Don't Forget Your Checklist at the Hospital
A Johns Hopkins study shows checklists before catheters almost eliminate infections
February 11, 2010 -- Last week, the British Medical Journal published a report by a Johns Hopkins University research team that was nothing short of astonishing.
The study showed that hospital intensive-care units which use a simple, five-item checklist -- and empower every member of the medical care team to enforce it -- can virtually eliminate life-threatening infections that start in central line catheters.
Catheters are the "needles" inserted into blood vessels through which critically ill patients receive medication and fluids, etc. Between 30,000 and 60,000 Americans die from central-line related infections each year.
The checklist contains five basic steps for doctors to follow when placing a central-line catheter:
1. Wash their hands.
2. Clean a patient's skin with chlorhexidine.
3. Wear a mask, hat, gown, and gloves and put sterile drapes over the patient.
4. Avoid placing a catheter in the groin where infection rates are higher.
5. Remove the catheter as soon as possible, even if there's a chance it might be needed again at some point.
Importantly, the checklist will bring sustained improvement only if it is accompanied by a cultural change that encourages nurses to question doctors who have not washed their hands or otherwise followed the checklist, the study's leader says.
If I were going into the hospital tomorrow, or if I had a loved one there, I'd carry the checklist with me and give copies to every doctor and nurse I saw.
For More Information:
See our related story on patient safety in Oregon.
Read the Johns Hopkins press release summarizing the results.
Abstract of the study in the British Medical Journal.
Free PDF download of the full article.
This page includes links to downloadable checklists and training materials that hospitals and health professionals can use.
INTERVIEW with study leader Dr. Peter Pronovost, about the need for checklists in hospitals.
Feb 11 2010