1. Ulrich, Beth T. EdD, RN, CHE

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"We should make some improvements." "We'll get that new plan implemented soon." "As soon as we get some new equipment, we can make some changes." Do any of those statements sound familiar? The amorphous words "some" and 'soon' leave a lot of wiggle room and a lot of room for excuses. In fact, if we never specify when something will happen or exactly what will happen, then we never have to defend why it didn't. Vagueness is a friend to those who do not wish to be held accountable.


A new program launched by the Institute for Healthcare Improvement (IHI) aims to get rid of the ambiguity, to set absolute goals, and, in doing so, to improve the care we deliver. The 100,000 Lives Campaign has set a goal of reducing the number of unintended deaths by 100,000 lives by 9:00 am, June 14, 2006. Nothing vague about that!


How did they come up with the target of 100,000 lives? Actually, it was pretty easy. They found a few proven interventions and, based on outcomes research, determined the number of lives saved when those interventions were implemented. Rapid Response Teams, for example, have been shown to decrease the number of cardiac arrests and deaths and to decrease the length of hospital stay required for the survivors.


The 6 interventions that were chosen include:


* Deploy Rapid Response Teams at the first sign of patient decline.


* Deliver reliable, evidence-based care for acute myocardial infarctions.


* Prevent adverse drug events.


* Prevent central line infections.


* Prevent surgical site infections.


* Prevent ventilator-associated pneumonia (IHI, 2005).



The interventions are each composed of a few evidence-based components. As an example, preventing central line infections includes hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, appropriate catheter site and administration system care, and no routine replacement. Nursing is a major player in every intervention.


The developers of the campaign are grounded enough in the reality of today's healthcare delivery systems to know that not every hospital will be able to commit to all 6 interventions and that some hospitals who already have been working on some of the 6 interventions will want to do more.


It's the commitment of senior leadership to do specific interventions by the target date that's important to achieving the goal. More than 2,200 hospitals have already signed up for the 100,000 Lives Program. Even if your hospital does not chose to participate in the campaign, you can learn a lot from the information provided on the interventions. All information about the campaign is free and can be found at


Nursing can make a valuable contribution to the 100,000 Lives Campaign through our part in implementing the proposed interventions, but we can do more. The slogan for the 100,000 Lives Campaign is "Some is not a number. Soon is not a time." Nursing can also make a valuable contribution by eliminating the words "some" and "soon" from our own vocabularies and challenging others to eliminate them too.


We increasingly have a solid evidence base for the clinical practice of nursing as well as for how we deliver care. "We think this works better" is increasingly becoming "We know this works better."


Nursing needs to follow the example of the 100,000 Lives Campaign and set clear goals for what we will do and when we will do it for the things we know will improve the morbidity and mortality of our patients. There isn't a nurse who doesn't know something that can be improved and how to improve it. Some is not a number. Soon is not a time.