Patient Safety is a top priority at Saint Francis. Our multidisciplinary teams work hard to increase safety and decrease risk. Our Patient Safety Committee meets every month to discuss safety across the system, with comprehensive action plans to provide BestCare for a Lifetime. At Saint Francis, we work toward compliance with all of the National Patient Safety Goals as determined by The Joint Commission. And we focus Patient Safety initiatives in the following areas:
Decreasing Catheter-Associated Urinary Tract Infections (CAUTI)
Catheter-Associated Urinary Tract Infections make up 40% of all hospital-acquired infections. Most often, these infections occur as a result of an indwelling urinary catheter. To prevent CAUTI at Saint Francis our nurses and doctors are trained in best practices for the appropriate placement and timely removal of catheters. We have adopted a comprehensive set of practice guidelines which ensure standard care of all urinary catheters in the hospital. The assessment of a sample group of Saint Francis surgical patients shows that we have reduced the post-operative CAUTI rate by 62%.
Eliminating Central Line-Associated Bloodstream Infections (CLABSI)
A central line is placed in patients who need frequent medications, blood, fluids, or nutrition. It can be very helpful, but can sometimes be a source of infection if bacteria are allowed to grow in the line and then spread to the bloodstream. Central line-associated infections are very dangerous, but are often preventable. The Central Line Bundle is a series of five steps that, when performed together, can help prevent almost all cases of CLABSI. Saint Francis healthcare professionals take exacting care to complete all five steps on every patient with a central line, using a special checklist as a reminder. Saint Francis has experienced huge success in reducing CLABSI in our intensive care units.
Transmission of healthcare-associated infections most often occurs through the hands of healthcare workers. Accordingly, hand hygiene is considered one of the most important infection-control measures in hospitals. We perform observations of handwashing compliance on a regular basis. Our goal is to wash our hands or use hand sanitizer each and every time we interact with our patients. But in case we forget, don’t hesitate to ask us to wash our hands!
Reducing Patient Falls
Our goal is to keep every patient in our care safe from falling while in the hospital. To accomplish this, we have designed a comprehensive fall prevention and management program. All nursing units at Saint Francis have identified a Fall Champion, who is responsible for education and data reports, as well as for actively planning and pursuing initiatives aimed at reducing falls. Our Call, Don’t Fall program identifies every patient at risk for falling by a green magnet on that patient's door, a green icon on the board, and a green bracelet on the wrist. In many of our nursing units, caregivers make hourly rounds to ensure that all patient needs are met. This consistent contact with patients, coupled with the identification of those patients at risk for falling, has helped us reduce falls by almost 25%.
Ensuring Medication Safety
Saint Francis embraces state-of-the-art technologies and processes to create a safe environment for medication use, which includes prescribing, dispensing, administration, and monitoring. Medication safety systems available at Saint Francis include:
- Computerized physician prescribing, with each medication order screened electronically and verified by a pharmacist.
- Bedside bar-coding of the medication and patient, guaranteeing that the correct medication is given to the correct patient.
- “Smart” infusion pumps for administering IV medication, ensuring accurate dosing rates.
- Bar-coding of IV medications during preparation, confirming the correct ingredients at the correct concentrations.
- Preparation of injectable medications using robotic technology, which ensures accuracy and purity.
- Use of automated medication dispensing machines on all nursing units, ensuring the secure and ready availability of ordered drugs that have already been reviewed and verified by a pharmacist.
- A dedicated Medication Safety Officer who conducts monitoring and training to ensure safe medication use at Saint Francis.
Decreasing Pressure Ulcers
Pressure ulcers, also called bed sores, are skin wounds that are caused by lying or sitting in one position for too long. They often appear on the bony areas of the body, such as elbows, heels, and buttocks. Pressure ulcers range from mild to severe. Millions occur in healthcare settings each year. Saint Francis strives to prevent pressure ulcers in our hospital by appropriately managing the risks. We assess patient skin integrity when they are first hospitalized, and during each day of the hospital stay. Our nurses use best practices to help reduce the risk of pressure ulcers by managing incontinence, ensuring nutrition, promoting activity, and repositioning patients. Saint Francis has a specialized wound-care team that can be consulted for guidance on the best ways to prevent pressure ulcers. We have seen a decrease in hospital-acquired pressure ulcers every year since 2005.
Ensuring Surgical Safety
Comprehensive surgical checklists improve patient care and safety in the Operating Room. Before every procedure, our operating room teams use a checklist to enhance team communication and prevent errors in accordance with The Joint Commission’s Universal Protocol. The checklist standardizes pre-procedure check-in, sign-in, time out, and sign out, including confirmation of patient identity, procedure to be performed, procedure site, and appropriate consent.
Decreasing Ventilator-Associated Pneumonia (VAP)
Ventilator-associated pneumonia is an infection of the lungs that can develop when a patient is on a ventilator. VAP can prolong hospital stays. Many such infections can be prevented with the proper care of the ventilator and the patient. At Saint Francis we have implemented the Ventilator Bundle, a series of interventions that, when completed together, reduce the chances of a patient on a ventilator developing VAP. The first three months of 2011 showed a 93% decrease in VAP rates when compared with our calendar year 2010 results.