31 Mar 2015 | Health Quality Intelligence
The success of nationwide efforts to prevent central line associated bacteraemia (CLAB) means it has made its last appearance as one of the Health Quality & Safety Commission’s quality and safety markers (QSMs).
The Commission estimates 260 CLABs have been avoided in the nearly three years of the programme, representing a saving of over $5.2 million, thanks to district health boards’ (DHBs) use of central line insertions fully compliant with the bundle recommended to combat CLAB.
In the latest recorded quarter, October to December 2014, the national average for compliance is 96 percent of cases, with seven of the 20 DHBs reaching 100 percent. As a result, CLABs continue to be very rare, at well under one per 1000 line days.
Richard Hamblin, the Commission’s director of health quality evaluation, describes the ‘continued and sustainable’ success as ‘remarkable, as good as anywhere in the world, which has given us the chance to free up one of the QSMs for medication reconciliation’.
The QSMs continue to show high performance on process markers, with most DHBs doing the right thing most of the time.
As the Commission’s Open for better care national patient safety campaign turns its focus to reducing harm from falls, there are slight increases in the percentage of older public hospital inpatients assessed for their risk of falling (from 89 percent to 91 percent) and the percentage of those patients assessed as at risk who then receive an individualised care plan (from 88 percent to 91 percent). Eighteen DHBs assessed 85 percent or more of older patients, with the number of lower achievers shrinking notably.
The percentage of operations where all three parts of the recommended surgical safety checklist were used dropped slightly, to 92 percent from 94 percent in the previous quarter. This, however, compares with 71 percent in the baseline quarter of January to March 2013.
The national average of patients receiving appropriate skin antisepsis preparation during surgery continues to nudge 100 percent, at 98 percent. Twelve DHBs are using appropriate antisepsis in 100 percent of cases, which is the QSM target threshold, and three in 99 percent.
There were also slight increases in the national average for the other two surgical site infection (SSI) markers, with cases where the right antibiotic was given in the right dose for a hip or knee replacement rising from 85 percent to 88 percent, and cases where an antibiotic was given in the right time rising from 94 percent to 95 percent.
The quarter recorded for SSIs was July to September 2014, earlier than other data because of a 90-day outcome measure.