Effort cuts down catheter-related infections

The Michigan initiative was accomplished using relatively cheap, yet highly effective, interventions.

By Kevin B. O'Reilly, AMNews staff. Jan. 22, 2007.

In the first statewide program of its kind, Michigan hospitals cut their average catheter-related bloodstream infection rates by 66% and slashed the median infection rate to zero per 1,000 catheter days, compared with national rates as high as 5.2 infections per 1,000 catheter days.

The achievement, part of the Michigan Health and Hospital Assn.'s Keystone: ICU project, was documented in a study published in the Dec. 28, 2006, New England Journal of Medicine and shows that hospitals that engage physicians and nurses and make relatively cheap system changes can successfully tackle this patient safety hazard. Catheter-related bloodstream infections kill at least 17,000 patients every year, and the average cost of caring for an infected patient is $45,000, studies show.

"There's a lot of quality improvement stuff that's nothing short of marketing," said Peter J. Pronovost, MD, PhD, lead author of the study and consultant on the Keystone: ICU project. "We wanted to be able to tell citizens in Michigan that we're all safer now. That's a novel shift in that it is not just one or two hospitals doing well when 98% didn't do well."

More than 100 Michigan hospitals, accounting for 85% of the state's intensive-care unit beds, implemented the project's interventions. About half that number contributed baseline data to gauge how effective the changes were in reducing infections.