title: Healthcare-associated infections must stop: a breakthrough project aimed at reducing healthcare-associated infections in an intensive-care unit.
abstract: BACKGROUND
  Healthcare-associated infections are a problem for the Swedish healthcare system. In order to reduce the risk of acquiring healthcare-associated infections, the intensive-care unit attended a breakthrough project in 2004-2005, with the aims of studying methods of increasing patient safety and systematically improving treatment outcomes. The intensive-care unit had no system for registering infections, and the authors wanted to ascertain the prevalence of healthcare-associated infections, and register and prevent them.
  
  
  OBJECTIVE
  40% reduction in healthcare-associated infections in ventilated patients. 100% of staff to implement basic hygiene routines.
  
  
  METHODS
  The method used was the Breakthrough Series, originally designed by the Institute for Healthcare Improvement in Boston, Massachusetts, USA. The method aims to bridge the gap between what is known and what is done, spreading best-practice methods even faster. Many ideas for changes are tested on a small scale, with the basic rule that the small changes combine to create large changes that lead towards the final goal.
  
  
  RESULTS
  The frequency of healthcare-associated infections in ventilated patients was reduced by 43%. Compliance with the basic hygiene routines improved greatly, from 72% on initial measurement to 98% today.
  
  
  CONCLUSIONS
  In order to reduce the risk of acquiring healthcare-associated infections and to increase patient safety, a continuous, systematic effort involving continual measurement and review is necessary.
authors.affiliation: Intensive-care unit, Gällivare Hospital, Gällivare, Sweden. doris.yngstrom@nll.se
authors.forename: Doris
authors.initials: D
authors.lastname: Yngström
authors.forename: Kurt
authors.initials: K
authors.lastname: Lindström
authors.forename: Kirsti
authors.initials: K
authors.lastname: Nyström
authors.forename: Kristina
authors.initials: K
authors.lastname: Nilsson-Marttala
authors.forename: Lena
authors.initials: L
authors.lastname: Hillblom
authors.forename: Lisa
authors.initials: L
authors.lastname: Hansson
authors.forename: Maria
authors.initials: M
authors.lastname: Klarin
authors.forename: Jeanette
authors.initials: J
authors.lastname: Larsson
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006235:Hand Disinfection; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial