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During the fall of 2004, the Idaho infection control department at Saint Alphonsus Regional Medical Center (SARMC) in Boise, Idaho, began using a Web-based data-mining software system (MedMined). As a result of using MedMined, it was identified that SARMCs Urine Nosocomial Infection Markers (NIMs) (likely nosocomial urinary tract infections) were steadily increasing throughout the facility during calendar year 2005. It was further identified that this was not only a patient safety issue, but a cost and length of stay issue. Based upon further analysis of SARMCs financial data and census data, each urine NIM marker was adding approximately $3,800 (variable cost) and 3.21 added days to each visit. As a result of this upward trend, a multidisciplinary team was created with members from the infection control department and the Nursing Quality Outcomes Committee.
Since June 2006 there have been several interventions that have been implemented using evidenced-based practices and by utilizing Six Sigma methodologies. One key focus area was the care of patients with Foley catheters. During a prevalence study conducted in April 2006, SARMC identified that only 5 percent of patients had their Foley catheters secured. It was also noted that in many cases drainage bags were touching the floor (40 percent of time), dependent loops (35 percent of time), tamper-proof seals were broken (36 percent of time), and many patients who could ambulate had Foleys (29 percent of time) that may have not been necessary. This prevalence study paved the way for many interventions (both hard-wired and soft-wired).
Since July 2006, SARMC has seen an 11 percent reduction in its Urine NIM rate throughout the organization. The Urine NIM rate decreased from 4.24 to 3.79 per 1,000 patient days. It is estimated that this decrease has prevented 160 additional days in the hospital and approximately $190,000 in variable costs.
Team members involved in the project were Ryan C. Lund, Debra Deyton, Patty Huffman, Marsha Franklin, Theresa Polzin, Chris Dent, Aline Lee, Mary Mager, Prisilla Lynn, Phyllis Cooper and Suzanne Wood. Saint Alphonsus is a 365-licensed bed regional medical center serving people throughout the Northwest. Saint Alphonsus emphasizes care that is patient-centered, innovative and community-based, and is renowned for its state-of-the-art digital environment and pioneering technologies, award-winning clinical services, a nationally accredited Life Flight program, and the regions Trauma Center.
Ryan C. Lund, MPH, CIC, is the infection control manager for Saint Alphonsus RMC in Boise, Idaho.