A hospital stay can be frightening enough without having to worry about getting an infection or receiving the wrong prescription. But nearly one in every 13 Canadian patients experiences a preventable hospital-related infection or incident.
An 18-month-long campaign, called Safer Healthcare Now!, has been looking at ways to prevent these incidents, focusing on six areas:
- Deploy Rapid Response Teams at the first sign of patient decline
- Deliver reliable, evidence-based care for Acute Myocardial Infarction to prevent deaths from heart attack
- Prevent Adverse Drug Events (by implementing medication reconciliation
- Prevent Central Line Infections by implementing a series of evidence-based steps to improve catheter insertion and maintenance
- Prevent Surgical Site Infections by taking steps before, during and after surgery to protect patients from unnecessary infections that can prolong hospital stays
- Prevent Ventilator-Associated Pneumonia protecting already vulnerable patients in intensive care units (ICU) from a life-threatening infection.
The campaign team has been working with 600 health professionals in more than 180 hospitals and health regions across Canada.
"We've been working with teams from hospitals across the country around strategies to reduce the likelihood of things going wrong in hospital," Dr. Ross Baker explained on Canada AM Wednesday.
One initiative is in the area of heart attacks. It's estimated that 80 per cent of patients who have a heart attack in hospital will die. Part of the problem is that many nurses are hesitant to call for help when they think a patient is going into cardiac arrest, worried they will get blamed if they make the wrong call.
The Safer Healthcare Now! group set up early-response teams in some intensive care units to support the nurses.
The teams provide a resource for nurses to turn to when they're not sure if a patient needs help. If they have a patient with an erratic heart rate, or with a declining respiratory rate, and they don't want to track down the attending doctor, they can contact the early-response team.
"Many hospitals really face severe shortages on nurses and nurses are running around trying to do things so this is a way to give expertise to the nurse to make sure the patient doesn't have a heart attack," explained Baker.
Baker says the early-response teams build in an extra measure of protection for patients, and have provided very encouraging results.
Another area the SHN group is working on is ventilator pneumonia. Mechanical ventilation can be an important way to support patients in the intensive care unit but it carries a risk of causing pneumonia in bed-ridden patients. The thinking had been that the risk was unavoidable, but the SHN team found that there are ways to significantly reduce the risk.
For example, raising the head of the patient's bed by 30 degrees helps prevent fluid from backing up into the lungs, and that helps avoid pneumonia.
"Raising the head of the bed 30 degrees greatly reduced the risk of the secretions getting into the lungs," Baker said.
A third area cited that needed improvement was medication errors. The SHN group found that, too often, doctors are not aware of the medications that patients who are admitted to hospital are taking.
"Many patients are on four, six, eight medications, and it can be very easy in the rush of getting a patient into hospital and getting them treated to not get a list of the full medication that they're on when they come in, to put them on new medications, to discontinue ones they should be on," explained Baker.
"So we've been working with teams to make sure there's a reliable process that allows the physician who's writing the orders to make sure they know what the patient's on and what they should receive."
The next step for the Safer Heathcare Now! campaign is to engage leadership of hospitals and health care teams to get on board to tackle these basic issues and to spread the message to other healthcare facilities across Canada.
