Preventing a common infection with an 'ounce' of rules

If someone were to ask you to name half a dozen things that Benjamin Franklin invented, could you? You might get bifocals and the lightning rod on your list, and perhaps the Franklin stove, maybe the library chair, and even swim fins and Daylight Saving Time. But there is another invention, which is commonly used in health care that might not make your list, but should. The catheter.

The man known for flying a kite in an electrical storm also is credited with inventing the flexible urinary catheter to help his ailing brother. Perhaps he was thinking of that discovery when he coined the phrased: "An ounce of prevention is worth a pound of cure."

In medicine, a catheter is a tube that is inserted in the body to remove or to inject fluids, or for access of surgical instruments. In this case, a catheter is used to drain urine from the bladder.

Because urinary tract infections are so common, Trinity Health of which Battle Creek Health System is a part has worked hard to find a way to reduce those complications for its patients. That compassionate and innovative spirit was present during the design of Trinity's latest set of catheter-associated urinary tract infections (CAUTIs) rules, slated for activation this spring. This program is part of Genesis, a state-of-the-art computer system at BCHS that standardizes clinical information including physician order entry, online patient documentation, electronic medical records, and adverse drug event alerts

The CAUTI protocol will help BCHS nurses and physicians further prevent inpatients from getting catheter-related infections, a longstanding challenge in the health care setting.

"Urinary tract problems are the most commonly acquired hospital infections, with more than 75 percent directly attributed to urinary catheters remaining in place too long," says Ann Pelisser Neeld, BCHS vice president of patient care services and chief nursing officer. "In fact, recent studies indicate that about 15 percent of inpatients nationally will develop a CAUTI during some point of their hospital stay. We think that is too high and are working on eliminating those infections."

The 'toll' from this includes

occurrences of bacteria in the blood and sepsis (whole-body infections) in a small percentage of patients, occurrences of nonbacterial urethral inflammation, and increased length-of-stay for the patient which translates into increased costs. For the health care provider, Medicare and Medicaid is no longer reimbursing them for CAUTIs acquired in the hospital.

As a result of this new CAUTI process, nurses will be notified when catheters have been in place longer than 48 hours and they will be directed to consider removing catheters for patients who meet certain pre-specified criteria.

"This new protocol will go a long way in aiding the prevention of CAUTIs," adds Heather West, patient care services manager and the nurse leader for this project. "It's exciting to see how our established technology can be leveraged to increase patient safety and quality of care here at BCHS."

So the next time you see a picture of Ben Franklin with his bifocals resting on his nose, or feel the warmth of a fire coming from that cast iron stove named in his honor, keep in mind that his inventiveness also helped provide more than an 'ounce' of comfort for those in the hospital.

Battle Creek Health System, sponsored by two parent organizations--Trinity Health (the fourth largest Catholic health system in the U.S. with 21 hospitals, 9 nursing homes, 19 senior house facilities, 8 home health care agencies, and 4 hospices in Michigan alone) and BCHS Community Partners, is accredited by the Joint Commission. Battle Creek Health System is a recipient of the 2008 HealthGrades Orthopaedic Surgery Excellence Award(tm) and 2009 Five Star rated for joint replacement surgery and total knee replacement. HealthGrades is a leading health care information company that provides objective 'report card' ratings nationwide. BCHS provides excellent health care for the community and promotes wellness for the whole person with access and compassion for all. For the latest medical information, visit the BCHS web site at www.bchealth.com or call the BCHS Marketing Department at (269) 966-8132.

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Patient Safety Initiatives at BCHS
Patient safety is not a slogan but a commitment to a way Battle Creek Health System cares for patients. As a result, BCHS has been recognized over the years for its many initiatives that make certain every patient who comes to this hospital is treated with the very best care possible. Here are some examples.

Blood Glucose Testing
Battle Creek Health System instituted a new policy of checking the blood sugar of every adult patient that is admitted to the hospital at least twice during their stay. Patients are tested once within the first hour of admittance and again within six hours to compare readings. Depending upon the results, additional tests may be administered. The purpose of this new protocol is for BCHS to help the patient avoid dramatic changes in their blood sugar levels so the body can heal more rapidly. Testing helps the patient's health care team keep blood sugar at safe levels and under control.

Colored Wristbands
Battle Creek Health System is standardizing the use of color-coded patient-alert wristbands in a statewide initiative focused on reducing inconsistencies between Michigan hospitals that can result in medical errors effective June 1, 2009. The goal of the effort is to decrease the risk of such errors by standardizing the colors of five patient-alert wristbands: allergy (red), fall risk (yellow), do-not-resuscitate (purple), limb risk (pink), and latex allergy (green).

Falls Program
Patients falling are a growing problem throughout the U.S. Battle Creek Health System is doing something about that issue through its 'Falling Star!' prevention program. BCHS has educated its nursing staff so it can be aware of the signs that patients exhibit making them a fall risk. The hospital also uses a color-coded wristband to identify patients who may be prone to falling or are in a condition that makes them unsteady so others will keep an extra eye out for their safety.

Genesis
Battle Creek Health System (BCHS) took a giant leap in 2005 by transitioning to a paperless, electronic health record. By switching all inpatient nursing and ancillary documentation from traditional, paper-intensive, medical charts to an electronic medical record system, BCHS became one of only a handful of hospitals in the United States to 'go-live' with comprehensive, new technology that promises to increase patient safety and cut costs by reducing the potential for human error.

Keystone Initiative
Partnering with Johns Hopkins University and Michigan Health and Hospital Association, Battle Creek Health System joined other select Michigan hospitals to implement a unique quality improvement project that helps provide better care for patients in their intensive care units (ICU). The project, called Keystone ICU, is the largest patient safety collaborative in the world. Keystone ICU uses three 'interventions' into normal ICU procedures. 1) A daily goals sheet is created for planning patient treatments. 2) Elimination of all bloodstream infections is a priority. 3) Care for patients on ventilators is improved-the longer a patient is on a ventilator, the greater the risk for blood clots and pneumonia.

Rapid Response Team
Battle Creek Health System introduced a Rapid Response Team. This multidisciplinary medical group, composed of critical care registered nurses and respiratory therapists, is empowered to act swiftly using physicians' protocol orders if need be to assess and then treat a patient who exhibits early signs of clinical deterioration or distress. It is like a SWAT team that is available 24/7 to offer help at the first sign of an impending crisis like a heart attack or stroke before it happens.