One of the most significant changes children's hospitals can make to reduce errors and save lives is:
Reduce catheter-associated bloodstream infections (CABSIs)
by implementing a series of evidence-based practices system-wide.
To move you further faster, California Perinatal Quality Care Collaborative (CPQCC) in partnership with California Children’s Services (CCS) has already adapted the scientific evidence to make it neonatal-specific and hand-selected a panel of the nation's leading improvement experts to guide the CPQCC/CCS Healthcare Associated Infection (HAI) collaborative.
Catheter-associated bloodstream infections (CABSIs) are a serious threat to our patients’ safety. Our aim is to reduce the occurrence of catheter-associated blood stream infections (CABSI) to almost zero system-wide. This collaborative provides an opportunity for your NICU to aggressively pursue an improved care system for newborns requiring treatment involving central catheters.
The Agency for Healthcare Research and Quality (AHRQ) and the Centers for Disease Control and Prevention (CDC) have acknowledged that central catheters are critical components of medical care for many patients, but their use can lead to catheter-associated blood stream infections. These infections are both costly and dangerous. The mean cost of a bloodstream infection has been estimated at $46,133 in the Pediatric Intensive Care Unit (PICU) due to the longer length of stay and additional ancillary utilization (Slonim et al), making it the most expensive of all nosocomial infections. Bloodstream infections account for 30% of all health care associated infections in pediatrics according to the CDC’s National Healthcare Safety Network (NHSN), formerly known as the National Nosocomial Infection Surveillance System (NNIS). Although the association between bloodstream infections and death is somewhat controversial, AHRQ concluded that findings in the literature are consistent with a 10-20% increase in mortality. The CDC in 2006 reported a pooled mean of 3.1 (>2500 grams birthweight) to 6.4 (< 750 grams birthweight) infections per 1000 catheter-days. Both the AHRQ and CDC have recommended several key practices to reduce the chances of a central catheter infection.
In addition, beginning January 2008 your infection surveillance and prevention process measures will become increasingly transparent, as California Senate Bill 739 requires hospitals “to prepare a written report that examines the hospitals existing resources and evaluates the quality and effectiveness of the hospitals infection surveillance and prevention program including specified information”. The bill “will require each general acute care hospital that uses central venous catheters to implement policies and procedures to prevent the occurrence of Healthcare Associated Infections (HAIs), as recommended by specific guidelines and other evidence”.
The mission of this collaborative is to achieve breakthrough improvements in reducing infections associated with central catheters. We intend to close the gap between what is known and what is practiced to establish new neonatal systems that will produce: better clinical outcomes, lower costs, and better coordination of care. This will be achieved through the consistent application of the best available scientific knowledge using central catheter protocols, which have proven to significantly improve outcomes and reduce costs. CPQCC will help collaborative participants meet the collaborative goals by sharing the best available scientific knowledge, by teaching and applying methods for organizational change, and by involving experienced external and CPQCC hospital experts.