User login
Computerized checklist can reduce CLABSI rate
Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.” 
Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.”
Staphylococcus infection
Credit: Bill Branson
A computerized safety checklist that pulls information from patients’ electronic medical records can reduce the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in Pediatrics.
The study was conducted among children admitted to the pediatric intensive care unit at Lucile Packard Children’s Hospital Stanford in California.
Researchers found the safety checklist increased overall staff compliance with best practices for CLABSI prevention and resulted in a 3-fold reduction in CLABSI incidence.
The automated checklist, and a dashboard-style interface used to interact with it, was designed to help caregivers follow national guidelines for CLABSI prevention. The system combed through data in a patient’s electronic medical record and pushed alerts to physicians and nurses when a patient’s central line was due for care.
The dashboard interface displayed real-time alerts on a large LCD screen in the nurses’ station. Alerts—shown as red, yellow, or green dots beside patients’ names—were generated if, for example, the dressing on a patient’s central line was due to be changed, or if it was time for caregivers to re-evaluate whether medications given in the central line could be switched to oral formulations instead.
“The information was visible and easy to digest,” said study author Deborah Franzon, MD. “We improved compliance with best-care practices and pulled information that otherwise would have been difficult to look for. It reduced busy work and made it possible for the healthcare team to perform their jobs more efficiently and effectively.”
The system was implemented on May 1, 2011, but the researchers considered the rollout period to extend to August 31, 2011. So this period was not included in the analysis.
The team compared data on CLABSI rates, compliance with bundle elements, and staff perceptions/knowledge before the intervention began—from June 1, 2009, to April 30, 2011—and after the system was fully implemented—September 1, 2011, to December 31, 2012.
CLABSI rates decreased from 2.6 per 1000 line-days before the intervention to 0.7 per 1000 line-days afterward (P=0.02). There were a total of 19 CLABSIs per 7322 line-days pre-intervention and 7 CLABSIs per 6155 line-days post-intervention.
The researchers estimated that the intervention saved approximately $260,000 per year in healthcare costs. Treating a single CLABSI costs approximately $39,000.
The team also found that daily documentation of line necessity increased from 30% before the intervention to 73% after (P<0.001). Compliance with dressing changes increased from 87% to 90% (P=0.003).
Compliance with cap changes increased from 87% to 93% (P<0.001). And compliance with port needle changes increased from 69% to 95% (P<0.001). However, compliance with insertion bundle documentation decreased from 67% to 62% (P=0.001).
After the system was implemented, there was a significant increase in staff perception that the medical team addressed central line necessity during rounds (P=0.02). But there was no significant difference in communication among team members (P=0.73) or knowledge regarding the components of the maintenance bundle (P=0.39).
Nevertheless, the researchers concluded that their system promotes compliance with best practices for CLABSI prevention, thereby reducing the risk of harm to patients.
The team hopes to use the system in other ways, such as monitoring the recovery of children who have received organ transplants.
“[The system] lets physicians focus on taking care of the patient while automating some of the background safety checks,” said study author Natalie Pageler, MD. “The nice thing about this tool is that it’s integrated into the electronic medical record, which we use every single day.”
Rare outbreak in cancer clinic tied to saline flush
Credit: Rhoda Baer
The first reported outbreak of Tsukamurella species bloodstream infections was due to improper handling of intravenous saline, according to a report published in Infection Control and Hospital Epidemiology.
From September 2011 to May 2012, 15 immunocompromised patients treated at an outpatient oncology clinic in West Virginia developed infections with Tsukamurella, which are gram-positive bacteria that rarely cause disease in humans.
All patients had received a cancer diagnosis and had an indwelling central line, although central line types varied.
A case-control study revealed that the only risk factor for developing Tsukamurella infection was the receipt of a saline flush in September or October 2011, when clinic staff were using a common-source bag of saline.
