15 Dec 2014 | Health Quality Intelligence
The Health Quality & Safety Commission has released quality and safety markers data for the July to September 2014 quarter.
Thirteen district health boards (DHBs) are now using appropriate skin antisepsis preparation during surgery in 100 percent of cases, compared with 11 in the previous quarter and eight in the baseline period of July to September 2013. The national average of patients receiving appropriate skin antisepsis is 97 percent.
There are increases in the national average for the other two surgical site infection markers: cases where the right antibiotic was given in the right dose for a hip or knee replacement rose from 78 to 85 percent; and cases where an antibiotic was given in the right time rose slightly from 92 to 94 percent.
The quarter recorded for SSIs was April to June 2014, earlier than other data because of a 90-day outcome measure.
In July to October 2014, the goal for opportunities taken for the recommended ‘five moments’ of hand hygiene was raised from 70 to 75 percent. Nationally, that goal is already being reached, compared with 73 percent in April to June 2014. Fifteen DHBs are at 75 percent or higher, up from nine.
Staphylococcus aureus rates rose briefly in April to June 2014 but are now back to their long-term national average of around 0.12 per 1000 bed days.
Most other process markers remain consistent this quarter.
Older patients assessed for their risk of falling stay at 89 percent, with 88 percent compared with last quarter’s 90 percent of older patients assessed as being at risk then receiving an individualised care plan.
The percentage of operations where all three parts of the recommended surgical safety checklist were used is at 94 percent, compared with 95 percent last quarter.
Intensive care unit central line insertions fully compliant with the bundle recommended to combat central line associated bacteraemia (CLAB) are at 95 percent, compared with 96 percent last quarter. CLAB infections continue to be less than 1 per 1000 line days. As a result of this low rate, 234 CLAB infections have been avoided at a saving of over $4.7 million since March 2012.
Reducing harm from high-risk medicines is the focus of the Commission’s Open for better care national patient safety campaign until March 2015, with the medication safety programme then continuing its 18-month focus on the safe use of opioids in hospital settings until April 2016.
Currently, no quality and safety markers have been assigned to high risk medicines, but there is now a marker that focuses on medicines reconciliation – a process that ensures all medicines a patient is taking are known and are reviewed to ensure they are appropriate and safe in combination with each other.
There is a national programme to roll out an electronic medicines reconciliation (eMR) system to make reconciliation more straightforward, with a view to it becoming routine.
The new marker records which DHBs have implemented eMR – four in this first report, with a further three scheduled to do so in the first quarter of 2015.
Future reports will show the proportion of older patients (ie, those typically likely to benefit most) having their medicines reconciled.