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Massive fall in infections in intensive care units

Five key practices were responsible for a 60% fall in two years

Ingrid Torjesen

Tuesday, 25 June 2013

Hospitals in England have reduced the rate of serious bloodstream infections in intensive care units (ICUs) by more than 60% over two years by carrying out five key practices, research has shown.

More than 200 ICUs in England participated in the National Patient Safety Agency's Matching Michigan programme, which aimed to bring down infections linked to central venous catheters to the rate seen in a landmark programme in the US state of Michigan.

Infection rates not only declined in ICUs that were in the two-year programme, but also in ICUs waiting to join the programme.

Research funded by the Health Foundation found that ICUs that were not yet participating were responding to the evidence of best practice in this area and to policy pressures at the time of the programme.

Professor Mary Dixon-Woods of the University of Leicester, who led the research, said: "Simply carrying out five key practices consistently can help control infections. Our research showed that many units had already improved their procedures, and several showed considerable ingenuity in making care safer for patients."

The five practices are: observing strict hand hygiene; cleaning the skin with the correct antiseptic; avoiding the groin as the route of insertion; using full barrier protection – cap, gown, gloves and mask; and reviewing daily whether the patient still needs the catheter.

Although the programme did boost efforts in some ICUs, the improvements that were occurring anyway meant that it was difficult for the programme overall to show additional impact.

Professor Julian Bion of Birmingham University, who was clinical lead for the Matching Michigan initiative said: "No national data existed before this programme. The work showed that ICUs were already performing well at the beginning, with half the infection rate seen at the start of the equivalent US effort. By the end, two thirds of the English ICUs were reporting no infections."

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