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Hospital checklists, part 2: infection prevention in the ICU

In the first part of this post, we began discussing the importance of hospital checklists as a method to help prevent medical malpractice.

We noted, for example, that research supports the contention that checklists can be effective for this purpose – as long as they are actually used. Checklists cannot be effective if they are merely given lip service.

In this part of the post, we will discuss the consequences that can result from failing to follow checklist protocols, focusing particularly on intensive care units.

In many ways, a key problem with failing to follow checklist protocols can be summarized in one word: infections.

By one estimate, infections acquired in hospitals, or associated with health care in some way, claim about 100,000 lives a year across the nation. To be sure, not all infections are the result of hospital negligence. But many are.

Protocols calling for proper hand hygiene are only one of the most obvious examples of checklist protocols.

But the need for checklists goes well beyond ensuring that doctors and nurses wash their hands before interacting with patients. This is particularly true in intensive care units (ICUs).

Recent research showed that many hospitals fail to use checklists to guard against infections associated with such key ICU apparatus as catheters, feeding tubes and ventilators.

A recent study found that only about one-third of the intensive care units had a monitoring system in place to electronically track the implementation of infection-prevention policies.

This finding further reinforces theme of this post: checklists, to be effective, must be used, not merely honored in the abstract.

Source: The Huffington Post, "Many Hospitals Don't Follow Their Infection-Prevention Policies," Feb. 7, 2014

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