Hospital Acquired Infections Out of Control

A few weeks ago a historic report released by a state agency in Pennsylvania (PHC4) discovered that during 2005, over 19,000 patients contracted an infection while they were in the hospital which led to one in nine dying. Turns out, patients are almost six times more likely to die during a hospital stay if they acquire an infection than not. It is the first report in the nation identifying the rate of infections acquired by patients by individual hospitals. The Institute of Medicine, a few years back, found that at least 98,000 patients a year die nationwide from acquiring infections while they are hospitalized. Most experts believe this number is even higher.

Imagine if we put these numbers in the context of airplane crashes. Let’s say that only one-third of the infections could have been prevented – that’s just over 32,600 people or three plane crashes EVERY WEEK carrying 200 passengers each. Imagine the public outcry. Think the airlines could go on with business as usual? Think we’d still be flying? Or picture how you’d react tomorrow morning if the local headlines read that nearly 100,000 people were going to die of SARS in the next twelve months. Got your attention?

The industry tells us that hospitals, of course, are places for very sick people, and very sick people have germs. Doctors, nurses and technicians make contact in the most intimate of ways: via blood, urine and bodily contact. It doesn’t take much for germs to travel from one person’s hands to dozens of people every day. The problem for patients, however, is that their immune systems are weakened creating a “Welcome Mat” for bacteria. They contend that the severity of a patient’s illness is what increases the risks of getting a hospital acquired infection (HAI).

BUT health policy expert David Nash, editor of American Journal of Medical Quality and chair of the Department of Health Policy at Thomas Jefferson University, argues that, "It's the process, not the patients" that spawns hospital-acquired infections. According to Nash, three recent independent studies 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." Nash recommends that hand washing among hospital workers, carefully keeping surgical gowns and clothing sterile during procedures, reduced numbers of hospital personnel going in and out of operating rooms and more selective use of antibiotics could significantly reduce the alarming infection rate (Washington Post, 11/21). Marc Volavka, Executive Director of PHC4, is even more adamant: "The simple fact is that every patient who enters a hospital in Pennsylvania and in this country is at risk for a hospital-acquired infection. This is about flawed processes and the chaos currently existing within our health care delivery system."

YOUR TURN

1. Should hospitals require that every doctor, nurse and technician wash their hands in front of patients before examining or treating them? Should they tell patients on admission to ask hospital personnel, "Did you wash your hands?" Would you ask?

2. Should Medicare start linking its payments to hospital infection rates? For example, if someone gets a urinary tract infection that is hospital acquired, Medicare wouldn’t pay the hospital the added costs to treat the patient’s infection.

3. Should every state issue annual consumer reports on hospital acquired infections by hospital? Would you use this data to select a hospital for your next surgery?