of anesthesiology and critical care medicine at The Johns Hopkins University School of Medicine. Dr. Pronovost led development of the AHRQ-sponsored Keystone Intensive Care Unit Project and implemented it in Michigan hospitals with the help of the Michigan Health and Hospital Association. “These results are very exciting, and further research should be done to address other important issues impacting the safety and quality of patient care,” added Dr. Lipitz-Snyderman. The Keystone Project uses a comprehensive approach that includes promoting a culture of patient safety, improving communication among ICU staff teams, and implementing practices based on guidelines by the Centers for Disease Control and Prevention (CDC), such as checklists and hand washing, to reduce rates of catheter-related bloodstream infections and ventilator-associated pneumonia. AHRQ continues to support the Keystone Project through a contract with the Health Research & Educational Trust, an affiliate of the American Hospital Association, by reaching more hospitals and other settings in addition to ICUs and applying the approach to various HAIs. For AHRQ’s recently funded HAI projects, go to http://www.ahrq.gov/qual/haify10.htm. According to the CDC, HAIs are one of the most common complications of hospital care, accounting for an estimated 1.7 million infections, and 99,000 associated deaths in 2002. These infections are responsible for $28 billion to $34 billion in preventable health care expenses every year. Infectious agents, such as bacteria, found in health care settings can cause patients to develop HAIs when they have surgery or require central lines or urinary tract catheters. The Keystone Project is part of a Department-wide effort to address HAIs, as outlined in the HHS Action Plan to Prevent Healthcare-Associated Infections (http://www.hhs.gov/ash/initiatives/hai/index.html). Partners across HHS, including AHRQ, CDC, the Centers for Medicare & Medicaid Services, and National Institutes of Health, are working together to achieve the goals of the Action Plan. For more information, please contact AHRQ Public Affairs: (301) 427-1864 or (301) 427-1855. Use Twitter to get AHRQ news updates:http://www.twitter.com/ahrqnews/

Additional articles about this news release

• Safety checklist use yields 10 percent drop in hospital deaths (Science Blog)
• Program reduces serious hospital infections – report (Reuters)

Articles about related studies

• Study finds MRSA screening saves hospitals money
• Private room intensive care unites associated with lower infection rates
• More doctors must join nurses, administrators in leading efforts to improve patient safety, outcomes

Nursing homes are seeking to end the stupor

[Editor Flahiff’s note: I remember visiting my great aunt in a nursing home in the early 70’s (I was in my late teens) I found the stupor among the residents very sad…this story was very refreshing to read…

My husband can attest to the importance of personal attention…he is retired and goes to senior centers daily for lunch and the “pool halls”. He makes it a point to visit with those sitting alone at lunch…and has brought a number of folks out their shells during the past few years]

Instead of treating behavioral problems with antipsychotic drugs, the Ecumen chain of 15 homes is using strategies including aromatherapy, massage, music, games, exercise and good talk. The state is helping out.

From the December 4th Star Tribune article by Warren Wolfe (via a NetGold Posting by David P Dillard )

The aged woman had stopped biting aides and hitting other residents. That was the good news.

But in the North Shore nursing home‘s efforts to achieve peace, she and many other residents were drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.

“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minn. “But what kind of quality of life is that?”

Working with a psychiatrist and a pharmacist, Lanigan started a project last year to find other ways to ease the yelling, moaning, crying, spitting, biting and other disruptive behavior that sometimes accompany dementia.

They wanted to replace drugs with aromatherapy, massage, games, exercise, personal attention, better pain control and other techniques. The entire staff was trained and encouraged to interact with residents with dementia.

Within six months, they eliminated antipsychotic drugs and cut the use of antidepressants by half. The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”…

….Medicare spends more than $5 billion a year on those [antipsychotic] drugs for its beneficiaries, including about 30 percent of nursing home residents. Several studies have concluded that more than half are prescribed inappropriately. The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization….

….

Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.”

Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread….

…

Get Smart : Know When Antibiotics Work

The US Centers for Disease Control publishes a wealth of information about antibiotics for consumers, health practitioners, and the media.

Topics include appropriate antibiotic use, dangers of antibiotic resistance, and an antibiotic quiz.

Information for Everyone includes both print and online materials, fact sheets, and Q and A’s.

Information for Healthcare Providers includes Treatment Guidelines, Patient Education Materials, and Continuing Education materials.

Sensors in Surgical Sponges May Mean Fewer Left Behind

Radio-frequency tags plus counting could improve patient safety, surgeons report

From a Oct 5 HealthDay news item

Placing radio-frequency tags inside surgical sponges could help reduce the number left behind in patients after operations, according to U.S. researchers.

The tags — which use the same technology as clothing store tags and pet microchips — could be used along with manual counting and X-ray detection to improve patient safety, said the surgeons at the University of North Carolina (UNC) at Chapel Hill School of Medicine.

“Any foreign body present long enough has a risk of causing infection,” lead investigator Dr. Christopher Rupp, a gastrointestinal surgeon, said in a UNC news release. “We have seen patients in whom sponges have eroded into other organs, mainly the intestines. People can come back with chronic pain issues after an operation that also leads to detection of a retained surgical sponge.”