Jefferson University Hospitals

Infection Rates & Ratios

Quality of care and patient safety are top priorities for the entire staff at Jefferson University Hospitals. We include patients and their families as key partners in achieving the highest level of quality and safety.

Preventing healthcare-associated infections is an important initiative to reduce complications, shorten hospitalizations and ensure the highest quality of care provided to our patients. Preventing infections saves lives.

Laboratory Identified Hospital-Onset Methicillin Resistant Staphylococcus Aureus (MRSA) Bloodstream Infection

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MRSA infections are common in healthcare settings such as hospitals and nursing homes, as well as in the community. Staph is a common bacteria. About one in three of us has the bacteria on our skin or noses, although most do not develop infections.

Hospitalized patients, however, are particularly susceptible to contracting staph infections and are at increased risk of more serious infections, including of the bloodstream and lungs (pneumonia).

MRSA infections are of great concern because the bacteria is more difficult to kill with a commonly used family of antibiotics that include penicillin, methicillin, oxacillin and amoxicillin. Because Staph bacteria are so common, it is important that care is taken by staff and visitors alike to follow good hand hygiene practices.

What We Are Doing to Reduce the Risk of Methicillin-Resistant Staphylococcus Aureus

  • All high-risk patients, those transferred from nursing homes and those who have been in a healthcare facility within 30 days, are screened for MRSA as are all patients admitted to an ICU.
  • All patients scheduled for spine surgery and open brain surgery are screened for Staph aureus before surgery to identify and "decolonize" patients prior to surgery in order to reduce the risk of surgical site infection.
  • Infection control efforts by various working groups including the hand hygiene working group implement evidence-based procedures to reduce infections and boost hand washing to reduce our incidence of hospital-acquired MRSA
  • "Speak Up About Hand Hygiene" initiative rolled out to promote increased compliance to hand washing

Catheter-Associated Urinary Tract Infections (CAUTI)

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Urinary tract infections (UTIs) are a common type of infection in hospitals and in the community. Bacteria or fungi can cause UTIs that develop in the bladder, kidneys, urethra or the ureters – the tubes that carry urine from the kidneys to the bladder.

Hospitalized patients may require urinary catheters – a tube inserted into the bladder through the urethra to drain urine. Urinary catheters can be sources of infections in these patients, particularly critical care patients. The chart above reflects our standardized infection ratios* for those critical care patients. A standard infection ratio less than 1.0 is lower than the expected target.

A key to preventing catheter-associated urinary tract infections is to only place catheters when necessary, the use of sterile technique when placing and removal of the catheter as soon as possible by making sure to routinely re-assess each patient's need.

As with other types of infection, using proper hand hygiene can reduce the risk of UTIs. Appropriate hand hygiene should be performed immediately before and after insertion or manipulation of the catheter or near the site.

What We Are Doing to Prevent Catheter-Associated Urinary Tract Infections

  • Increase awareness of rates with enhanced communication with all clinicians
  • Continuous education for staff on best practices and use of the urinary catheter bundle to aid removal as soon as medically safe
  • Updated competency on Foley Bundle with bladder scanning and straight cath regimens
  • Skills training held for nursing on insertion, maintenance and post Foley removal

Central Line-Associated Bloodstream Infections (CLABSI)

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A central line is a catheter or tube placed in a large vein in the neck, chest or groin to deliver medication or fluids. Patients in intensive care units (ICUs) often have central lines placed and in some cases these catheters remain there for several weeks or even months, creating a heightened risk of infections. The chart above reflects our standardized infection ratios* for those critical care patients. A standard infection ratio less than 1.0 is lower than the expected target.

Bloodstream infections can occur when bacteria or other germs gain access through a central line.

Jefferson uses evidence-based, best practices in established protocols to help reduce the risk of central line-associated bloodstream infections. Those hospital-wide protocols include following proper hand hygiene, applying antiseptic to the skin prior to placing the line and using sterile gloves, gown, cap, mask and drape when inserting a central line or maintaining a central line.

Patients in ICUs often require central lines, and due to the acuity of their condition are often the most susceptible to developing infection.

What We Are Doing to Reduce the Risk of Central Line-Associated Bloodstream Infections

  • Rigorous adherence to sterile technique at insertion and to strict protocols for line maintenance
  • Do not disconnect the line for routine care such as transport and changing gowns
  • Use alcohol to disinfect system every time a central line is accessed
  • Avoid drawing blood from the central line
  • Re-education of sterile techniques for blood draws
  • Chlorhexidine gluconate bathing for all ICU patients

About Standardized Infection Ratios (SIRs)

Standardized infection ratios are risk-adjusted measures used to track healthcare-associated infections. A SIR significantly lower than 1.0 indicated fewer-than-expected infections based on the patient population; a SIR significantly higher than 1.0 indicated that the number of infections was higher than predicted.