Infections lower at hospitals but still a concern

(Allentown Morning Call) With all the training and technology hospitals employ to care for patients, the best practice, said Dr. Kara Mascitti, is one that health care workers learned as children.

Wash your hands.

Mascitti, the director of health care epidemiology and infection prevention at St. Luke’s Hospital and Health Network, says controlling infections at hospitals is primarily a prevention-first practice.

“The key to infection prevention is back to basics,” she said. “To be honest, something as simple as washing your hands both before and after seeing a patient is the most important thing you can do.”

The focus on infection control, even with something as routine as hand-washing, is no small matter. In a report released Friday, the Pennsylvania Health Care Cost Containment Council said 21,319 patients admitted to a Pennsylvania hospital in 2010 acquired an infection. These patients stayed in the hospital three times longer than patients without infections; were far more likely to be readmitted up to a month after their hospital stay; and were more than five times likely to die than patients without infections.

Nationwide, theU.S. Centers for Disease Control and Preventionestimate 1.7 million patients contract infections associated with health care and 99,000 of them die.

All this naturally means far higher health care costs. An average Medicare in-patient stay in a Pennsylvania hospital cost $6,709, the report said. For patients who got an infection, the bill averaged $21,378.

The good news is that infection rates fell close to 6 percent from 2009 to 2010, the report said.

“This report demonstrates that hospitals’ continued efforts to prevent infections are working, even in the most complex and vulnerable patients, such as trauma and cancer patients,” said Carolyn F. Scanlan president and CEO of The Hospital and Healthsystem Association of Pennsylvania.

But Mascitti said 21,000-plus infections show that much work remains to be done.

The report indicates that patients’ surgical sites are the area most vulnerable to infection. Those patients also had the highest rate of readmission at 62 percent. Urinary tract and gastrointestinal infections and pneumonia were other leading sources of hospital infections, it said.

Urinary tract infections had been a long-standing problem, and its lower rank among infections illustrates the heath care industry’s efforts to reduce them, said Terry Burger, Lehigh Valley Hospital’s director of infection control and prevention.

LVH in the past year went the high-tech route in adding to its arsenal against infection. It bought five portable machines that emit UV-C light, which disrupts the DNA of bacterial and spores, rendering harmless germs such as Clostridium difficile, staph infections and influenza.

Berger said LVH uses the light-emitting units daily in operating rooms and tried it on a patient floor where a cluster of infections had occurred. “It totally stopped the problem,” she said.

Aside from new technology, infection control specialists say best practices have been identified and promoted to health care institutions. Mascitti and Alida Ammon, director of infection control at Sacred Heart Hospital in Allentown, said the protocols help identify if an invasive procedure is necessary, on the theory that the insertion of fewer catheters and intravenous lines means fewer infections.

They also said that controlling infections is not just the work of an inspector scolding a nurse for not washing his hands. It’s something that begins with workers who clean instrumentation, and extends to the nurses who prepare a patient, and the doctor who performs a procedure.

“We all have to be diligent in making sure we maintain those practices,” Ammon said.

Money is at stake, they said. Highmark Blue Cross/Blue Shield has worked with both hospitals and rewards them for improvement. At St. Luke’s, a program that pays hospitals for achieving certain targets led to an 81 percent reduction in urinary tract infections from catheters, Mascitti said. Sacred Heart’s infection rate is now below 1 percent of patients and the hospital in the past year had no deaths associated with a hospital-acquired infection, said Vice President of Marketing Valerie Downing.

Even more important, it’s a patient-satisfaction issue, specialists say. No one expects to go into a hospital and come out in worse health.

Ammon knows that personally. Her daughter acquired a hospital infection while at college and lost weeks of class time.

“It’s very emotional,” Ammon said. “It’s not just the dollars and cents. It’s seeing somebody you love be hurt.”

HOW PATIENTS CAN HELP

Speak up. Talk to your doctor about any worries you have and what precautions the hospital is taking to protect you.

Keep hands clean. If you do not see your providers wash their hands, ask them to do so. Also remind your family and visitors to wash their hands.

•Ask if you still need a central line or urinary catheter. Leaving a catheter in too long increases the risk of infection.

Ask your health care provider if a new needle, syringe and vial will be used for each procedure. Needles and syringes should never be reused on more than one patient.

Be careful with medications. Follow directions. Also, to avoid harmful drug interactions, tell your doctor about all the medications you are taking.

Get smart about antibiotics. Take all your antibiotics as prescribed. Don’t share them.

Know some of the signs of infection. You might see drainage at an IV catheter or surgical site or redness of the skin or pain.


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