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preventing_hospital_infections

Preventing Hospital Infections

Having been in the hospital five times during the past year has made me acutely aware of, interesting in and concerned about acquiring one of those hospital acquired infections we are hearing so much about.

These infections have become a major problem and it is estimated that about 100,000 people a year die from them and another couple million will suffer some type of in hospital infection. Another statistic I saw was that it is estimate that perhaps ten percent of all hospital patients will acquire an infection.

My medical history includes hereditary lymphedema, lymphoma and a greatly diminished immune system, so it is critical for me to do all I can to prevent this disaster from happening.

Basic tips of Preventing Infections in a Hospital

If you have lymphedema, talk with your physician about starting antibiotic therapy at least five days before you are admitted to the hospital.

Before tools such as stethoscope, monitors etc are used on you, ask that they be wiped with alcohol or an anti-bacterial agent.

You might consider asking visitors to wash their hands before giving ou something and especially to avoid sitting on your bed.

Some suggest having your doctor take a nasal swab culture for staphylococcus aureus BEFORE you enter the hospital to see if you are a carrier.

Gloves should always be used.

If you are able to shower, insist and make sure the shower is cleaned/sterilized daily.

Don't allow anything that has been dropped on the floor to then be used on you. Sounds redundant? Not really, you would be amazed at what I have seen.

Don't go barefoot on the hospital floor. Even those little cloth booties can help create a barrier between you and that floor.

Make sure doctors and nurses wash their hands before examining you. The CDC cites hand washing as the single most effective way to control the spread of disease.

Wash your own hands carefully after using the bathroom or handling soiled materials: Scrub for at least 15 seconds with warm, soapy water.

If you're receiving fluids through an intravenous catheter, let your nurse know if the dressing around it becomes wet or soiled.

Infections from urinary catheters are common, so these dressings should be clean and dry, and the catheter should not remain in longer than necessary.

Keep an eye on wound dressings and drainage tubes, and let your nurse know if they become loose or wet.

Ask friends and family not to visit if they're feeling ill.

If you need surgery and are overweight, losing a few pounds before you go in the hospital can help reduce your risk of post-surgery infection.

Be extra vigilant if you have diabetes because high blood sugar increases your risk of infection. Work with your doctor to control your blood sugar before, during, and after your hospital stay.

Don't be afraid to ask questions! Understanding your treatment plan will make it easier for you to be involved in your own recovery.

Pat

How to Prevent Hospital Infections

CBS) About two million infections are acquired in U.S. hospitals each year, killing about 90,000 patients.

There is a growing movement to require hospitals to disclose the number of infections that are acquired during surgery and other routine procedures. The Early Show medical correspondent Dr. Emily Senay reports on the growing problem.

On Christmas Eve 2002, 16-year-old Raymond Wagner III shattered his left elbow in a sledding accident. He had surgery later that night to repair his bones.

“They said everything went well,” Raymond Wagner says. “The next morning, I woke up; it was Christmas; it was my birthday; went home, opened presents, and I had a fever, but the doctors kept on telling me that it was a fever from the trauma of the surgery.”

But the fever persisted for days, and his condition worsened. Back in the hospital, he was diagnosed with osteomyelitis, a serious bacterial infection of the bone. Raymond Wagner was treated unsuccessfully for months afterward. Antibiotics didn't work to kill the infection. And he had to have more surgeries to stop it from spreading.

“It was a harrowing experience for all of us,” his father, Ray Wagner Jr., says, “There was concern on the part of some of the medical team that this infection might migrate into other organs in his body, which would have proved fatal.”

His son's persistent illness had all the hallmarks of a hospital-acquired infection.

Dr. Tim Wilkin of Weill-Cornell Medical College says the types of bacteria in a hospital are different from bacteria out in the world in general.

“They can be quite different,” he says. “They can be resistant to antibiotics, which makes them more difficult to treat. What it means is that they have to use stronger, more expensive, antibiotics to treat the infection, and can often require antibiotics for a longer period of time.”

