Reminders: another simple, low-tech way to reduce hospital infections
There’s a best-selling book out about how simple checklists can prevent complications of medical treatments. It’s simple, the lowest of low tech, requires no expensive equipment, and it works. It seems a bit sad that we need research to confirm common sense. Now a new study describes how yet another very simple thing can reduced complications — simple, automated reminders.
Medical care in the PICU is quite complicated at times and the pace is often hectic. When we are going from patient to patient we focus on the major stuff — the mechanical ventilator, for example. It’s easy to overlook smaller items; smaller items which, in the longer term, can become much bigger things. Urinary catheters are an example of this.
We use these tubes to drain urine out of the bladder of a patient who is unable to urinate themselves. They’re useful and handy. But urinary catheters do carry some risk of infection, especially if they are left in for a long time.
A recent study showed that simply asking the doctor — prompting them with a small reminder each day — if the catheter was still needed led to a 50% drop in catheter-associated infections. It’s simple, easy, and cheap. It’s something I now have on my daily checklist for each patient.
Followed a link over from your recent comment on Maggie Mahar’s blog, glad I did.
I also read Dr. Gawande’s Checklist Manifesto with great interest, and am encouraged that some in the medical community are following the tenets of his book. It amazes me that some of the most seemingly trivial tasks bring about some of the most dramatic results, but are often the most resisted. More complicated is rarely better.
Question: have you shared your UTI results with your peers, and if yes, what has been the response? Anyone else following your lead?
We don’t have a formal process yet in the PICU. The adult ICU is trying to automate reminders each day for each patient, simply asking: does this patient — today — need their central venous line, arterial line, or urinary catheter? It’s too soon to see if infection rates will drop, but the research suggests they will.
Low-tech has an important role to play in the high-tech environment of the ICU.