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We must get control of hospital-related infections. There is no doubt about it. Who hasn’t had a patient almost die from septic shock because of a seemingly innocent indwelling central line or require a colectomy to save his life from overwhelming C. diff colitis?
We’ve all heard the staggering statistics about the number of patients who die needlessly in the hospital each year. It seems unreal. Yet doctors and patients alike are keenly aware of the dangers that lurk within the doors of our nation’s hospitals, and the institutions that are set up to save lives often bear full responsibility for lives lost as a result of human error and sometimes just plain carelessness.
As we are all painfully aware, the Centers for Medicare & Medicaid Services now withholds payments from hospitals when certain conditions are acquired during the hospitalization, even if all reasonable attempts were made to prevent those complications. Among these hospital-acquired conditions are catheter-associated urinary tract infections and vascular catheter–associated infections. Although it may have seemed unrealistic to dramatically decrease these infections, the truth is they can be minimized, and drastically so, often by simple measures.
A recent study examined the behavior of health care workers in four U.S. hospitals (Infect. Control Hosp. Epidemiol. 2013;34:69-73 [doi:10.1086/668775]).
"Secret shopper" observers monitored 7,743 visits over 1,989 hours. They found that health care workers performed hand hygiene on exiting rooms with contact precautions 63.2% of the time, compared with 47.4% of the time when there were no contact precautions in place. Unfortunately, the low frequency with which the workers – including physicians – performed appropriate hand hygiene in this study demonstrates how far we are from truly optimizing patient safety.
The toll on human life is by far the most important consideration, but millions of dollars of lost revenue is not insignificant. In an effort to decrease the incidence of hospital-acquired infections, many hospitals have devised a variety of overt and covert strategies. Some are as obvious as a computerized reminder to consider removing a foley catheter or central line if it is no longer absolutely necessary. Others are much more obscure, such as the aforementioned secret-shopper approach.
In some institutions, the information obtained may be reported to the hospital administration and serious consequences can ensue for repeat offenders. Hospital privileges may be revoked in serious cases. So remember, whenever you exit (and enter) a patient’s room, perform appropriate hand hygiene. Someone may be watching you.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.
We must get control of hospital-related infections. There is no doubt about it. Who hasn’t had a patient almost die from septic shock because of a seemingly innocent indwelling central line or require a colectomy to save his life from overwhelming C. diff colitis?
We’ve all heard the staggering statistics about the number of patients who die needlessly in the hospital each year. It seems unreal. Yet doctors and patients alike are keenly aware of the dangers that lurk within the doors of our nation’s hospitals, and the institutions that are set up to save lives often bear full responsibility for lives lost as a result of human error and sometimes just plain carelessness.
As we are all painfully aware, the Centers for Medicare & Medicaid Services now withholds payments from hospitals when certain conditions are acquired during the hospitalization, even if all reasonable attempts were made to prevent those complications. Among these hospital-acquired conditions are catheter-associated urinary tract infections and vascular catheter–associated infections. Although it may have seemed unrealistic to dramatically decrease these infections, the truth is they can be minimized, and drastically so, often by simple measures.
A recent study examined the behavior of health care workers in four U.S. hospitals (Infect. Control Hosp. Epidemiol. 2013;34:69-73 [doi:10.1086/668775]).
"Secret shopper" observers monitored 7,743 visits over 1,989 hours. They found that health care workers performed hand hygiene on exiting rooms with contact precautions 63.2% of the time, compared with 47.4% of the time when there were no contact precautions in place. Unfortunately, the low frequency with which the workers – including physicians – performed appropriate hand hygiene in this study demonstrates how far we are from truly optimizing patient safety.
The toll on human life is by far the most important consideration, but millions of dollars of lost revenue is not insignificant. In an effort to decrease the incidence of hospital-acquired infections, many hospitals have devised a variety of overt and covert strategies. Some are as obvious as a computerized reminder to consider removing a foley catheter or central line if it is no longer absolutely necessary. Others are much more obscure, such as the aforementioned secret-shopper approach.
In some institutions, the information obtained may be reported to the hospital administration and serious consequences can ensue for repeat offenders. Hospital privileges may be revoked in serious cases. So remember, whenever you exit (and enter) a patient’s room, perform appropriate hand hygiene. Someone may be watching you.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.
We must get control of hospital-related infections. There is no doubt about it. Who hasn’t had a patient almost die from septic shock because of a seemingly innocent indwelling central line or require a colectomy to save his life from overwhelming C. diff colitis?
We’ve all heard the staggering statistics about the number of patients who die needlessly in the hospital each year. It seems unreal. Yet doctors and patients alike are keenly aware of the dangers that lurk within the doors of our nation’s hospitals, and the institutions that are set up to save lives often bear full responsibility for lives lost as a result of human error and sometimes just plain carelessness.
As we are all painfully aware, the Centers for Medicare & Medicaid Services now withholds payments from hospitals when certain conditions are acquired during the hospitalization, even if all reasonable attempts were made to prevent those complications. Among these hospital-acquired conditions are catheter-associated urinary tract infections and vascular catheter–associated infections. Although it may have seemed unrealistic to dramatically decrease these infections, the truth is they can be minimized, and drastically so, often by simple measures.
A recent study examined the behavior of health care workers in four U.S. hospitals (Infect. Control Hosp. Epidemiol. 2013;34:69-73 [doi:10.1086/668775]).
"Secret shopper" observers monitored 7,743 visits over 1,989 hours. They found that health care workers performed hand hygiene on exiting rooms with contact precautions 63.2% of the time, compared with 47.4% of the time when there were no contact precautions in place. Unfortunately, the low frequency with which the workers – including physicians – performed appropriate hand hygiene in this study demonstrates how far we are from truly optimizing patient safety.
The toll on human life is by far the most important consideration, but millions of dollars of lost revenue is not insignificant. In an effort to decrease the incidence of hospital-acquired infections, many hospitals have devised a variety of overt and covert strategies. Some are as obvious as a computerized reminder to consider removing a foley catheter or central line if it is no longer absolutely necessary. Others are much more obscure, such as the aforementioned secret-shopper approach.
In some institutions, the information obtained may be reported to the hospital administration and serious consequences can ensue for repeat offenders. Hospital privileges may be revoked in serious cases. So remember, whenever you exit (and enter) a patient’s room, perform appropriate hand hygiene. Someone may be watching you.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.
