DHB efforts to lower patient harm pays off

MidCentral District Health Board is making good progress in preventing surgical site infections, but there is room for improvement, a report shows.

The Health Quality and Safety Commission released its quarterly report into quality and safety markers, measuring the work DHBs have put in to reduce patient harm from January to March 2014.

In April, HQSC introduced a new marker on surgical site infections.

MidCentral performed above the national average for the majority of the markers of surgical safety and reducing surgical site infections. However, the use of the particular antibiotic cefazolin as the prophylactic antibiotic in hip and knee replacement surgeries was at 0 per cent.

The national average for the marker is 68 per cent. A spokesman for the DHB said surgeons routinely used antibiotics as a precautionary measure in all operations - "just not this particular one".

The assessment of older patients for risk of falls was also below the national average of 90 per cent, at 86 per cent.

DHB acting director of patient safety and clinical effectiveness Susan Murphy said of the 1078 patients admitted during this quarter, 925 had a specific assessment completed for the risk of falling, not quite achieving target.

"An individualised care plan to address those risks was in place for 92 per cent of these patients sampled, which is consistent with previous quarters and above the national average rate," Murphy said.

"There were no in-hospital falls that resulted in a fractured neck or femur this quarter . . . we have several strategies in place to help reduce or prevent likelihood of patients falling, including being in a falls-aware ward."

MidCentral's quality markers for reducing infections were also under the national average.

Compliance with procedures for inserting central line catheters was at 81 per cent, under the average of 97 per cent, while compliance with good hand hygiene practice was at 66 per cent, under the national 73 per cent.

A DHB spokesman said the low rates were due to documentation not being kept up to date in the intensive care unit and work was being done on improving this.

"The clinical leads for this programme are confident that the procedures undertaken are up to standard."

Associate Health Minister Jo Goodhew welcomed the data showing that DHBs were making good progress with taking steps to prevent surgical site infections (SSIs).

"SSIs are uncommon but can cause emotional and financial stress, serious illness, longer hospital stays, long-term disabilities and even death," Goodhew said.

The latest results from the markers showed that DHBs were already improving their performance in giving the right dose of antibiotics at the right time to prevent SSIs, she said.

"It is also pleasing to see a very high level of compliance with safety procedures for inserting central line catheters to prevent bloodstream infections.

"We estimate that we have prevented more than 180 of these potentially serious infections in just under two years, saving over $3.5 million to be spent on other areas of healthcare."

Manawatu Standard