Infections acquired by patients while receiving medical treatment are a
growing problem in the United States and worldwide. It is estimated that 5-10%
of hospitalized patients in the U.S. develop infections, leading to 100,000
potentially preventable deaths each year.
About 18 months ago, Medicare declared that it would “no longer pay the extra
costs of treating preventable errors, injuries and infections that occur in
hospitals.” (Federal Register, Aug 2007. Emphasis added). Those infections
include catheter-associated urinary tract infections and certain surgical-site
infections. It is widely anticipated that other infections will be added to the
list, and other insurers will surely follow Medicare’s lead on this issue.
What hospitals and clinicians are doing to prevent infections
Over the last 40 years, professional organizations, federal agencies, and
even state governments developed their own (at times conflicting) infection
control guidelines, and this lack of consistent recommendations and
methodologies sometimes hampered quality improvement efforts.
In response, a group of experts from the Joint Commission, the Centers for
Disease Control, the American Hospital Association, the National Quality Forum,
and other professional organizations released “A Compendium of Strategies to
Prevent Healthcare-Associated Infections in Acute Care Hospitals”(Infection
Control and Hospital Epidemiology 2008, 29:S1-92). The Compendium provides
separate recommendations for six key areas:
- Central line-associated bloodstream infections.
- Ventilator-associated pneumonia.
- Catheter-associated urinary tract infections.
- Surgical-site infections.
- Methicillin-resistant staph aureus (MRSA) infections.
- Clostridium difficile-associated disease.
In January of this year, the U.S. Department of Health and Human Services
(HHS) published online its own guidelines addressing the same six areas.
Healthcare-associated infections: “an epidemic that causes
about 2 million infections and 100,000 deaths each year…This epidemic ranks
sixth among the leading causes of death” nationwide.
Rep. Henry Waxman, chairman of the U.S. House Committee on Oversight and
Government Reform, April 16, 2008.
What is Intermountain doing?
We’ve analyzed our current infection control practices and found that we have
good processes and tools in place in most of these target areas. However, we’ll
continue to refine our processes and work towards more consistent application of
best practices. We’ve created an Infection Control Guidance Council, consisting
of a physician and a nurse from each region, that meets monthly to evaluate our
system-wide approach to infection control. Subgroups of the committee will
address more specific issues, like multiple-drug resistant organisms and more
sensible use of antibiotics.
What can you do?
- During the quality and patient safety portion of your local board meetings,
be sure to ask about the hand-hygiene performance at your hospital. Hand-hygiene
is a key component in preventing all types of hospital-acquired infections. Our
Patient Safety goal for 2009 is 90% compliance with our hand-hygiene policy.
- Ask about MRSA and surgical-site infections.
- When you visit your local hospital, ask about hand-hygiene and promote our