Medical Teams Are Key to Patient Safety
New England Journal of Medicine editorial cites value of medical teams
Thursday, Dec. 28, 2006
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Medical teams – not individuals – are critical to theprevention of catheter-related
bloodstream infections, as well as for the overall health, safety, and welfare
of patients, according to an editorial by two Virginia Commonwealth
University physicians published in today's issue of the New England Journal of
care unit professionals use a number of devices and catheters to deliver intravenous
fluids and medications to patients. There is risk of bloodstream infection
anytime a worker handles a catheter, and the key organisms linked to these
infections are commonly found on the patients' skin, or sometimes on healthcare
In the United States,
an estimated 50,000 bloodstream infections occur in ICUs each year related to
central catheters, with approximately half these cases resulting in patient death.
"When it comes to patient safety, we need teams of
healthcare workers to foster excellent care," said Richard P. Wenzel, M.D., professor
and chair in the Department of Internal Medicine in the VCU School of Medicine
and president of the International Society for Infectious Diseases, the largest
professional organization related to infectious disease. "Today any breech in technique is not acceptable, and we now
have zero tolerance. The team itself creates a social pressure of excellence
for patient safety."
editorial commenting on a recent study published in the New England Journal of
Medicine, Wenzel, together with Michael B. Edmond,
M.D., acting chair in the Division of Infectious Diseases, emphasized
the value of medical teams in the prevention of catheter-related bloodstream
infections. The study, by a research team from the Johns Hopkins University School of Medicine, showed that teams of physicians
and nurses in Michigan
hospitals reduced the rates of infection by almost 70 percent.
"The work of Dr. P. Pronovost and
colleagues is the most important paper published in infection control in the
last decade because it demonstrates that careful attention to good practices
results in a dramatic reduction in bloodstream infections," said Edmond.
Wenzel said that in
the past, colleagues in ICUs would avert their eyes from healthcare workers who
failed to wash their hands, or had a small tear in their glove, and would continue
with the procedure rather than restarting it.
"There have been significant improvements to patient
safety, and patients are safer in hospitals today, compared to 10 years ago," Wenzel
said. "It is reasonable for patients to take charge of their care to some
extent. I tell my patients not to allow anyone to touch them or any catheter unless
they first see them wash their hands and put gloves on," he said.
Wenzel said that to prevent infection, it is imperative
for the healthcare team to engage in the basic techniques of hand-washing, to follow
strict protocols and to use the catheters for only as long as necessary.
About VCU and VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 226 degree and certificate programs in the arts, sciences and humanities. Sixty-seven of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University comprise VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.