Intensive care unit (adult)
Nurses and nurse aids in intensive care units bathe patients each day using washcloths impregnated with an antiseptic agent, leading to a significant reduction in hospital-acquired infections.
As mandated by State law, the California Department of Health Services requires acute care hospitals to maintain minimum nurse-to-patient staffing ratios and to develop various systems to ensure adequate nurse coverage and quality, leading to more reasonable workloads, lower patient mortality, and higher job satisfaction.
Working as part of an “intensive care unit without walls,” critical care physicians (called intensivists) decide which patients require intensive care unit admission and oversee the care of all critically ill patients throughout the hospital, leading to declines in hospital and intensive care unit mortality, improved management of intensive care unit bed capacity, and low intensive care unit length of stay for terminally ill patients.
As part of a hospital collaborative, intensive care units implemented a multifaceted safety program that reduced infections and hospital days, saved lives, and lowered health care costs.
Intensivists guide care around the clock in two medical–surgical intensive care units, leading to lower length of stay and the near elimination of ventilator-associated pneumonia, hospital-acquired pressure ulcers, and central line infections.
A hospital protocol that encourages early mobility by respiratory intensive care unit patients reduced length of stay, both in the intensive care unit and overall.
Implementation of an evidence-based bundle of interventions led to a 75 percent reduction in central line infections in four intensive care units, yielding annual cost avoidance of approximately $1 million.
St. John Hospital and Medical Center developed and implemented nurse-enforced protocols and associated tools, leading to a significant reduction in the incidence of catheter-related bloodstream infections.
As part of a collaborative with other hospitals, a health system developed multiple strategies to improve the organ donation request and procurement process, leading to a high conversion rate (the percentage of potential donors who become actual donors); collaborative participants as a group experienced a marked rise in conversion rates and donors.
A cardiothoracic care unit uses a multifaceted approach to patient- and family-centered care, leading to a well-above-average performance with respect to patient outcomes and satisfaction.