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North Shore Hospital Sets Historic Infection Control Record

4 March 2013

North Shore Hospital Sets Historic Infection Control Record

Waitemata DHB is leading the way in a life-saving revolution that has seen it set a historic record in infection control.

The district health board’s Intensive Care & High Dependency Units (ICU/HDU) at North Shore Hospital have gone more than 400 days without a single case of the often fatal bloodstream infection known as central line associated bacteraemia (CLAB) – making it one of the largest ICU/HDU in New Zealand to achieve this significant milestone.

Central lines are catheters that go in large veins of seriously ill patients to deliver lifesaving medicines, manage fluid levels and aid blood monitoring.

But they can cause CLAB, which kills up to half the patients who develop the condition. And at Waitemata, about one patient every two months would develop CLAB.

“For a long time, CLAB was accepted as an unfortunate consequence that sometimes occurs when we do what we do,” says ICU/HDU consultant Dr Ywain Lawrey, “But hospitals overseas showed that they could cut could rates by up to 95% by strictly enforcing best practice.”

As part of a Health Quality and Safety Commission initiative, the team set to work, putting together a central line pack which included every item needed to insert a central line, from gown, hat and mask to gloves, sutures and antiseptics.

The ICU/HDU team also developed checklists for putting in and maintaining central lines, ensuring that the new protocol was strictly adhered to.

Waitemata DHB CEO Dr Dale Bramley says while a lot of work has gone into this, the result could not have been possible without the support from all staff.

“It’s been a real team effort, involving everyone from those who insert the lines in the theatre procedure room to those who maintain them in the wards. The infection control team have also played a key part in helping us achieve this milestone.”

The ICU/HDU is not alone in its success. Wards 4 and 8 at North Shore Hospital are also setting their own records, going more than 240 and 270 days CLAB-free respectively.

The central line pack has also been adopted as the national standard for all ICUs in New Zealand.

Dr Bramley says the work that has gone into minimising the risk of CLAB is part of the organisational promise of Best Care for Everyone.

“Ultimately this is about saving lives – if we can prevent just one case of CLAB, it would still have been absolutely worthwhile.”


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