(LONDON, Ontario) - As part of the province-wide public reporting initiative from the Ministry of Health and Long-Term Care, London Health Sciences Centre (LHSC) and St. Joseph’s Health Care, London (St. Joseph’s) posted their indicator rates today.
LHSC and St. Joseph’s posted surgical site infection (SSI) prevention and hand hygiene compliance rates. In addition, LHSC posted rates for central line infections (CLI) and ventilator associated pneumonia (VAP) – these indicators do not apply to St. Joseph’s.
Hand Hygiene Compliance
The hand hygiene compliance rate is based on the number of times care providers comply with the 4 moments of hand hygiene:
- Before initial patient/patient environment contact
- Before aseptic procedure
- After body fluid exposure risk
- After patient/patient environment contact
Moments 1 and 4, the most important opportunities to prevent infections, are publicly reported.
The rates for both LHSC and St. Joseph’s are low. “Our rates of hand hygiene compliance are unacceptable,” said Cliff Nordal, president and CEO of St. Joseph’s and LHSC. “Since we completed the hand hygiene audit in August 2008, we’ve done a tremendous amount of education and placed hand cleaner by bedsides to improve our hand hygiene rates. We know our compliance rates are improving; nevertheless, we still have a lot of work to do.”
LSHC and St. Josephs will again be auditing hand hygiene this summer, and will publicize the results at that time. “I am confident this second audit will show increased compliance, from what we are reporting today,” said Nordal.
Everyone from physicians and care providers to patients and families is responsible for cleaning their hands in the right way at the right time.
”It’s up to everyone who works at, or comes to, a hospital to be vigilant about hand hygiene. We all need to be part of the solution,’ said Nordal.
“We want to be clear that health care providers are washing their hands, and continually improving the practice as more is learned about hand hygiene best practice,” said Dr. Gillian Kernaghan, integrated vice-president of medical education and medical affairs. “Our goal is to make cleaning hands at the 4 moments for hand hygiene - which is an extremely high standard - second nature.
Surgical Site Infection (SSI) Prevention
The SSI prevention percentage refers to the use of antibiotics that help prevent surgical site infections from occurring in hip and knee joint replacement surgeries. Specifically, it is the percentage of these surgical patients who received a prophylactic, or preventative, antibiotic within the appropriate time prior to surgery. Appropriate times are within 60 minutes for standard antibiotics, and 120 minutes for Vancomycin. Actual surgical site infections are not reported.
“It is important to understand that this indicator is measuring a window for administering the antibiotics, which is best practice. If the antibiotic is not administered at the ideal time, this would be shown as not-compliant in the results,” says Kirsten Krull-Naraj, integrated vice president, surgery services. “This does not mean that patients didn't receive the antibiotics. Staff are administering the antibiotics, and we continue to improve our processes to ensure that our patients receive the antibiotics within the most appropriate time frame.”
Ventilator associated pneumonia (VAP) and central line infections (CLI)
When a patient requires long-term access to medication through an IV, a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. Patients in the ICU often require a central line since they are seriously ill, and will require a lot of medication, for a long period of time.
Ventilator associated pneumonia is a pneumonia (lung infection) occurring in patients in an intensive care unit (ICU), requiring external breathing support, intermittently or continuously, through a breathing tube for more than 48 hours. VAP can develop in patients because they are relying on an external machine to breath amd their normal coughing, yawning, and deep breath reflexes are suppressed.
“We are pleased with these results and will continue to maintain this high quality of care for our patients,” said Krull –Naraj.
Success in these areas is due in part to the implementation of the “safer health care now” educational initiative for CLI and VAP
Backgrounder public reporting statistics for LHSC
Backgrounder public reporting statistics for St. Joseph’s
For the complete patient safety indicator report from the Ministry of Health and Long Term Care, please visit www.ontario.ca/patientsafety.