Frequently Asked Questions

This is where the answer appears.

This is where the answer appears.

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

Patients should always follow instructions given to them by your health care team.  Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed

• Ask lots of questions.
• Find out why you need the line and where it will be placed.
• Learn what steps the hospital is taking to reduce the danger of infection.
• Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
• Try not to touch your line or dressing. 

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

Anyone who has a central line can get an infection. The risk is higher if you:

• Admitted to the ICU
• Have a serious underlying illness or debilitation
• Receiving bone marrow or chemotherapy
• Have the line in for an extended time 

• Redness, pain or swelling at or near the catheter site
• Pain or tenderness along the path of the catheter
• Drainage from the skin around the catheter
• Sudden fever or chills 

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

• Practising proper hand cleaning techniques
• Keeping the patient’s head of the bed elevated to a 30-45-degree angle
• Discontinuing mechanical ventilation as soon as safely possible
• and good oral care.

• Practising proper hand cleaning techniques
• Keeping the patient’s head of the bed elevated to a 30-45-degree angle
• Discontinuing mechanical ventilation as soon as safely possible
• and good oral care.

• Practising proper hand cleaning techniques
• Keeping the patient’s head of the bed elevated to a 30-45-degree angle
• Discontinuing mechanical ventilation as soon as safely possible
• and good oral care.

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

Generally, people do not die if they infected with VRE. In severe cases of VRE bacteremias can lead to death. This is rare and tends to occur in those people with other severe health problems. The vast majority of people recover from VRE once their health is restored.

If a patient is simply carrying VRE, no treatment is necessary, as the organism will be cleared on its own when the person’s health is restored. If it is determined that the patient is infected (they have a blood infection, urine infection or wound infection etc.) then the patient will treated with the appropriate antibiotic as determined by a physician.

We do not routinely monitor or isolate persons who carry VRE. Patients with VRE infections are identified during their care and treated accordingly.

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

Here at KGH we do not routinely place patients on precautions or isolate those who carry or are infected with VRE. Routine Practices are used because VRE, like other germs can be spread from one person to another by contact; hand hygiene is critical to preventing the spread of all infections in a healthcare setting. Health care providers are routinely required to clean their hands before, during and after patient contact. We also clean and disinfect all patient rooms and equipment to help stop the spread of VRE and other germs. 

VRE is spread from one person to another by contact, usually on the hands of health care providers (HCP). VRE can be present on the health care provider’s hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with VRE, such as towels, sheets and wound dressings. VRE can live on hands and objects in the environment.

Risk factors for VRE acquisition include severe underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and longer hospital stay.

Enterococci are bacteria that are normally present in the human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called Vancomycin-resistant Enterococci (VRE).

A bacteremia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

For more information and other related topics we recommend you visit:

• Ministry of Health and Long-Term Care - Patient Safety 
• Public Health Ontario - Regional Infection Control Networks (RICN)

All infection prevention and control precautions or Routine Practices aim to limit the spread of any bacteria to other patients and to health care providers.  

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

No. The HSMR results should not be used as a guide of choosing where to seek care. A higher than average HSMR result does not necessarily mean that a hospital is “unsafe” – nor does a lower than average HSMR mean a hospital is “safe.” Patients should know that KGH is safe and that the care they receive is top-notch. Every effort – on behalf of everyone serving patients in a hospital – is made to ensure patients receive the highest-quality care possible. Hospital care is complicated and depends on many factors, not all of which are reflected or accounted for by HSMR. That is why many indicators must be examined in order to get a sense of how hospitals are performing – where they excel and where improvements could be made. It is important to look at all of these indicators in combination. To judge performance on only one indicator would be misleading.

The HSMR is an overall quality indicator and measurement tool that allows for comparison of an acute care hospital’s mortality rate with the overall mortality rate among peer hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to assess and analyze in hospital mortality rates and to help improve quality of care and enhance patient safety. Ontario hospitals are beginning to use the HSMR for internal benchmarking purposes: to show hospitals how their HSMR has changed, where they have made progress and where they can continue to improve.

Morbidity and mortality patterns are changing. Hospitals, like ours, have implemented a range of initiatives to reduce mortality and improve patient care. As a result, HSMR results across the country have been progressively improving. So, this year, CIHI updated the methodology used to calculate HSMR results. For example, Quebec is now included, more diagnoses are added and a new approach to logistic regression modeling is used.

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

The Hospital Standardized Mortality Ratio (HSMR) is an overall quality indicator and measurement tool used by all acute care hospitals and regions in Canada. HSMR has been used by many hospitals in several countries to help improve quality of care and enhance patient safety.

The rate reported by CIHI for KGH has included patients whose secondary diagnosis included palliative care. These are patients whose hospitalization was for the purpose of palliative care for the majority of their hospital stay. Because palliative care was not the primary diagnosis, CIHI has included these patients in their calculation for KGH’s HSMR. At KGH, palliative patients accounted for 64 per cent of deaths last year. Without these palliative care deaths, the HSMR would be lower. 

Anyone who has a central line can get an infection. The risk is higher if you:

• Admitted to the ICU
• Have a serious underlying illness or debilitation
• Receiving bone marrow or chemotherapy
• Have the line in for an extended time 

Patients should always follow instructions given to them by your health care team.  Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.

Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed

• Ask lots of questions.
• Find out why you need the line and where it will be placed.
• Learn what steps the hospital is taking to reduce the danger of infection.
• Wash your own hands often. Use soap and water or an alcohol-based hand rub containing at least 60 per cent alcohol.
• Try not to touch your line or dressing. 

• All health care providers should practice proper hand cleaning techniques.
• Everyone who touches the central line must wash their hands with soap and water or use alcohol-based hand rub.
• Wear sterile clothing – a mask, gloves and hair covering – when putting in the line.
• The patient should be covered with a sterile drape with a small hole where the line goes in.
• The patient’s skin should be cleaned with “chlorhexidine” (a type of soap) when the line is put in.
• Choose the most appropriate vein to insert the line.
• Check the line every day for infection.
• Replace the line as needed and not on a schedule.
• Remove the line as soon as it is no longer needed.  

Health care providers who insert a central line in the vein of a patient fill out a central line insertion check list and procedure note which dates, tracks and documents the procedure.

Anyone who has a central line can get an infection. The risk is higher if you:

• Admitted to the ICU
• Have a serious underlying illness or debilitation
• Receiving bone marrow or chemotherapy
• Have the line in for an extended time 

• Redness, pain or swelling at or near the catheter site
• Pain or tenderness along the path of the catheter
• Drainage from the skin around the catheter
• Sudden fever or chills 

Central line infections occur when a central venous catheter (or “line”) is placed in the patient’s vein and the line gets infected. Patients in the intensive care unit (ICU) often require a central line since they are seriously ill and require a lot of medication for a long period of time. When a patient requires long-term access to medication or fluids through an intravenous (IV), a central line is put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream. The bacteria can come from a variety of places (skin wounds, environment etc.), though it most often comes from the patient’s own skin.

Anyone who has a central line can get an infection. The risk is higher if you:

• Admitted to the ICU
• Have a serious underlying illness or debilitation
• Receiving bone marrow or chemotherapy
• Have the line in for an extended time