The Wagners finally moved Raymond to another hospital, where doctors were able to cure him.

Raymond Wagner says, “They put a broviac tube in me, which is a tube that goes in your chest directly into your heart. And that fed antibiotics through me for half the summer.”

Today, Raymond Wagner III is back in fighting form: both he and his father are now dedicated to raising awareness of hospital infections.

Ray Wagner Jr. says, “I didn't know that I should ask: Is he more likely to acquire an infection in this hospital or that hospital or that hospital? And it occurred to me that as a consumer, as a patient, as a father, that I might need to know this - that I should've known this.”

The Wagners lobbied for a new law that took effect in August, requiring Missouri hospitals to publicly report rates of hospital-acquired infections.

Hospital-acquired infections are a major problem all over the U.S., but opinions differ on the best way to disclose hospital infection rates.

Dr. Don Nielsen, senior vice president for Quality Leadership for the American Hospital Association, believes hospitals can adequately provide this information on a voluntary basis.

“No physician, myself included, wants to see a patient have an infection,” Dr. Nielsen tells The Early Show co-anchor Harry Smith. “Hospitals are committed to ensuring the safety, and most certainly, preventing infections from occurring with regard to patients.”

Lisa McGiffert, campaign director for the Consumers Union, believes that legislation is required to force hospitals to fully disclose infection rates.

She says, “People want to be informed of the health care that they're getting and they want information based on quality. Hospital infections kill more people than homicides and car accidents combined every year. And the tragedy is that most of them can be prevented.”

Though Dr. Nielsen says he is not opposed to having some sort of public record that people could examine, he notes it is important for the documents to be accurate and reliable. The problem is that you can't make comparisons between hospitals when it comes to reporting information publicly.

He explains, “They have different ways of measuring the same thing, which leads to confusion among the general public when they are tring to make this comparison, and that's the reason that the Hospitals of America have joined together to form the National Hospital Quality Alliance, and we are publicly reporting data now on a number of conditions, and we will be reporting information with regard to infections in this coming year.”

McGiffert says it is thanks to the people who want to know this information that states are now looking into whether or not to require its release by legislation.

She says, “The public has played a role in bringing this agenda to all of the legislators. Over 30 states are considering this bill. These are mandatory reporting systems, and the one he's talking about is voluntary. It is important for people to have full information about every hospital in their community, and this information can be made comparable. There are ways you can adjust the data so that you can compare hospital to hospital.”

Dr. Nielsen says he does not disagree with the notion that the patient has a right to be able to examine this information. He says, “We think patients deserve the right to have accurate, reliable information. The CDC has recently come out now with a report recommending the type of information that should be the starter set.”

CBSNews

Beware the Catheter

By:Mary Elizabeth Terzella No one expects a hospital stay to make them sick, but it happens all the time.

An estimated two million patients contract infections while in the hospital annually, and about 40 percent are urinary tract infections. The main culprit: catheters. About one in every four patients gets a urinary catheter, and having it in place for more than two days increases the likelihood of developing a painful bladder infection or even a blood infection.

According to a University of Michigan study, the risk of infection could be reduced—and millions of patients spared longer-than-necessary discomfort and embarrassment—if their hospital records contained reminders for doctors to reauthorize or order removal of the catheter after two days. When busy doctors followed such reminders, the percentage of days subjects spent on a catheter went down by about 25 percent, says the study’s lead author Sanjay Saint, MD, a hospitalist and associate professor of internal medicine at the Ann Arbor VA Medical Center and the University of Michigan Medical School in Ann Arbor.

“Research has shown that many doctors forget which patients have catheters and that catheters stay in too long without appropriate medical justification,” says Dr. Saint. Currently, only a few hospitals have catheter-reminder systems, so play it safe and institute your own infection-protection plan. “If you’re still using a catheter after 48 hours, find out whether removal has been overlooked,” advises Dr. Saint. “Every day, ask the doctor if you still need the catheter. If you don’t feel comfortable asking—or are unable to—have a family member or friend politely inquire whether it is still necessary.”