Investigations by the West Virginia Bureau of Public Health (WVBPH) and the Centers for Disease Control and Prevention (CDC) uncovered several lapses in infection control procedures relating to the care of long-term intravenous catheters and preparation of chemotherapy for patients at the clinic.
However, these investigations also suggested that saline flush syringes were the likely source of infection.
So the WVBPH and the CDC recommended the clinic institute several changes to its infection prevention and control practices, including using pre-packaged, manufactured saline flushes.
After the clinic changed this practice, Tsukamurella bloodstream infections stopped occurring, further supporting the saline flush as the source of infection.
“This outbreak illustrates the need for outpatient clinics to follow proper infection control guidelines and medication preparation practices to minimize the risk of infection for patients with weakened immune systems,” said lead study author Isaac See, MD, of the CDC.
To that end, the CDC has developed a basic infection control plan tailored to outpatient oncology facilities.
The plan outlines policies and procedures needed to meet minimal requirements for patient safety, including the proper use and handling of injectable medications and correct procedures for assessing central lines.
Credit: Rhoda Baer
The first reported outbreak of Tsukamurella species bloodstream infections was due to improper handling of intravenous saline, according to a report published in Infection Control and Hospital Epidemiology.
From September 2011 to May 2012, 15 immunocompromised patients treated at an outpatient oncology clinic in West Virginia developed infections with Tsukamurella, which are gram-positive bacteria that rarely cause disease in humans.
All patients had received a cancer diagnosis and had an indwelling central line, although central line types varied.
A case-control study revealed that the only risk factor for developing Tsukamurella infection was the receipt of a saline flush in September or October 2011, when clinic staff were using a common-source bag of saline.
Investigations by the West Virginia Bureau of Public Health (WVBPH) and the Centers for Disease Control and Prevention (CDC) uncovered several lapses in infection control procedures relating to the care of long-term intravenous catheters and preparation of chemotherapy for patients at the clinic.
However, these investigations also suggested that saline flush syringes were the likely source of infection.
So the WVBPH and the CDC recommended the clinic institute several changes to its infection prevention and control practices, including using pre-packaged, manufactured saline flushes.
After the clinic changed this practice, Tsukamurella bloodstream infections stopped occurring, further supporting the saline flush as the source of infection.
“This outbreak illustrates the need for outpatient clinics to follow proper infection control guidelines and medication preparation practices to minimize the risk of infection for patients with weakened immune systems,” said lead study author Isaac See, MD, of the CDC.
To that end, the CDC has developed a basic infection control plan tailored to outpatient oncology facilities.
The plan outlines policies and procedures needed to meet minimal requirements for patient safety, including the proper use and handling of injectable medications and correct procedures for assessing central lines.
Credit: Rhoda Baer
The first reported outbreak of Tsukamurella species bloodstream infections was due to improper handling of intravenous saline, according to a report published in Infection Control and Hospital Epidemiology.
From September 2011 to May 2012, 15 immunocompromised patients treated at an outpatient oncology clinic in West Virginia developed infections with Tsukamurella, which are gram-positive bacteria that rarely cause disease in humans.
All patients had received a cancer diagnosis and had an indwelling central line, although central line types varied.
A case-control study revealed that the only risk factor for developing Tsukamurella infection was the receipt of a saline flush in September or October 2011, when clinic staff were using a common-source bag of saline.
Investigations by the West Virginia Bureau of Public Health (WVBPH) and the Centers for Disease Control and Prevention (CDC) uncovered several lapses in infection control procedures relating to the care of long-term intravenous catheters and preparation of chemotherapy for patients at the clinic.
However, these investigations also suggested that saline flush syringes were the likely source of infection.
So the WVBPH and the CDC recommended the clinic institute several changes to its infection prevention and control practices, including using pre-packaged, manufactured saline flushes.
After the clinic changed this practice, Tsukamurella bloodstream infections stopped occurring, further supporting the saline flush as the source of infection.
