Hospital-acquired infections (HAI) can cause serious problems for patients. Northwell Health has zero tolerance for healthcare acquired infection and has received recognition at the national level from the National Patient Safety Foundation, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of Healthcare Quality and the Critical Care Societies Collaboration and at the state level from the Health Care Association of New York State (HANYS).
Our goal is to eliminate infections that arise following admission to the hospital. Infections can cause patients to remain in the hospital for a longer than expected period of time due to treatment and management of the infection. In certain severe situations, an infection can cause death.
Northwell Health has implemented a rigorous campaign to reduce the chance of acquiring an infection. In keeping with the national agenda to make hospitalizations safer for patients, the Northwell Health has the following goals to reduce healthcare associated infections:
- Reduce and eliminate healthcare associated central line associated bacteremias (CLABS) or bloodstream infections
- Reduce and eliminate surgical site infections (SSIs) associated with a surgical procedures
- Promote hand hygiene
- Educate patients on infection prevention
- Commit to decreasing new and emerging pathogens that impact hospitalized patients, such as clostridium difficile (c-diff)
Catheter-Associated Urinary Tract Infections (CAUTIs)
Northwell Health’s “Aiming for Zero” program focused on reducing catheter infections across the health system’s 15 acute care and children’s hospitals throughout the New York area. Catheters are used to drain urine from the bladder into a bag outside the body. From 2014-15, the initiative resulted in a 52 percent decrease in CAUTIs, only a single catheter-associated infection at its children’s hospital and a nearly 20 percent decrease in “indwelling” catheter days – indwelling catheters are inserted inside the body and are typically used for patients experiencing urinary incontinence, urinary retention (those unable to urinate), and those recovering from surgery or another health problem.
The program also decreased antibiotic exposure to patients, decreased the risk of other infections that occur as a result of antibiotic resistance and reduced potentially life-threatening harm to patients. Northwell’s senior leadership prioritized the CAUTI initiative to eliminate intensive care unit (ICU) and non-ICU CAUTIs and reduce the potential for patient harm across acute care hospitals and the children’s hospital.
Central line associated bacteremias
Northwell Health's goal is to reduce and eliminate healthcare-associated central line-related bloodstream infections. Central lines are placed in patients and used to deliver medications, fluids, nutrients, and blood products. A central line is a catheter that is placed into a large vein usually in the upper portion of the chest area or at times in the area of the groin. Although a central line is necessary at times for management of an illness or disease, it can lead to an infection. Northwell Health has special procedures for placing and caring for the central line to prevent infection. Northwell Health facilities have been very successful in decreasing infections associated with a central line.
Preventing surgical site infections
In a majority of surgical procedures, the skin is cut to gain entry under the skin. This incision breaks our body’s first line of defense against infection. When there is a break in the body’s defense, the risk for bacteria to enter the body and cause an infection increases.
Northwell Health strives to reduce and eliminate surgical site infections. The health networks is dedicated to minimizing the risk of infection associated with surgical procedures. The following is a list of infection prevention measures that have been implemented and are monitored to ensure continuous improvement:
- Administering antibiotics specific to the surgical procedure within 1 hour of the incision
- Removal of hair at the surgical procedure site with a clipper when necessary
- Keeping the sugar level in the blood at a certain range in cardiac procedures
- Maintenance of body temperature for select procedures involving the large intestine/colon
- Preparing the patients skin prior to the incision
Hand washing prevents infection. We have made this a top priority at Northwell Health. Each month a random sample of employees are observed to make sure they are adhering to proper hand washing procedures. The results that you see posted are a combined rate of hand washing across all of our hospitals.
We would like everyone to wash their hands, and that includes our visitors. To help make this easier we have prominently placed kiosks with hand gels and foams in our lobbies and cafeterias, as well as in the patient care areas. Here are some of the other things that we have done to help promote hand hygiene:
- Staff education on infection prevention at orientation, annually and as appropriate
- Use of ultra-violet light and specific hand gel to assist with hand hygiene education
- Contract and competency for all staff
- Computer screen savers
- Promotional recording that plays when health networks phones are placed on hold
We ensure compliance with the Joint Commission's National Patient Safety Goal for hand hygiene.
Northwell Health works to ensure safety and quality by maintaining standards of care in coordination with patients. The following patient information may help to reduce infection:
- CDC: Rceiving vaccination for vaccine preventable diseases
- Joint Commission: Speak Up — 5 things you can do to prevent infection
- What you should know before surgery
Influenza, or the “flu,” is seasonal. The flu is caused by a virus that can cause mild to severe respiratory illness and may cause death in especially vulnerable patients, such as infants, the elderly, and those with certain chronic diseases. Every year a new strain of flu is associated with illness, which is the reason for annual vaccination. Each hospital has an internal process to identify the need for vaccination.
Ensuring up-to-date vaccinations for children is especially important for infection prevention. Northwell Health is working to make sure all patients receive appropriate vaccines.
Preventing clostridium difficile
Clostridium difficile (C. diff) is a type of bacteria that grows in the colon and can cause abdominal discomfort, bloating and diarrhea. It is a spore that can be found in the environment – on places like toilet seats or doorknobs. Northwell Health is committed to decreasing the occurrence of this infection.