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UMC’s pediatric ICU earns top national rating

The University Medical Center pediatric intensive care unit is one of only five such units in the United States to earn the Consumer Reports’ top rating for preventing bloodstream infections.

UMC and the other four top hospitals had zero bloodstream infections during 2010 and were recognized ahead of 86 hospitals with pediatric ICUs, including Childrens Hospital and UCLA in Los Angeles, the Mayo Clinic in Minnesota, St. Jude’s Children’s Research Hospital in Memphis, Tenn., and New York Presbyterian Hospital in New York City.

An investigation of 91 hospitals released Thursday by the magazine found that pediatric ICUs had infection rates that were 20 percent higher than national rates for adult ICUs and found that too many hospitals aren’t following best practices for inserting and maintaining central line catheters, which deliver medication, nutrition and fluids to critically ill patients.

Dr. Meena Vohra, medical director for the UMC pediatric ICU and chief of pediatrics, said the investigation by Consumers Reports confirms that the protocols put in place by her and her staff over the years has paid off.

UMC treats 1,000 pediatric patients a year in its ICU.

"We have a checklist that we carefully follow," she said. "This shows that doctors and nurses and therapists are doing what they’re supposed to be doing, ensuring that our patients are as safe as possible."

Measures include careful disinfection of the insertion site, changing dressings regularly, standardizing the procedures for changing the catheter caps and tubes and developing prepackaged kits with all the necessary tools to do the jobs right.

"Dr. Vohra and her staff have worked diligently to always do things the right way," said Dr. Dale Carrison, UMC’s chief of staff.

According to Consumer Reports, which used Centers for Disease Control and Prevention statistics, there were up to 28,000 ICU infections in 2009, and up to 25 percent of them were fatal.

The magazine said parents of children should ask what the infection rates are at the hospital where they bring their children.

Consumer Reports found that in 2009 there were 1.8 bloodstream infections for every 1,000 days that children were on central lines, compared with an estimated national average of 1.5 bloodstream infection per 1000 central line days in adult ICUs. And some pediatric ICUs had infections more than four times the national average for adult ICUs.

The magazine noted that children have less-developed immune systems and "are thus more susceptible to bacterial infections."

Simple things, like staffers washing their hands, can make a big difference, the magazine reported.

Lisa McGiffert, director of Consumer Union’s Safe Patient Project, said patients should speak up if they sense something is wrong with catheters and make themselves part of the team caring for their child.

"If things don’t seem right, trust your instincts and say something — and make sure someone responds to you," she told the magazine. "I’ve heard too many stories of children who died because the parents trusted the hospital’s system. Don’t let anything go. You know your child, and you are part of the team."

The magazine used publicly reported infection data to make its ratings, with the high ranking a 5 and the lowest a 1. The magazine noted that less than half of the nation’s hospitals are reporting data that are critical to consumers’ making intelligent choices for families. "Making that information public motivates hospitals to get better," McGiffert said.

The four hospitals in addition to UMC to earn the top rating of 5 were Childrens Hospitals and Clinics of Minnesota, Medical University of South Carolina, Robert Wood John University Hospital in New Jersey and Tulane Medical Center in New Orleans.

Sunrise Children’s Hospital was the only other hospital in Nevada rated by the magazine. It earned a rating of 3.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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