“This outbreak illustrates the need for outpatient clinics to follow proper infection control guidelines and medication preparation practices to minimize the risk of infection for patients with weakened immune systems,” said lead study author Isaac See, MD, of the CDC.
To that end, the CDC has developed a basic infection control plan tailored to outpatient oncology facilities.
The plan outlines policies and procedures needed to meet minimal requirements for patient safety, including the proper use and handling of injectable medications and correct procedures for assessing central lines.
National plan to lower HAIs shows signs of success, investigators find
Credit: CDC
New research suggests a federally sponsored plan to decrease the incidence of healthcare-acquired infections (HAIs) in the US was successful in addressing the challenges of prioritizing and coordinating strategies.
The plan has also been associated with reductions in the rates of HAIs, with progress made toward most targets where data are available.
Descriptions of the plan and its initial results appear in a series of articles published in a supplement to the February issue of Medical Care.
“Much progress has been made in raising awareness of and developing strategies for curbing the life-threatening infections that strike patients too often when they are receiving medical care,” said Katherine Kahn, MD, a leader of the project and professor at the Geffen School of Medicine at the University of California, Los Angeles.
“In order to make even more progress, we need to build our systems of care to be safer within and across hospitals, nursing homes, clinics, and community settings.”
In 2009, the US Department of Health and Humans Services released a national plan aimed at preventing HAIs, called “National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination.”
Researchers performed an evaluation of the first few years of the plan, reviewing the structure of the effort, as well as the results thus far.
The plan focuses on evidence-based strategies, such as considering the benefits and risks when deciding about the use and duration of treatments like antibiotics.
Most of the prevention initiatives have focused on hospital settings, but the action plan has focused attention on efforts in other care settings, such as outpatient surgery centers, kidney dialysis centers, and long-term care facilities.
The investigators said these efforts have likely contributed to stakeholders’ reported perceptions of greater momentum in adopting strategies to prevent HAIs.
The national plan has generated clinical, political, and financial support for the complex efforts required to eliminate HAIs across federal, regional, state, and local settings.
Despite an influx of federal funding to support elimination of HAIs, the researchers said ongoing dedicated resources will be required to maintain momentum and sustain efforts made to date.
On the other hand, because future funding for efforts to further reduce HAIs is unclear, the investigators said it may be best to incorporate the efforts into the overall movement to improve patient safety.
Credit: CDC
New research suggests a federally sponsored plan to decrease the incidence of healthcare-acquired infections (HAIs) in the US was successful in addressing the challenges of prioritizing and coordinating strategies.
The plan has also been associated with reductions in the rates of HAIs, with progress made toward most targets where data are available.
Descriptions of the plan and its initial results appear in a series of articles published in a supplement to the February issue of Medical Care.
“Much progress has been made in raising awareness of and developing strategies for curbing the life-threatening infections that strike patients too often when they are receiving medical care,” said Katherine Kahn, MD, a leader of the project and professor at the Geffen School of Medicine at the University of California, Los Angeles.
“In order to make even more progress, we need to build our systems of care to be safer within and across hospitals, nursing homes, clinics, and community settings.”
In 2009, the US Department of Health and Humans Services released a national plan aimed at preventing HAIs, called “National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination.”
Researchers performed an evaluation of the first few years of the plan, reviewing the structure of the effort, as well as the results thus far.
The plan focuses on evidence-based strategies, such as considering the benefits and risks when deciding about the use and duration of treatments like antibiotics.
Most of the prevention initiatives have focused on hospital settings, but the action plan has focused attention on efforts in other care settings, such as outpatient surgery centers, kidney dialysis centers, and long-term care facilities.
The investigators said these efforts have likely contributed to stakeholders’ reported perceptions of greater momentum in adopting strategies to prevent HAIs.
The national plan has generated clinical, political, and financial support for the complex efforts required to eliminate HAIs across federal, regional, state, and local settings.
Despite an influx of federal funding to support elimination of HAIs, the researchers said ongoing dedicated resources will be required to maintain momentum and sustain efforts made to date.
