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Enhancing Safety and Quality

At University of Missouri Health Care, we focus on patient safety by investigating, reporting and preventing medical errors. We use the latest medical evidence to help us meet national patient safety goals. We also apply lessons from other businesses and industries, such as the pilot training that has helped make air travel the safest form of transportation.

To keep our patients safe, we are continually at work developing new technologies. Educating our doctors, nurses and other health care providers, as well as patients, about patient safety is an ongoing commitment for everyone at University of Missouri Health Care.

Quality Improvement Innovation

University of Missouri Health Care is dedicated to enhancing the quality of patient care. One way we improve care is by following proven techniques based on the latest health care research. Another way we strive to improve health care is by developing and implementing programs aimed at improving patient care in new ways:

Preventing Infection

People can catch infections anywhere. That cold you caught at work last fall was an infection, and when your son needed antibiotics to treat that playground injury, that was an infection, too.

Patients seeking health care often have weakened immune systems or other medical conditions that make them especially vulnerable to infections. State-of-the-art heath care requires the use of many tools and techniques to improve and save lives, such as surgery, urinary catheters and ventilators to help patients breathe. However, every medical treatment carries a risk of complications or side-effects. Fortunately, the risk of complications can be lowered and many infections can be prevented when health care professionals follow careful practices. Learn more about different infections and what we are doing to prevent them:

Hand Hygiene

University of Missouri Health Care is continually working to improve our hand hygiene rates through numerous initiatives:

  • Alcohol-based hand gels and hand-washing sinks are available throughout our hospitals and clinics.
  • We monitor our staff to see how well they are doing with hand hygiene.

What can patients and families do to help?

We encourage all patients, family members and visitors to clean their hands often. Every hospital room has a hand washing sink with soap and water, and hand sanitizer dispensers are located throughout our hospitals and clinics.

How are we doing?

Over the past several years, our hand-hygiene rates have increased from approximately 40 percent in 2003 — then the worldwide standard — to our current rate of approximately 99 percent. Our efforts to improve hand hygiene have included staff education, continuous monitoring by trained experts and greater availability of hand-hygiene resources such as sanitizing gel.

While our hand hygiene rate is among the highest reported rates of hand-hygiene compliance according the World Health Organization's "WHO Guidelines on Hand Hygiene in Health Care," we continue to strive for higher levels of excellence. Over the past three years, we gradually have increased our hand-hygiene goals from 86 percent to 88 percent to 90 percent to 95 percent — with an ultimate goal of 100 percent compliance.

Clostridium difficile Infections

What are Clostridium difficile infections?

Clostridium difficile, often called C. diff by health care professionals, is a type of bacteria that causes diarrhea and other intestinal diseases. It usually does not make healthy people ill, but it can cause serious illness in older people or people with weakened immune systems, such as many health care patients. The germ is naturally occurring in the intestines of some people, but it can overwhelm a patient's body if the balance between good and bad bacteria in his or her intestines is disrupted, which can sometimes be caused by antibiotics. C. diff is a tough bacteria and can live outside the human body for long periods of time, so hospitals must use strict infection control measures to prevent hospital patients from becoming sickened by the bacteria.

What are we doing to prevent Clostridium difficile (C. diff) infections?

To prevent C. diff infections, doctors, nurses and other health care team members:

  • Wash their hands with soap and water or clean their hands with an alcohol-based sanitizer before and after caring for every patient.
  • Only prescribe and give patients antibiotics when necessary.
  • Carefully clean all of our hospital rooms and medical equipment to remove C. diff germs.

Additionally, all patients with C. diff are given a private room or share a room with another patient who has C. diff, to avoid spreading the bacteria. When caring for patients with C. diff, caregivers wear gloves and a gown over their clothing.

What can patients do to help?

Patients and their families can also help reduce the risk of C. difficile infections. To learn more, please read the C. difficile fact sheet.

How are we doing?

University of Missouri Health Care has kept our infection rates low for C. difficile during the past several years by following recognized best practices such as those listed above. Our infection rates are calculated by comparing the average number of infections for every 1,000 days patients are in our hospitals. 

Methicillin-resistant Staphylococcus aureus (MRSA)

What is MRSA?

Staphylococcus aureus, commonly known as Staph, is a common bacteria; about one out of three people carries this germ on his or her body. Staph can sometimes can cause serious infections, especially in people with weakened immune systems, such as many health care patients. Staph can cause skin, wound or blood infections, or pneumonia. Most Staph infections can be treated with regular antibiotics. Some types of Staph bacteria, however, such as methicillin-resistant Staphylococcus aureus (MRSA), are resistant to treatment with antibiotics.

What are we doing to reduce MRSA infections?

To prevent MRSA infections, doctors, nurses and other health care team members:

  • Wash their hands with soap and water or clean their hands with an alcohol-based sanitizer before and after caring for every patient.
  • Carefully clean all of our hospital rooms and medical equipment with germ-killing antiseptic materials.

What can patients do to help?

Patients and their families can also help to reduce the risk of MRSA infection. For more information, please read the MRSA fact sheet.

How are we doing?

University of Missouri Health Care has succeeded in reducing our MRSA rates by carefully following the practices listed above. MU Health Care's health care-associated MRSA rates have steadily decreased during the past several years. Our infection rates are calculated by comparing the average number of infections for every 1,000 days patients are in our hospitals. MU Health Care's current rates of MRSA infection are less than 0.2 infections per 1,000 patient days. We attribute that success to following the best practices named above, especially strict adherence to guidelines, called body-substance precautions.

Catheter-associated Urinary Tract Infections

What are catheter-associated urinary tract infections?

Catheter-associated urinary tract infections (CAUTIs) are the source of approximately 30 to 40 percent of all hospital-acquired infections. Any time a foreign object is placed in the body there is a risk of infection. MU Health Care has taken steps to reduce these infections by emphasizing multiple interventions.

What are we doing to reduce these infections?

We are taking the following steps:

  • Implementation of an electronic reminder system to emphasize the importance of removing urinary catheters as soon as possible. Nurses and physicians are asked to evaluate the need for urinary catheters prior to inserting them, when ordering them and twice daily.
  • Hand hygiene and glove use prior to insertion and touching the urinary catheter
  • Trained, skilled individuals to insert catheters
  • Use of alternatives to a urinary catheter whenever possible
  • Daily care of the catheter, including cleaning and maintaining unrestricted flow
  • Ongoing surveillance by champions on each unit to ensure indications are met
  • Training for staff members who handle and insert catheters
  • Use of internal reporting to all units on rates of use of catheters and rates of infection
  • Rewarding individuals and units for making improvements on usage and decreasing infection rates

What can patients do to help?

Each day that a catheter is in the urinary tract causes a risk of an infection. Ask your care providers if there is really a need for the catheter and insist that it be removed as soon as possible.

How are we doing?

Since implementation of the set of interventions beginning in December 2013, the rate of catheter use has been reduced by 4 percent per 1,000 catheter days. This rate is calculated using the amount of catheter days and the average number of patients in our hospital per day. When compared with fiscal year 2013, we have decreased our rate of infection by 21 percent in fiscal year 2013 in MU Health Care’s adult intensive care units.

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