Patient Safety Indicators
A hospital-acquired infection happens as a consequence of a hospital stay. Factors that increase the risk of these infections include the level of a patient’s immune system, surgery and medical procedures that create cuts or breaks in the skin, and the transmission of bacteria capable of causing infection from one person to another because of close contact in hospitals.
Infections are the most common serious complication of hospital stays, and preventing as many of them as possible is an important goal at Mount Sinai Hospital. Below are several patient safety and quality indicators that Mount Sinai tracks on a regular basis.
Clostridium difficile (C. difficile) are bacteria that can be carried in the bowel without making people sick, but can also cause disease, sometimes serious disease. C. difficile can also be spread by contact with hands, or contaminated surfaces, objects or equipment. Hand hygiene and environmental cleaning are very important to prevent spread in hospitals and nursing homes.
Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. It can grow on the skin or mucous membranes without causing illness (this is called “colonization”). Staphylococcus aureus can also cause infections, most commonly wound infections. When Staphylococcus aureus develops antibiotic resistance, it is called methicillin-resistant Staphylococcus aureus, or MRSA. At Mount Sinai Hospital, we screen patients to detect colonization with MRSA regularly, to help prevent MRSA infections.
Enterococci are germs that live in the gastrointestinal tract (bowels) of most individuals and generally do not cause harm (this is called “colonization”). Enterococci can cause infections in other parts of the body outside the bowel, most commonly urinary tract infections. Vancomycin-resistant enterococci (VRE) are strains of enterococci that are resistant to the antibiotic vancomycin. At Mount Sinai Hospital, we screen patients to detect colonization with VRE regularly, to help prevent VRE infections.
Central Line Infection
A central line-associated infection (CLI) is a hospital acquired blood stream infection that can be attributed to the use of a central line catheter. Central lines are flexible tubes (catheters) that are inserted into a large vein to allow health-care providers to deliver essential care to critically ill patients. In order to insert a central line, an incision in the skin has to be made. This disruption in skin integrity makes it possible for bacteria to spread to the bloodstream causing an infection. These serious infections are usually treated with antibiotics.
Ventilator Associated Pneumonia
Ventilator associated pneumonia (VAP) is a hospital acquired lung infection that may occur in patients who need to be on a mechanical ventilator (breathing machine) for more than two days. These serious infections are usually treated with antibiotics.
Surgical Site Infection Prevention
A surgical site infection (SSI) is an infection that can develop after an operation, at the site where tissue is cut during the procedure. One important preventive practice is giving an appropriate antibiotic to the patient immediately before the surgery is started. These antibiotics are called prophylactic antibiotics.
As health care providers move from patient to patient and room to room while providing care, their hands pick up organisms which can cause infections. Hand hygiene works by interrupting this transmission of organisms.
Patient safety remains the most important priority for Mount Sinai Hospital and this involves ensuring a safe experience for patients who undergo surgery here. A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anaesthesiologists, and others) to discuss important details about each surgical case.
The Hospital Standardized Mortality Ratio (HSMR) is a measure calculated and reported for health-care institutions in Canada by the Canadian Institute for Health Information (CIHI).