On the other hand, because future funding for efforts to further reduce HAIs is unclear, the investigators said it may be best to incorporate the efforts into the overall movement to improve patient safety.
Credit: CDC
New research suggests a federally sponsored plan to decrease the incidence of healthcare-acquired infections (HAIs) in the US was successful in addressing the challenges of prioritizing and coordinating strategies.
The plan has also been associated with reductions in the rates of HAIs, with progress made toward most targets where data are available.
Descriptions of the plan and its initial results appear in a series of articles published in a supplement to the February issue of Medical Care.
“Much progress has been made in raising awareness of and developing strategies for curbing the life-threatening infections that strike patients too often when they are receiving medical care,” said Katherine Kahn, MD, a leader of the project and professor at the Geffen School of Medicine at the University of California, Los Angeles.
“In order to make even more progress, we need to build our systems of care to be safer within and across hospitals, nursing homes, clinics, and community settings.”
In 2009, the US Department of Health and Humans Services released a national plan aimed at preventing HAIs, called “National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination.”
Researchers performed an evaluation of the first few years of the plan, reviewing the structure of the effort, as well as the results thus far.
The plan focuses on evidence-based strategies, such as considering the benefits and risks when deciding about the use and duration of treatments like antibiotics.
Most of the prevention initiatives have focused on hospital settings, but the action plan has focused attention on efforts in other care settings, such as outpatient surgery centers, kidney dialysis centers, and long-term care facilities.
The investigators said these efforts have likely contributed to stakeholders’ reported perceptions of greater momentum in adopting strategies to prevent HAIs.
The national plan has generated clinical, political, and financial support for the complex efforts required to eliminate HAIs across federal, regional, state, and local settings.
Despite an influx of federal funding to support elimination of HAIs, the researchers said ongoing dedicated resources will be required to maintain momentum and sustain efforts made to date.
On the other hand, because future funding for efforts to further reduce HAIs is unclear, the investigators said it may be best to incorporate the efforts into the overall movement to improve patient safety.
Compliance with HAI policies varies across US
Credit: Rhoda Baer
An analysis of US intensive care units (ICUs) shows uneven compliance with policies for preventing healthcare-associated infections (HAIs).
The survey of more than 1500 ICUs showed that a majority of hospitals had prevention policies in place for central line-associated bloodstream infections (CLABSIs). But adherence to these policies ranged from 37% to 71%.
And both the prevalence of and adherence to policies was even lower for 2 other common HAIs.
Patricia W. Stone PhD, of the Columbia University School of Nursing in New York, and her colleagues shared these results in the American Journal of Infection Control.
The researchers surveyed 1534 ICUs at 975 hospitals. They assessed the implementation of 16 prescribed infection-prevention measures, as well as clinician adherence to these policies for the prevention of CLABSIs, ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTIs).
The survey revealed that most hospitals had policies in place to prevent CLABSIs. Prevalence ranged from 87% for checking lines daily to 97% for applying chlorhexidine at catheter insertion sites.
This was followed by VAP prevention policies, which ranged from 69% for providing chlorhexidine mouth care to 91% for raising the head of the bed.
And finally, the presence of CAUTI policies ranged from 27% for nurse-initiated urinary catheterization to 68% for portable bladder ultrasounds. The researchers said it was surprising that evidence-based practices related to CAUTI prevention have not been well implemented, as CAUTIs are the most frequent HAI.
The survey also showed that many of the ICUs fell short in adhering to infection-prevention policies. Adherence ranged from 37% to 71% for CLABSIs, 45% to 55% for VAP, and 6% to 27% for CAUTIs.
The researchers analyzed other characteristics of the hospitals and their infection-prevention programs as well. The hospitals had an average of 52,578 annual patient-days, with 11,377 admissions, 32 ICU beds, 12 specialty beds, and 182 other beds.
Roughly a third of the departments (34%) had an electronic surveillance system, and most were commercially developed (86%).
