Wringing Our Hands Over Infection Control
A number of thoughtful comments arrived concerning my January 23 hand-washing post, about a study showing that a much-increased rate of hand-washing is no guarantee that a hospital's infection rate will budge, let alone dive. A couple of correspondents (notably anesthesiologist-blogger Counting Sheep and hospital-CEO-blogger Paul Levy of "Running a Hospital") contributed thoughts that might prevent a few infections here and there.
The following came as a real letter, if also as an E-mail attachment, from Kathy Warye, another CEO. She runs the Association for Professionals in Infection Control and Epidemiology, whose obvious interest in this subject makes her note very welcome.
Mr. Comarow makes a critical point that even the single most effective intervention (in this instance, hand hygiene) alone can't solve the problem of healthcare-associated infections. Certainly, even the best hand hygiene compliance only gets us so far.
Lessons learned from our 12,000 members who manage infection prevention programs in healthcare facilities around the world tell us that to reduce the risk of infection and protect people coming into hospitals means adopting a full range of strategies. The first step, from a facility-wide perspective, is conducting a proper risk assessment. Good infection prevention and control professionals don't just know their patients—they know their hospital, they know which areas are at high risk and where there may be hidden reservoirs of bacteria, be it the ER or the OR.
System-wide adoption of proper hand hygiene, contact precautions including use of gloves and gowns, and the "checklist" for device-related care that is receiving so much attention of late are among the tools known to be effective in preventing healthcare-associated infections.
But without adequate resources and proper funding for infection prevention and control programs, and without the support of hospital leadership, we don't stand a chance in the war on infections. Hospital administrators must arm their infection control departments with the personnel and the dollars to implement comprehensive programs that include multiple interventions coordinated throughout the system. Only then can we prevent hospital-acquired infections and save lives.
Tags: hospitals | infections
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Reader Comments
Hospital Infections
Kathy Warye's comments are important and well received. However, some of what she is saying may be lost on some readers.
The most egregiously out of control hospital bugs are MRSA and VRE and they have grown into this category not because of a lack of resources or a lack of knowledge as to how they can be controlled. Healthcare leadership has known for decades that isolating the reservoir of spread of these pathogens is an essential component of infection control yet many healthcare leaders have CHOSEN not to recommend such an approach. The reasons for that unfortunate position are many and too complex for this posting. Yes, there are many strains of bacteria that cause disease in hospitalized patients and it is important to control all of them. Attacking that which is most out-of-control should be a priority. The epidemic of MRSA and VRE spread throughout hospitals, nursing homes and dialysis clinics is the result of failed healthcare leadership and not the inevitable result of dealing with sick people or the consequence of antibiotic-resistance. All of the points that Kathy makes are important parts of the overall infection control picture. But without identifying the carriers of these deadly bugs (MRSA and VRE) in order to prevent their spread, disease will continue to be passed to more and more victims and the specter of even more deadly organisms resulting from this failure is already upon us.
Toxicity not infection.
Until we realize the inseparable relationship between toxicity and infection we will continue to fail. Don't blame the garbage on the rats who come to eat it. Same with micro-organisms, who have shared the planet and our digestive tracts for millions of years. Does it strike anyone else as absurd that the highest form of life on the planet (man) has so focused and directed his attention and resources in a declared war against the lowest forms of life on the planet (microbes)?
The enemy is petro-chemical toxicity, aluminum, mercury, fluoride and chlorine, not the microbial flora. But the system exists to sell drugs and sell drugs it will, like vaccines - the great experiment with unknown results using unproven, untested, gene-altering retro-viruses. Pay no attention to that man behind the curtain - there is no link between vaccines and anything at all. They are absolutely good for people. Until people change, the health care system will not change. People need to stop believing in a medical 'Jesus', who will come and save them from themselves - it's your health - you built it just the way it is.
The Fresh Air Factor
Fresh air reduces infection rates better than anything else known to makind. Open the windows and let the breezes blow!
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U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since their debut in 1990. In his reporting on all aspects of clinical medicine from the latest cholesterol guidelines to robotic surgery, he has kept one question in the front of his mind: What does this mean to patients? That perspective uniquely qualifies him to observe and comment on the efforts by hospitals and other healthcare providers to improve care and patient safety.
