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Deadly blood infections down in ICUs

At least 26 Florida intensive care units have protected their patients from deadly bloodstream infections in the past year, according to the Florida Hospital Association.

That's a marked improvement according to data from a patient safety program aimed at eliminating the infections by preventing catheter contamination.

Three Florida ICUs have had no infections for two years while 23 have avoided them for a year.

“The hospitals share best practices, literature and research,” said Bill Bell, general council at the Florida Hospital Association. “They've come up with various ideas that seem to work.”

“Central line” infections occur when a catheter or port into the neck, chest or groin is contaminated. Such intravenous lines provide easy entry for chemotherapy drugs, dialysis chemicals, and the like.

Three Florida ICUs have had no infections in two years: Mariners Hospital ICU, Sacred Heart Hospital Pensacola's Pediatric ICU and Shands Jacksonville Cardiovascular ICU.

Analysts used national data to determine that the program has saved 19 lives, 1,232 hospital days and $8.1 million for Florida's health system, Bell said.

Molly Vlach, inspection control manager at Mariners Hospital in South Florida, said the ICU has kept its rate at zero by requiring that everyone who touches a central line follow a checklist. Each person must wear a mask, eye shield, large sterile gown, sterile gloves and a cap. They must also wash their hands, chemically sanitize the site and cover it with a drape.

Patients with central lines are informed of the risk and are asked to stop doctors or nurses if they don't follow protocol.

“It helps a lot to have patients involved in their own care,” she said.

Vlach did not know why some of the other hospitals didn't perform as well. But she did suggest that those with trauma centers may cater to populations that are more vulnerable to the infections.

The 72 hospitals that participated in the program average less than one bloodstream infection per 1,000 line days, which is below the national average of 1.04 per 1,000 line days.

Yet, there's still room for improvement, Vlach said. The infections still kill about 30,000 Americans per year, according to the Agency for Healthcare Research and Quality, which organized the program with the American Hospital Association.

Some experts, and the federal government, consider the infections 100 percent preventable. But opinions vary over whether that is realistic.

Dr. Tim Flynn, associate dean for clinical affairs at the University of Florida College of Medicine, said careful attention to insertion technique and to the surgical site can help prevent the infections.

While some programs, most notably protocols developed by Michigan's Keystone Center for Patient Safety and Quality, have avoided the infections for years at a time, Flynn said it's unlikely that bloodstream infections can be eliminated across the board.

“We aim for zero, but the truth is it's probably not reducible to zero,” he said.

As Health News Florida reported in May, some of Florida's largest hospitals have recently had such a huge problem with preventing the infections they were offered extra help through a federal grant program. 

Orlando Regional Hospital, for example, had four times the national average rate of vascular-catheter associated central line infections between October of 2008 and June of 2010, Medicare data showed.

Seventy Florida hospitals had higher-than average rates of the infections, according to the data.

--South Florida reporter Brittany Davis can be reached at 954-495-6766 or at Brittany.Davis@HealthNewsFlorida.org.