Eighty-four percent of the institutions used hospitalists, 49% used intensivists, and 50% had a physician hospital epidemiologist. The average number of infection preventionists per 100 beds was 1.2, but certification of these staff members varied.
Having gained new insight into infection-prevention policies at hospitals across the US, the researchers are now planning to analyze the associations between HAI rates and characteristics of infection-prevention programs. They also plan to look at the relationship between HAI rates and adherence to evidence-based policies.
Credit: Rhoda Baer
An analysis of US intensive care units (ICUs) shows uneven compliance with policies for preventing healthcare-associated infections (HAIs).
The survey of more than 1500 ICUs showed that a majority of hospitals had prevention policies in place for central line-associated bloodstream infections (CLABSIs). But adherence to these policies ranged from 37% to 71%.
And both the prevalence of and adherence to policies was even lower for 2 other common HAIs.
Patricia W. Stone PhD, of the Columbia University School of Nursing in New York, and her colleagues shared these results in the American Journal of Infection Control.
The researchers surveyed 1534 ICUs at 975 hospitals. They assessed the implementation of 16 prescribed infection-prevention measures, as well as clinician adherence to these policies for the prevention of CLABSIs, ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTIs).
The survey revealed that most hospitals had policies in place to prevent CLABSIs. Prevalence ranged from 87% for checking lines daily to 97% for applying chlorhexidine at catheter insertion sites.
This was followed by VAP prevention policies, which ranged from 69% for providing chlorhexidine mouth care to 91% for raising the head of the bed.
And finally, the presence of CAUTI policies ranged from 27% for nurse-initiated urinary catheterization to 68% for portable bladder ultrasounds. The researchers said it was surprising that evidence-based practices related to CAUTI prevention have not been well implemented, as CAUTIs are the most frequent HAI.
The survey also showed that many of the ICUs fell short in adhering to infection-prevention policies. Adherence ranged from 37% to 71% for CLABSIs, 45% to 55% for VAP, and 6% to 27% for CAUTIs.
The researchers analyzed other characteristics of the hospitals and their infection-prevention programs as well. The hospitals had an average of 52,578 annual patient-days, with 11,377 admissions, 32 ICU beds, 12 specialty beds, and 182 other beds.
Roughly a third of the departments (34%) had an electronic surveillance system, and most were commercially developed (86%).
Eighty-four percent of the institutions used hospitalists, 49% used intensivists, and 50% had a physician hospital epidemiologist. The average number of infection preventionists per 100 beds was 1.2, but certification of these staff members varied.
Having gained new insight into infection-prevention policies at hospitals across the US, the researchers are now planning to analyze the associations between HAI rates and characteristics of infection-prevention programs. They also plan to look at the relationship between HAI rates and adherence to evidence-based policies.
Credit: Rhoda Baer
An analysis of US intensive care units (ICUs) shows uneven compliance with policies for preventing healthcare-associated infections (HAIs).
The survey of more than 1500 ICUs showed that a majority of hospitals had prevention policies in place for central line-associated bloodstream infections (CLABSIs). But adherence to these policies ranged from 37% to 71%.
And both the prevalence of and adherence to policies was even lower for 2 other common HAIs.
Patricia W. Stone PhD, of the Columbia University School of Nursing in New York, and her colleagues shared these results in the American Journal of Infection Control.
The researchers surveyed 1534 ICUs at 975 hospitals. They assessed the implementation of 16 prescribed infection-prevention measures, as well as clinician adherence to these policies for the prevention of CLABSIs, ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTIs).
The survey revealed that most hospitals had policies in place to prevent CLABSIs. Prevalence ranged from 87% for checking lines daily to 97% for applying chlorhexidine at catheter insertion sites.
This was followed by VAP prevention policies, which ranged from 69% for providing chlorhexidine mouth care to 91% for raising the head of the bed.
