Given the outbreak of six lethal conditions that lead to 1.7 million hospital infections a year, the nation’s top epidemiologists along with leading hospital groups, have issued new guidelines aimed at limiting hospital infections.
Commonly occurring hospital infections include:
* Central-line-associated bloodstream infections – lines used for delivering fluids to patients in intensive care can be infected when microorganisms travel down the catheter and enter the blood.
* Ventilator-associated pneumonia – VAP can occur when a patient depends on assistance to breathe from a ventilator. One in four patients on a ventilator will develop VAP.
* Catheter-associated urinary tract infections – Urinary tract infections occur when thin tubes are used to help patients who cannot urinate on their own. 80 percent of urinary tract infections in the hospital are linked to long time use of a urinary catheter, according to the guidelines.
* Surgical site infections – SSI develops in two to five percent of patients who undergo inpatient surgery.
* Methicillin-resistant Staphylococcus aureus, or MRSA – while staph is present everywhere, MRSA is resistant to methicillin, a common antibiotic and can cause serious infections of the skin, blood, lungs or open wound.
*Clostridium difficile, an intestinal bacteria – also known as C. diff, is a bacteria that can cause intestinal infections and diarrhea. The number of serious cases is increasing.
Hospital infections affect one of every 22 patients.
The CDC finds that hospital infections kill 99,000 patients every year (along with their existing condition). The cost of treating these infections is estimated to be at least $4.5 billion a year.
A survey of hospitals last year found that 87 percent are not following existing recommendations, even the basics like hand-washing.
An intense focus on cleanliness can help reduce these infections and the aim of the guidelines is to increase consistency from one hospital to another.
Dr. Robert A. Wise, of the Joint Commission, tells the New York Times that “The same hospital which does great at inserting a central line and maintaining that central line might do poorly in the way it handles urinary catheters,” he said, adding, “All hospitals are partially effective. Few hospitals are completely effective.”
While some of the guidelines resemble current recommendations, they are written more clearly and concisely with additional suggestions that hospitals might employ.
Vigorous hand washing continues to be the top priority.
Patients with ventilators are recommended to be kept in raised hospital beds. They should receive regular antiseptic oral care. For MRSA, the antibiotic resistant staph infection, the recommendations suggest patients be tested for the infection before being admitted to the hospital.
If confirmed, that patient should be isolated and treated with special precautions and protective clothing. MRSA is linked to 19,000 deaths a year. Some hospitals believe that prevention programs such as hand-washing are just as effective and less costly than isolation.
The guidelines should carry weight as they represent a consensus from scientists representing top infection control organizations as well as the American Hospital Association and the Joint Commission, which accredits hospitals. The new guidelines will appear in those the Commission issues for all hospitals beginning in 2010.
American Hospital Association President Richard Umbdenstock said at a news conference announcing the guidelines, “As of today, the nation’s infection control team has a common playbook.” #