DECREASING INFECTIONS

When a patient gets an infection while in a hospital, it is called a 'Nosocomial Infection'. Nosocomial Infection, also known as hospital-acquired infection ("HAI"), typically appear within 48 hours or more after hospital admission or within 30 days after discharge.

Tens of thousands of patients contract HAIs. And many of those people die or suffer complications. Costs of HAIs to hospitals run into the billions of dollars. Dr. Peter Pronovost, a champion in the fight to reduce HAIs, testifying before Congress in early 2008, estimated that HAI's affect 1 in 10 patients nationally and kill about 90,000 people a year, costing the health care system $5 billion to $11 billion.

Hospitals are working to decrease the rate of HAIs using checklists and reminders about regular hand washing between patients. And you can help by speaking up. Probably the most important thing you can do is insist that EVERYONE who comes into the hospital room and has contact with the patient first wash their hands. It's good medicine. To learn more about how to minimize HAIs for you and your loved ones, read the following information.

HAIs have always been with us. However, they have become more alarming in the 21st century.
Some of the main reasons are:

- Hospitals house large numbers of very sick people whose immune systems are often in a weakened state;

- Healthcare staff move from patient to patient, spreading germs as they go;

- Many medical procedures are invasive; and

- Hospital staff may not pay attention to sanitation protocol regarding uniforms, equipment sterilization, washing, and other preventative measures designed to isolate patients from HAIs.

Thorough hand washing and/or use of alcohol rubs by all healthcare staff before and after each patient contact is one of the most effective ways to combat HAIs.

A LIFESAVING CHECKLIST

Peter J. Pronovost M.D., now an internationally recognized expert on hospital safety, started studying hospital-acquired infections in 2001. He created a simple five-item checklist protocol to greatly reduce infections when inserting a central venous catheter, as follows:

Doctors should:

1. Wash their hands with soap.
2. Clean the patient's skin with chlorhexidine antiseptic.
3. Put sterile drapes over the entire patient.
4. Wear a sterile mask, hat, gown and gloves.
5. Put a sterile dressing over the catheter site.

The Pronovost five-item checklist was thoroughly tested, first at Johns Hopkins and later in 108 intensive-care units in Michigan, where it succeeded beyond anyone's wildest dreams in saving lives and reducing costs for patients who received the major fluid tube called a central venous catheter. The checklist worked so well that in the first eighteen months of the program it was estimated that 1,500 lives and $200 million were saved. These results were sustained for almost four years.
⇒ Checklist Results

How could this be? "A large body of evidence gathered in recent years has revealed a profound failure by healthcare professionals to follow basic steps proven to stop infection and other major complications. We now know that hundreds of thousands of Americans suffer serious complications or die as a result. It's not for lack of effort. People in healthcare work long, hard hours. They are struggling, however, to provide increasingly complex care in the absence of effective systematization. Excellent clinical care is no longer possible without doctors and nurses routinely using checklists...." Atul Gawande,M.D., a surgeon at Brigham and Women's Hospital in Boston, and the author of "Better."

To someone on the outside, this list may seem like a no-brainer. But oftentimes in the rush of high-tech medicine a simple step, like hand washing, is often neglected, sometimes with disastrous results. Quality hospitals are turning to ways to expand the simple checklist concept to many other procedures.

WHAT YOU CAN DO

For instance, forty percent of all HAIs are urinary. There is no widely-used strategy to prevent hospital-acquired urinary tract infections. Moreover, many hospitals have no system in place telling them which patients had a catheter, or how long the catheter was in place or whether it had been removed. And only a small minority of hospitals used any system to remind doctors to check daily on whether a patient's catheter was necessary; the longer one is in, the greater the likelihood of infection.

A nationally imposed checklist for safe urinary catheter insertion and removal could sharply reduce the risk to patients and the costs of hospital care. Consumers can ask local hospitals whether they are using checklists to reduce infections. In addition, hospital patients should be their own advocates, armed with their own checklist and asking medical personnel whether they are using it "to help assure that I don't get an infection" or asking, "Do I still need this catheter?"

Here's another one: taking a timeout to wash hands. We teach our children to wash their hands after using the rest room, and before they eat a meal. We may use hand sanitizers when we travel or after we shake someone's hand. Hand washing has been credited with drastically reducing the number of HAIs. So why not insist on clean hands for patients and staff? Hospitals have enlisted patients to spread the word that clean hands save lives. Patients and family members are urged to watch whether the healthcare staff and their doctors wash their hands and to remind them if they do not. Ask about the "Clean Hands Save Lives" checklist at your hospital.