And finally, the presence of CAUTI policies ranged from 27% for nurse-initiated urinary catheterization to 68% for portable bladder ultrasounds. The researchers said it was surprising that evidence-based practices related to CAUTI prevention have not been well implemented, as CAUTIs are the most frequent HAI.
The survey also showed that many of the ICUs fell short in adhering to infection-prevention policies. Adherence ranged from 37% to 71% for CLABSIs, 45% to 55% for VAP, and 6% to 27% for CAUTIs.
The researchers analyzed other characteristics of the hospitals and their infection-prevention programs as well. The hospitals had an average of 52,578 annual patient-days, with 11,377 admissions, 32 ICU beds, 12 specialty beds, and 182 other beds.
Roughly a third of the departments (34%) had an electronic surveillance system, and most were commercially developed (86%).
Eighty-four percent of the institutions used hospitalists, 49% used intensivists, and 50% had a physician hospital epidemiologist. The average number of infection preventionists per 100 beds was 1.2, but certification of these staff members varied.
Having gained new insight into infection-prevention policies at hospitals across the US, the researchers are now planning to analyze the associations between HAI rates and characteristics of infection-prevention programs. They also plan to look at the relationship between HAI rates and adherence to evidence-based policies.
Music therapy helps AYAs undergoing HSCT
Credit: Chad McNeeley
A music therapy intervention can help adolescents and young adults (AYAs) cope with cancer and its treatment, according to research published in the journal Cancer.
The intervention consisted of writing song lyrics and producing music videos.
It helped AYA cancer patients communicate their feelings about their disease and its treatment, hematopoietic stem cell transplant (HSCT).
The program also had positive effects on patients’ social integration and family environment.
About the intervention
The therapeutic music video (TMV) intervention was designed to improve resilience in AYA cancer patients undergoing HSCT. Resilience is the process of positively adjusting to stressors.
“Adolescents and young adults who are resilient have the ability to rise above their illness, gain a sense of mastery and confidence in how they have dealt with their cancer, and demonstrate a desire to reach out and help others,” said study author Joan Haase, PhD, RN, of the Indiana University School of Nursing.
Dr Haase and her colleagues wanted to use the TMV intervention to help AYAs explore and express thoughts and emotions about their disease and treatment that might otherwise go unspoken.
The patients did this by writing song lyrics and producing videos with the help of a board-certified music therapist. As they moved through phases of the intervention—making sound recordings, collecting video images, and storyboarding—patients had opportunities to involve family, friends, and healthcare providers in their project.
Results of the study
To test the intervention, Dr Haase and her colleagues enrolled 113 cancer patients (aged 11 to 24 years) who were undergoing HSCT.
The patients were randomized to the TMV intervention group or a control group that received audiobooks. All patients completed 6 sessions over 3 weeks.
After the intervention, the TMV group reported significantly better courageous coping. And at 100 days after HSCT, the TMV group reported significantly better social integration and family environments.
Parents reported that the videos gave them insight into their children’s cancer experiences. However, parents needed help to initiate and sustain conversations about messages shared through their children’s videos.
The investigators said these findings provide evidence supporting the use of a music-based intervention delivered by a music therapist to help AYAs cope with high-risk, high-intensity cancer treatments.
“The availability of music therapy services from a board-certified music therapist in the United States has become more widespread, and, through studies like this one, we hope to see increased availability and access to this important allied health service,” said study author Sheri L. Robb, PhD, also of the Indiana University School of Nursing.
“One of our team’s next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained.”
Credit: Chad McNeeley
A music therapy intervention can help adolescents and young adults (AYAs) cope with cancer and its treatment, according to research published in the journal Cancer.
The intervention consisted of writing song lyrics and producing music videos.
It helped AYA cancer patients communicate their feelings about their disease and its treatment, hematopoietic stem cell transplant (HSCT).
The program also had positive effects on patients’ social integration and family environment.
About the intervention
The therapeutic music video (TMV) intervention was designed to improve resilience in AYA cancer patients undergoing HSCT. Resilience is the process of positively adjusting to stressors.
