Maimonides has made it a priority to reduce hospital-acquired infections, especially among its critical care patients by implementing evidence-based "bundles" of best clinical practices in its ICUs to prevent central line infections and ventilator-associated pneumonia.
Maimonides has paid close attention to the consistent application of evidence-based clinical practices proven to reduce the chance of surgical site infections. Adherence to such guidelines has helped Maimonides to prevent surgical infections in its facilities.
Infections are examined in the intensive care unit on the basis of how many infections there are for every 1,000 central line days. The chart shows Maimonides rates for its Medical, Cardiac, Cardiothoracic and Surgical ICU Units, as well as its Pediatric ICU and Neonatal ICU.
Another way New York State examines infection rates is based on surgical site infections. The rates are based on 100 surgical procedures and compares surgical procedures for colon, hips, CABG chest and donor site* infections.
In 2010, an indicator was added to NYS Infection Report. Clostridium difficile (C. difficle) is a common cause of diarrhea in healthcare settings. C. difficile infection has been associated with taking antibiotics. Antibiotics can disrupt the normal bowel bacteria populations and produce an overgrowth of C. difficile resulting in infection. In addition to antibiotics being associated with developing C.difficile infection, patients can also become infected if they touch their mouth after touching contaminated environmental surfaces or patient care teams.
*donor site refers to the area from which your surgeon will take a vein or artery for your surgery.
Evidence-based "bundles" of best clinical practices:
The central line bundle is a group of proven interventions for patients with intravascular central catheters, that when implemented as a group, leads to better patient outcomes.Maimonides compliance with these efforts are indicated as a percentage.
- Hand hygiene: One of the easiest ways to prevent infections is through hand washing. Maimonides has implemented a hospital wide hand-washing initiative to help reduce hospital acquired infection.
- Maximal barrier precautions upon insertion
- Chlorhexidine skin antisepsis
- Optimal catheter site selection, with subclavian vein as the preferred site for non-tunneled catheters
- Daily review of line necessity with prompt removal of unnecessary lines
The ventilator bundle is a series of interventions related to ventilator care, that when implemented together, will achieve significantly better outcomes than when implemented individually. The key components of the ventilator bundle are:
- Elevation of the head of the bed
- Daily "sedation vacations" and assessment of readiness to extubate
- Peptic ulcer disease prophylaxis