Patient Safety Metrics

Central lines are IVs placed into large veins of the body to give medicines, fluids and/or nutrition. They are at risk for infections because they are in place for long periods of time, usually weeks or months. Here are some things we are doing to prevent these infections:

• We use a list of leading practices, called a bundle, to insert and care for the lines.
• We place central lines in locations that are at lower risk for infection when possible.
• We use a transparent bandage with a chemical in it that kills bacteria.
• We remove central lines when they are no longer needed.

Catheters are sometimes placed through the urethra into a patient’s bladder to help them to urinate. Bacteria that normally live in this area of the body can sometimes enter these catheters and cause infections. Here are some things we are doing to prevent these infections:

• We use a list of leading practices, called a bundle, to insert and care for the catheters.
• We remove catheters as soon as possible and give patients a chance to urinate on their own before replacing.
• We keep the perineal area clean.

Clostridioides difficile (C. diff; formerly Clostridium difficile) can cause fever, diarrhea, abdominal pain and other symptoms. Patients who have received multiple courses of antibiotics, especially broad-spectrum antibiotics, are at higher risk. Here are some things we are doing to prevent C. diff infection:

• We are careful to use the most appropriate antibiotics to treat bacterial infections.
• We avoid using antibiotics to treat viral illnesses.
• We use a testing strategy to distinguish simple presence of C. diff from true infection.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that can cause serious illness when it  gets into the blood (bacteremia). It does not respond to many antibiotics and can be difficult to treat. MRSA bacteremia can sometimes start at an IV site. Here are some things we are doing to prevent these infections:

• We remove IVs after 7 days or sooner if needed.
• We evaluate IVs on rounds.
• Please also see the section on CLABSI above.

Pressure injuries can occur to the skin when a patient remains in one position for extended periods of time. They can also be caused by some medical devices. Here are some things we are doing to prevent them:

• We frequently assess patients for early signs of skin changes.
• We have clinicians who are trained as skin champions.
• We have skin experts round routinely in our intensive care units where risk is the highest.
• We use technology to help identify early injuries which may not be visible.

Falls with injury are more likely to occur when a patient is acutely ill, with some chronic medical conditions, and when a patient is in an unfamiliar environment like the hospital. Here are some things we are doing to prevent them:

• We round frequently to assist patients with toileting and other personal needs.
• We partner with patients to promote safe transfers and mobility.
• We utilize bed and chair alarms.
• We utilize low beds.