From the April 2016 issue of HealthCare Business News magazine
Proven safety practices
Evidence-based guidelines from many medical groups, including the CDC, recommend ultrasound-guided CVC due to its many safety benefits. Increasingly, leading hospitals around the U.S. are adopting a six-point bundle of safety practices to prevent CLABSIs that includes ultrasound guidance — and have seen rates of these infections drop as a result. The six-point bundle takes the established IHI five-point bundle and adds ultrasound guidance.
For example, after implementing this approach, Cedars-Sinai Medical Center in Los Angeles has seen striking reductions in CLABSIs, while White Memorial, also in Los Angeles, was able to achieve a rate of zero between January 2010 and August 2011, at the 353-bed hospital. The six-point bundle used consisted of these components:
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1. Hand hygiene.
2. Maximal barrier precautions.
3. Chlorhexidine skin antisepsis.
4. Optimal catheter site selection.
5. Daily review of CVC necessity, with prompt removal of unneeded lines.
6. Ultrasound-guided central line placement (not part of the IHI bundle). It remains to be seen to what extent integrating procedures such as ultrasound-guided central line placement will help drive improvements in HAC scores, but the evidence of potential based upon reports from institutions has been compelling.
In addition, robust evidence from multiple peer-reviewed studies demonstrates the powerful role that ultrasound guidance can play in reducing — or even eliminating — medical harm from needle-based procedures performed to help patients heal. As Medicare continues to intensify the focus on improving hospital performance, it is incumbent upon health care institutions to implement the safety practices that have been shown to lead to the best outcomes.
Dan Conley is a freelance writer and contributor to HealthCare Business News. He writes frequently about infection control and technology.Back to HCB News
