Infection prevention case study: 4 takeaways from one California hospital's process improvement journey

California nurse Karlee Campos, BSN-RN, embarked on a research and process improvement effort focused on reducing healthcare-associated infections by switching to single-use electrocardiogram lead wires in her hospital.

During a June Becker's Hospital Review webinar sponsored by Cardinal, Ms. Campos discussed the problem of HAIs, offered evidence-based research on the effectiveness of single-use ECG lead wires to decrease HAIs and described her hospital's process improvement journey.

Four key takeaways:

  • HAIs remain a persistent problem. According to CDC estimates, HAIs account for 1.7 million patient infections annually, contributing to 99,000 associated deaths. The economic burden falls between $28 billion and $45 billion each year, with $3.3 billion attributed to surgical site infections alone. Ms. Campos finds the rates of SSIs particularly troubling. "The mortality rate is 3 percent, and 75 percent of related deaths are directly attributed to SSIs," she said. "That means these patients would not have died if they had not acquired the infection during the course of care."
  • Single-patient-use ECG lead wires can help prevent contamination and ultimately reduce HAIs. Ms. Campos completed a retrospective analysis of HAI incidence leveraging publicly-available data from the State of California, which suggested that facilities that used Kendall DL (KDL) single-use lead wire system had lower HAI rates across a variety of measures.
  • An analysis of HAIs for operative procedures in California suggests that ECG leads are more likely to contribute to infections when direct contact is likely. By examining data from California's Health and Human Services Agency, Ms. Campos observed a pattern where HAI rates were lower even when ECG leads did not come into direct contact with surgical sites. "We saw a more pronounced impact on SSI rates for cardiovascular surgery where it's more likely that contaminated leads touch the surgical site and transfer pathogens," she said, but the lower rates seen across other HAIs was a surprise.
  • As single-patient-use ECG leads reduce the incidence of SSIs, length of hospital stays will decrease and result in significant economic benefits. According to a Medicare inpatient and outpatient limited data set cited by Ms. Campos, SSI reductions from single-patient-use ECG leads resulted in $450 savings in 40-year per patient costs, mostly attributed to reduced length of stay. Medicare savings were projected to total $40 million per year by switching to single-patient-use ECG.

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