23 Oct Hospitals’ struggles to beat back familiar infections began before Ebola arrived
While Ebola stokes public anxiety, more than one in six hospitals – including some top medical centers – are having trouble stamping out less exotic but sometimes deadly infections, federal records show.
Nationally, about one in every 25 hospitalized patients gets an infection, and 75,000 people die each year from them – more than from car crashes and gun shots combined. A Kaiser Health News analysis found 695 hospitals with higher than expected rates for at least one of the six types of infections tracked by the federal Centers for Disease Control and Prevention. In 13 states and the District of Columbia, a quarter or more of hospitals that the government evaluated were rated worse than national benchmarks the CDC set in at least one infection category, the KHN analysis found.
The missteps Texas Health Presbyterian Hospital made this month in handling an Ebola patient echo mistakes hospitals across the nation have made in dealing with homegrown infections. Kevin Kavanagh, MD, a patient safety expert from Kentucky, said hospitals too often don’t strictly follow protocols to deal with infectious diseases, and the government’s standard responses are not specific enough. “Right now there are too many recommendations on how to handle infectious diseases, too much leeway,” he said.
A 2011 study in the New England Journal of Medicine underscored the problem, observing that while hospitals have reduced the frequency of many infections over the last decade, they could do better if staff complied with recommendations. Those include always washing their hands and using maximal barrier procedures when tubes are being inserted, such as covering patients from head to toe with a sterile drape and wearing sterile caps, masks gowns and gloves.
“The percentage of time that healthcare providers do all of the things they are supposed to do when caring for a patient with a contagious disease can be pretty low,” said one of the authors, Don Goldmann, MD, chief medical and science officer at the Institute for Healthcare Improvement, a nonprofit in Cambridge, Mass. “There’s a lot of room for improvement.”
Goldmann said that hospitals tend to become more focused on following procedures when facing novel, highly publicized outbreaks such as Ebola. “When (an infection risk has) been around for a long time, it kind of becomes part of the background,” he said.
Since 2012 the federal government has been analyzing and publishing the CDC rates for specific hospitals on Medicare’s Hospital Compare website. Starting this fall, Medicare is considering infection rates when deciding how much to pay hospitals.