High-risk rounds reduce HACs by 47% in Colorado PICU

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A two-year program at Children’s Hospital Colorado in Aurora reduced the rate of hospital-acquired conditions by 46.5%, according to research published Feb. 1 in Critical Care Nurse

Children’s Hospital Colorado operates a 38-bed pediatric ICU that averages 3,500 annual admissions, according to the study. To improve patient safety, a 17-person team developed and launched a PICU high-risk rounding program. The initiative had weekly rounds on patients at high risk of developing at least one hospital-acquired condition. 

The program focused on rates of catheter-associated urinary tract infection, central line catheter-associated bloodstream infection, pressure injury and unplanned extubation. 

The goal was to build an effective, sustainable program in the busy PICU. Between March 2022 and March 2024, 624 high-risk rounds were completed for 488 patients. 

Before implementation, the HAC rate was 5.41 per 1,000 patients days. Afterward, it was 2.89 per 1,000 patient days. The 46.5% reduction is equal to 50 prevented HAC events and between $650,000 and $5 million in cost savings, according to the study. 

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“This sustainable model extends past traditional HAC prevention models and is a way teams can successfully go ‘beyond the bundle’ by creating a safe and objective space to think solely about patient safety and identify additional process improvements,” the researchers concluded. “Implementation requires minimal resources beyond those already offered in any unit.”

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