“Adolescents and young adults who are resilient have the ability to rise above their illness, gain a sense of mastery and confidence in how they have dealt with their cancer, and demonstrate a desire to reach out and help others,” said study author Joan Haase, PhD, RN, of the Indiana University School of Nursing.
Dr Haase and her colleagues wanted to use the TMV intervention to help AYAs explore and express thoughts and emotions about their disease and treatment that might otherwise go unspoken.
The patients did this by writing song lyrics and producing videos with the help of a board-certified music therapist. As they moved through phases of the intervention—making sound recordings, collecting video images, and storyboarding—patients had opportunities to involve family, friends, and healthcare providers in their project.
Results of the study
To test the intervention, Dr Haase and her colleagues enrolled 113 cancer patients (aged 11 to 24 years) who were undergoing HSCT.
The patients were randomized to the TMV intervention group or a control group that received audiobooks. All patients completed 6 sessions over 3 weeks.
After the intervention, the TMV group reported significantly better courageous coping. And at 100 days after HSCT, the TMV group reported significantly better social integration and family environments.
Parents reported that the videos gave them insight into their children’s cancer experiences. However, parents needed help to initiate and sustain conversations about messages shared through their children’s videos.
The investigators said these findings provide evidence supporting the use of a music-based intervention delivered by a music therapist to help AYAs cope with high-risk, high-intensity cancer treatments.
“The availability of music therapy services from a board-certified music therapist in the United States has become more widespread, and, through studies like this one, we hope to see increased availability and access to this important allied health service,” said study author Sheri L. Robb, PhD, also of the Indiana University School of Nursing.
“One of our team’s next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained.”
Credit: Chad McNeeley
A music therapy intervention can help adolescents and young adults (AYAs) cope with cancer and its treatment, according to research published in the journal Cancer.
The intervention consisted of writing song lyrics and producing music videos.
It helped AYA cancer patients communicate their feelings about their disease and its treatment, hematopoietic stem cell transplant (HSCT).
The program also had positive effects on patients’ social integration and family environment.
About the intervention
The therapeutic music video (TMV) intervention was designed to improve resilience in AYA cancer patients undergoing HSCT. Resilience is the process of positively adjusting to stressors.
“Adolescents and young adults who are resilient have the ability to rise above their illness, gain a sense of mastery and confidence in how they have dealt with their cancer, and demonstrate a desire to reach out and help others,” said study author Joan Haase, PhD, RN, of the Indiana University School of Nursing.
Dr Haase and her colleagues wanted to use the TMV intervention to help AYAs explore and express thoughts and emotions about their disease and treatment that might otherwise go unspoken.
The patients did this by writing song lyrics and producing videos with the help of a board-certified music therapist. As they moved through phases of the intervention—making sound recordings, collecting video images, and storyboarding—patients had opportunities to involve family, friends, and healthcare providers in their project.
Results of the study
To test the intervention, Dr Haase and her colleagues enrolled 113 cancer patients (aged 11 to 24 years) who were undergoing HSCT.
The patients were randomized to the TMV intervention group or a control group that received audiobooks. All patients completed 6 sessions over 3 weeks.
After the intervention, the TMV group reported significantly better courageous coping. And at 100 days after HSCT, the TMV group reported significantly better social integration and family environments.
Parents reported that the videos gave them insight into their children’s cancer experiences. However, parents needed help to initiate and sustain conversations about messages shared through their children’s videos.
The investigators said these findings provide evidence supporting the use of a music-based intervention delivered by a music therapist to help AYAs cope with high-risk, high-intensity cancer treatments.
“The availability of music therapy services from a board-certified music therapist in the United States has become more widespread, and, through studies like this one, we hope to see increased availability and access to this important allied health service,” said study author Sheri L. Robb, PhD, also of the Indiana University School of Nursing.
“One of our team’s next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained.”