Improve patient safety and cut costs with single-patient-use ECG cable and lead wire systems
A single-patient-use electrocardiography (ECG) cable and lead wire system may reduce transmission of pathogens, reduce false alarms, and result in time and cost savings compared to reusable lead wires.
Hospital-acquired infections (HAIs) pose a significant problem for hospitals and their patients. These HAIs, which develop during regular medical treatments, are linked to increased morbidity and mortality among patients.1
Nearly half of adult patients who have an extended stay in intensive care units after cardiac surgery had one or more HAI. Such infections are not only bad for patient health, they also increase costs related to the patient’s underlying disease by prolonging the duration of hospital stays and adding diagnostic and therapeutic interventions not related to the underlying disease.1
One specific HAI, vancomycin-resistant enterococci (VRE), infects up to 85,000 patients annually in U.S. hospitals. VRE endangers patients and poses a significant burden on health systems.2
The number of U.S. hospitalizations with VRE discharges more than doubled between 2000 and 2006 to 9.48 hospitalizations with VRE infection per 100,000 people and 6.51 VRE infections per 100,000 hospitalizations.2
ECG lead wires are implicated in transmission of pathogens
ECG lead wires that were properly cleaned by hospital staff remain a significant vector of HAIs.1
Contaminated ECG lead wires may also be a factor in the development of surgical site infections (SSIs), particularly ECG lead wires that directly contact the patient’s skin on or near open wounds. SSIs also increase the risk of in-hospital mortality. Reducing the incidence of SSIs not only improves patient outcomes, but reduces costs and overall burden on the healthcare system.5
Despite infection prevention best practices, it can be difficult to effectively keep reusable ECG lead wires pathogen free. For one, ECG lead wires are usually decontaminated after patient use with disinfectant wipes. However, small ridges and clamps in ECG lead wires can lead to incomplete cleaning and disinfecting.1
In a study published in the American Journal of Critical Care, researchers tested more than 400 cleaned and disinfected ECG lead wires in four intensive care units and one post-anesthesia care unit. They found that more than half of the reusable lead wires were contaminated with bacteria or other risky pathogens. Researchers even found drug-resistant organisms on clean, ready-to-use lead wires and storage containers in a large academic hospital.4 These numbers reveal the scope of the problem of ECG lead wire contamination and the difficulties in cleaning every lead e effectively.2
Transitioning to a single-patient-use ECG cable and lead wire system
One evidence-based solution to this contamination problem is the Kendall DL™ single-patient-use cable and lead wire system. Research shows it may help reduce the risk of lead wire cross-contamination.
Transitioning to this single-patient-use ECG cable and lead wire system as part of a multimodal infection prevention strategy may significantly reduce SSI incidence.5
Single-patient-use ECG cable and lead wires may help reduce false alarms
In addition to contamination, the high incidence of false alarms is another significant problem related to the use of ECG lead wires in hospitals. Research has found that between 72% and 99% of all patient alarms in hospitals are false. This contributes to alarm fatigue and increases the burden on healthcare staff — typically nurses — who must deal with them.11 Nursing staff can suffer desensitization to the sounds of alarms or may have trouble differentiating the urgency of any alarm due to their frequency. This can lead to signi cant interruptions in care, compromise patient safety if relevant alarms are missed, and contribute to job dissatisfaction and burnout.7
The problem has become so significant that in 2008 the ECRI Institute started including false alarms on its list of Top 10 Health Technology Hazards. In 2019, alarm, alert, and notification overload ranked sixth in hazard status.10
ECG lead failures are a common cause of false alarms.9 A single-patient-use cable and lead wire system with a push button design, like the Kendall DL™ system, may provide a better option. The lead wire is secured to the electrode with a patented, pressure-less push-button design that ensures a secure fit even with highly mobile patients.
The study also cites a comparison of three brands of disposable lead wire connectors and found that the Kendall DL™ disposable lead wire had greater retention forces than the other products.9
Single-patient-use ECG lead wires save time
When nurses and other healthcare professionals hurry over to respond to false alarms, a lot of time gets wasted that could be better spent. Another time-consuming task is putting lead wires on a patient and taking them off.
The Kendall DL™ lead wire system helps to improve patient ow because it is one system that travels with the patient throughout their entire stay in the hospital. It comes with a universal adapter that allows for seamless transition between di erent types and departments of care. Its dual connect system makes for an easier transition between bedside and telemetry monitoring, and because it’s standardized and consolidated it reduces setup time for nurses. Additionally, less time spent touching the lead wire system means less time touching the patient.
Single-patient-use ECG cable and lead wire systems are cost-effective
To better understand the nancial impact of introducing single-patient-use lead wires, a cost-e ectiveness analysis was conducted and published in the journal Frontiers in Cardiovascular Medicine. The study found that transitioning to Kendall DLTM signi cantly reduced the cost of care for the hospital and increased patient quality of life.6
These Medicare savings are a result of lower costs associated with shorter hospital stays and fewer hospital readmissions.
While the researchers did not study other patient populations besides Medicare patients, they extrapolate that it is likely that other care practices would be equivalent in their results, saving money for non-Medicare patients as well. Additionally, based on the cited studies, single-patient-use ECG lead wires may help hospitals meet the quality measures informing CMS Pay-for-Performance programs, such as Hospital Acquired Condition Reduction Program (HACRP), Hospital Value Based Purchasing (HVBP), and the Hospital Readmission and Reduction Program (HRRP).
REFERENCES:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746603/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836830/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746603/
4. https://www.ncbi.nlm.nih.gov/pubmed/25179038
5. https://www.ajicjournal.org/article/S0196-6553(18)30068-3/abstract
6. https://www.frontiersin.org/article/10.3389/fcvm.2019.00061
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756058/
8. https://www.jointcommission.org/assets/1/6/Perspectives_Alarm.pdf
9. https://aacnjournals.org/ajcconline/article-abstract/24/1/67/4038/Differences-in-Alarm-Events-Between-Disposable
10. https://www.ecri.org/Resources/Whitepapers_and_reports/Haz_19.pdf
11. https://www.ncbi.nlm.nih.gov/pubmed/24153215