Caring Today

Studies Hospital Could Do More to Avoid Infections

By Christopher Lee

Washington Post Staff Writer Tuesday, November 21, 2006;

Infections acquired in hospitals, which take a heavy toll on patients, arise mainly from poor hygiene in hospital procedures, not from how sick patients were when they were admitted, according to three new studies.

The studies, published yesterday in the American Journal of Medical Quality, provide new evidence for experts who argue that hospitals could prevent many of the growing number of infections that afflict patients nationwide, cost billions of dollars to treat and are responsible for thousands of deaths each year.

“It's the process, not the patients,” said David B. Nash, the journal's editor and chairman of the Department of Health Policy at Thomas Jefferson University in Philadelphia. “These three groups independently found that despite hospitals' claim that in the sickest patients it's inevitable that someone is going to get a hospital-acquired infection, that's just not the case.”

Rather than accepting some infections as unavoidable, Nash said, health professionals should do more to promote hand-washing among medical staff, take greater care in donning gowns and other infection-preventing clothing during medical procedures, reduce traffic in and out of operating rooms, isolate patients when necessary and use antibiotics more selectively.

The government can do more to educate the public and encourage hospitals to report infections, Nash said. And patients should speak up more, even asking doctors and nurses, “Did you wash your hands?” before being treated. Hospital officials agree, said Nancy Foster, vice president for quality and patient safety at the American Hospital Association, which represents more than 4,800 hospitals and health-care systems nationwide.

“The new wave of research is showing that our previous expectations around what was preventable underestimated what we could actually achieve,” Foster said. “We can prevent more infections than we thought before. Lots of hospitals are striving to get to zero” infections.

Preventing infections is a “delicate balancing act,” she said, because simple measures such as greater antibiotic use would simply speed up the evolution of drug-resistant germs. “It's really the germs that are the bad guys here,” she said.

Previous studies have shown that patients with hospital-acquired infections spend many more days in the hospital, undergo more extensive procedures and are more likely to die than patients who do not contract them. The problem has been the subject of congressional hearings and reports by the federal Institute of Medicine.

Solid national estimates are not available. But in Pennsylvania, the first state to collect such data, 19,154 patients contracted an infection in hospitals last year, up from 11,668 in 2004, according to a survey released last week by the Pennsylvania Health Care Cost Containment Council. The council, a state agency, said some of the increase was because of better reporting by hospitals.

The average hospital stay in Pennsylvania was nearly 21 days for those with hospital-acquired infections, and five days for patients without them. The average hospital charge was $185,260 for those with infections, nearly six times the $31,389 incurred by others. Twelve percent of patients who acquired infections died, compared with 2.3 percent of other patients. The Pennsylvania survey, involving 168 hospitals and 1.6 million patients, examined four types of hospital-acquired infection: urinary tract infections associated with catheter use, infections from a central line inserted in large veins, ventilator-associated pneumonia, and infections at the site of incisions.

In one study released yesterday, researchers at Allegheny General Hospital in Pittsburgh found that age and severity of illness did not appear to be risk factors among 54 patients with ailments such as heart attacks and respiratory failure who contracted central line-associated bloodstream infections during the three-year period that was reviewed. On average, the hospital lost $26,839 caring for each patient, illustrating that there are financial advantages to reducing infections, the study found.

A second study, by researchers affiliated with provider Cardinal Health Inc. in Massachusetts, found that patients with hospital-acquired infections stayed in the hospital longer, were more likely to die and faced higher costs than patients with similar underlying illnesses who did not contract such infections. The severity of the effects of the infection could not be attributed to how sick the patient was on admission, the study found.

The third study, led by Christopher S. Hollenbeak, a professor of surgery at Penn State College of Medicine in Hershey, Pa., examined Pennsylvania's data for more than 180,000 surgical patients. It found that, while factors such as age and obesity, and conditions such as diabetes helped determine whether a patient was likely to develop a surgical wound infection, hospital practices such as hand-washing, the duration of surgeries and traffic through the operating room played a greater role.

