Leading Quality and Safety

August 19, 2014

WSHA Partnership for Patients Reduces Number of Women in ICU for Preeclampsia by 76.6%

Recent data shows that since the first quarter of 2012 the number of women admitted to Washington hospital ICUs for preeclampsia decreased by 76.6%.

Preeclampsia is a complication of pregnancy characterized by high blood pressure and large amounts of protein in the urine. If left untreated, preeclampsia can have serious or even fatal consequences for a mother and infant. Although the cause is unknown and there is no cure other than delivery of the baby, early recognition and treatment can prevent damage to the mother’s internal organs, death, or premature delivery of the baby.

As part of its Partnership for Patient’s goal to reduce adverse obstetrical events, WSHA and member hospitals are working with Dr. Larry Shields and Dr. Elliott Main from the California Maternal Quality Care Collaborative to determine the best strategies for improving the outcomes of women with this condition. The work focuses on early recognition and treatment of preeclampsia.

These strategies outlining best practices presented at WSHA Safe Tables, along with a preeclampsia toolkit from California Maternal Quality Care Collaborative, can be found on the Partnership for Patients webpage. (Mara Zabari, MaraZ@wsha.org)

FDA Alert: Recall of Potentially Contaminated Drug Products

The Food and Drug Administration (FDA) issued an alert of a voluntary recall of all non-expired drug products produced for sterile use by Unique Pharmaceuticals Ltd. of Temple, TX. These products may be contaminated and health care professionals should quarantine them immediately and not administer them to patients. Unique Pharmaceuticals Ltd. has stopped their sterile compounding operations until sufficient corrections are made. The FDA asks health care professionals and consumers to report adverse events or quality problems associated with use of the products to the MedWatch program. (Rebecca Snyders, RebeccaS@wsha.org)

Yakima Valley Memorial Earns National Award for End-of-Life Care Efforts

Yakima Valley Memorial Hospital is one of three organizations honored nationally this year with a 2014 Circle of Life Award for its comprehensive programs to improve the care of patients near the end of life or with life-limiting conditions.

The Circle of Life Award celebrates innovative programs that have made great strides in palliative and end-of-life care across the nation. The Circle of Life Award is presented annually by the American Hospital Association.

Memorial operates a hospice house, Cottage in the Meadow, and offers a largely volunteer-driven Transitions palliative care program that serves more than 200 patients each year in their homes. Monthly community talks provide guidance on various subjects, such as living wills and advance directives, and Memorial’s outreach programs work to build dialogue within the Yakima Valley about end-of-life issues. Read more. (Beth Zborowski, BethZ@wsha.org)

Can You Answer Basic Questions from Patients on Ebola?

The current Ebola outbreak is centered in three countries in West Africa: Liberia, Guinea, and Sierra Leone. While having a huge impact in these countries, the Centers for Disease Control and Prevention (CDC) states that “Ebola does not pose a significant risk to the U.S. public.”

What is Ebola?

Ebola virus in human causes a viral hemorrhagic fever disease. Symptoms include: fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite, and abnormal bleeding. Symptoms do not appear immediately. They most often appear 8-10 days after exposure although they can appear as late as 21 days later.

How is Ebola transmitted?

Contact with the blood or bodily fluids of an infected symptomatic person is most common although transmission can also occur through exposure to objects (such as needles) that have been contaminated with infected secretions.

Individuals who are not symptomatic are not contagious.

Can Ebola be transmitted through the air, food, or water?

No, Ebola is not transmitted through the air, food, or water.

Has anyone contracted Ebola in the U.S.?


What is being done to prevent ill passengers in West Africa from getting on a plane?

Airports in Liberia, Sierra Leone and Guinea are screening all outbound passengers for Ebola symptoms. This includes checking for fever and requiring passengers to answer a questionnaire.

What about ill Americans with Ebola who are being brought to the U.S. for treatment? How is CDC protecting the American public?

CDC is using the established protocols similar to what was used during SARS for transport and care of patients with infectious diseases back to the United States. These procedures cover the entire process — from patients leaving their bedside in a foreign country, to their transport to an airport and boarding a non-commercial airplane equipped with a special transport isolation unit, to their arrival at a medical facility in the United States that is appropriately equipped and staffed to handle such cases. CDC’s role is to ensure that travel and hospitalization is done in such a way as to minimize risk of spread of infection and to ensure that the American public is protected.

What does the CDC’s Travel Alert Level 3 mean to U.S. travelers?

Citizens are encouraged to defer unnecessary travel to Guinea, Liberia, and Sierra Leone. Travelers may not have access to health care facilities and personnel should they need them in those countries.

This information was taken from the CDC FAQ document. For more information go to the CDC web site.  (Carol Wagner, CarolW@wsha.org)

Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

Best practices for preventing hospital acquired infections are based on evidence. For hospitals and infection prevention staff, this means that what was best practice five years ago may not be today.

In 2008, the Society for Healthcare Epidemiology of America (SHEA) sponsored an expert guidance document for prevention of surgical site infections, “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals.” This document was recently updated with comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs), including surgical site infections (SSI). Here are some SSI prevention best practices recommended for all acute care hospitals by the 2014 Compendium Guidelines.

  • Administer antimicrobial prophylaxis according to evidence-based standards and guidelines including weight based dosing.
  • Do not remove hair at the operative site unless the presence of hair will interfere with the operation. Do not use razors.
  • Control blood glucose during the immediate postoperative period for cardiac surgery patients and non-cardiac surgery patients.
  • Maintain normothermia (temperature of 35.5°C or more) during the perioperative period. Even mild degrees of hypothermia can increase SSI rates.
  • Optimize tissue oxygenation by administering supplemental oxygen during and immediately following surgical procedures involving mechanical ventilation.
  • Use alcohol-containing preoperative skin preparatory agents if no contraindication exists.
  • Use impervious plastic wound protectors for gastrointestinal and biliary tract surgery.
  • Use a checklist based on the World Health Organization (WHO) checklist to ensure compliance with best practices to improve surgical patient safety.
  • Perform surveillance for SSI.
  • Provide ongoing feedback of SSI rates to surgical and perioperative personnel and leadership. For more strategies and information on prevention of SSI, visit the WSHA Partnership for Patients web page.

(Amber Theel, AmberT@wsha.org)


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