Simple hospital checklist may save lives

A program that includes a simple 5-step safety checklist for preventing bloodstream infections caused by large central-line catheters in hospital intensive-care units in Michigan appears to reduce patient deaths by 10 percent, according to a report published online this week in the British Medical Journal.

The research team, led by Johns Hopkins professor and patient-safety crusader Peter Pronovost, M.D., Ph.D., compared Medicare data from 95 Michigan hospitals that used the checklist program, with those from 364 hospitals in the Midwest from October 2001 to December 2006.

They found that patients in Michigan hospitals were 10 percent more likely to survive their hospital stay after the implementation of Pronovost's checklist program compared with the patients in the 11 surrounding states. The researchers said the checklist program was the only large-scale quality-improvement initiative in the area during the study period, making it likely that it was responsible for much if not all of the observed benefit. But they also said that the study was not large enough to detect any reductions in the length of hospital stay.

The checklist is a common-sense series of hygienic precautions to follow when inserting, using, or removing a central line catheter to deliver medication, nutrition, and fluids to patients in hospital intensive care units. The steps require equipment no more complex than hand soap, an antiseptic solution, and sterile drapes and garb. Other key components: giving nurses and others the authority to make doctors follow all the steps, and measuring and reporting infection rates.

Each year, an estimated 80,000 people get bloodstream infections from central-lines—and some 31,000 die. In July 2009, Health and Human Services Secretary Kathleen Sebelius called on hospitals across America to use the checklist to reduce central-line infections in ICUs by 75 percent over the next three years.

—Doug Podolsky, senior editor

Read more about preventing hospital infections.