“Hospital-acquired infections . . . should not be viewed as inevitable,” said Marc P. Volavka, executive director of the Pennsylvania agency. “They are not just about the very elderly or the very sick. The simple fact is that every patient that enters a hospital in Pennsylvania and in this country is at risk for a hospital-acquired infection.”

WashingtonPost

Essential Facts You Need to Know About Hospital Infections

Keep in mind:

·We have the knowledge to prevent hospital infection deaths.

·We don't have to wait for a scientific breakthrough. ·Yet most hospitals have failed to act.

·The situation is growing more dangerous because, increasingly, hospital infections cannot be cured with commonly-used antibiotics.

Essential facts:

1. Infections contracted in hospitals are the fourth largest killer in America. Every year in this country, two million patients' contract infections in hospitals, and an estimated 103,000 die as a result, as many deaths as from AIDS, breast cancer, and auto accidents combined.

2. A few hospitals in the U.S.—too few—are proving that infections are almost entirely preventable. How are they doing it? Through rigorous hand hygiene, meticulous cleaning of equipment and rooms in between patient use, testing incoming patients to identify those carrying dangerous bacteria, and taking precautions to prevent these bacteria from spreading to other patients.

3. In 2003, the Society for Healthcare Epidemiologists of America (SHEA) announced the precautions that research proves can eradicate most hospital infections. Yet only a few hospitals have taken these precautions, and the CDC still has not called on all hospitals to implement them.

4. Hospital infections add an estimated $30.5 billion to the nation's hospital costs each year. Patients, insurers and taxpayers pay part of that cost, but hospitals have to absorb much of the cost. As a result, infections erode hospital profits. Preventing infections can turn a financially failing hospital profitable.

5. Better infection prevention in hospitals is essential to prepare the nation for avian flu or bioterrorism. If avian flu were to wing its way to the U.S., the death toll would depend largely on what American hospitals did when the first avian flu patients were admitted. If hospitals have effective infection controls in place, they can prevent bird flu from infecting other patients who did not come in with it. If not, bird flu could sweep through hospitals. Right now, most hospitals are woefully under prepared. Hospitals have failed to stop the spread of ordinary infections spread by touch and would not be able to contain flu viruses, which are communicated by droplets from coughing and sneezing as well as touch. Even more challenging would be small pox, plague, and other bioterrorism weapons that can travel through the air. Shoddy infection control is poor preparation for a flu epidemic and poor homeland security as well.

6. Hospital infection is a far deadlier problem than the number of uninsured. The Institute of Medicine estimates that as many as 18,000 people a year die prematurely because they don't have health insurance. That's tragic. But five times as many people die each year from hospital infections, and most of them are insured.

Reduce Infection Deaths

External Links

Committee to Reduce Infections Deaths

http://www.hospitalinfection.org/index.shtml

Hospital Acquired Infections Emedicine – August 21, 2007

http://www.emedicine.com/ped/topic1619.htm

An increasing threat in hospitals: multidrug-resistant Acinetobacter baumannii

http://www.nature.com/nrmicro/journal/v5/n12/abs/nrmicro1789.html;jsessionid=9E66836DEEF088474FB7749450030CC1

Bacterial and fungal infections among diagnostic laboratory workers: evaluating the risks. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T60-4R34DYM-1&_user=10&_coverDate=11%2F08%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9969e2bd742401c89296f6a887d3a341

Use of safety devices and the prevention of percutaneous injuries among healthcare workers.

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17994515&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Epidemiology of multi-drug-resistant Gram-negative bacteria: Data from an university hospital over a 36-month period

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7GVY-4R2HKX6-1&_user=10&_coverDate=11%2F05%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d49bf763c05abc0294a2a9d5f5a41aa2

A method to determine hospital costs associated with nosocomial infections

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17937330&ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

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preventing_hospital_infections.txt · Last modified: 2012/10/16 14:40 (external edit)