Re: O/T: Husband Has MRSA Again-
- From: Martijn <Kw3Ls@xxxxxxxxxxx>
- Date: Sat, 29 Oct 2005 05:12:35 +0200
derdrittemann2003@xxxxxxxxx wrote:
Close family member of mine also recently acquired an infection subsequent to minor surgery...hospital stay.
Scary, because the hospital infections seem to be automatically e so resistant, I guess...good luck, Cal, and hubby.
Ironically, hospitals can be dangerous places to acquire infections.
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California lawmakers approve bill aimed at curbing deadly hospital acquired infections:
http://www.consumersunion.org/pub/core_health_care/001321.html
-------------------------------------- http://www.ulsterpublishing.com/index.cfm?fuseaction=article&articleID=349466
Health 8/4/2005 *Hospitals can be dangerous places* by Aimee J. Frank
Nosocomial infection. It sounds like a terrible disease and it can be serious. But the term refers not to a single illness but to any infection that you contract in the hospital while being treated for something else.
While people may go to the hospital to get well, two million patients annually contract a disease in U.S. hospitals, and approximately 90,000 die as a result of their infections. In 2000, the Centers for Disease Control and Prevention (CDC) reported that nosocomial infections add almost $5 billion to health care costs annually.
Most of the cost results from the additional days a patient must be hospitalized for treatment of the hospital-acquired infection, depending upon the illness contracted. Urinary tract infection can require an additional one to four day stay in the hospital while bloodstream infection or pneumonia can require additional hospital stays ranging from seven to 30 days.
The problem is widespread enough that the federal government has implemented campaigns to educate and encourage hospital personnel to improve sanitary practices to avoid transmitting infections and several states have passed laws requiring hospitals to track, report and publicize their nosocomial infection rates.
INFECTION-TRACKING LAW PENDING IN NEW YORK
Legislation to require public reporting from hospitals statewide on their nosocomial infection rates for specified surgical procedures is awaiting the signature of Governor George Pataki in order to become law.
Bill sponsors argued that the law is necessary to protect state residents. "Patients should not get sicker because of an infection they get while hospitalized for some other medical problem," wrote bill sponsors. "Making risk-adjusted data available to the hospital community and the public will promote improvement in patient safety."
Among the types of infections that hospitals would be required to track are surgical site infections, ventilator-associated pneumonia, central line-related bloodstream infections and urinary tract catheter infections, all of which are common hospital-acquired infections.
The data would have to be understandable to a lay audience and presented by hospitals to the health commissioner and, in turn, to the governor and legislature annually. The state health department would establish a statewide database of all reported hospital acquired infection information. Health department officials would also develop an auditing process to assure the accuracy of the self-reported hospital data.
The public reporting is designed to both encourage hospitals to improve their sanitary practices by publicizing their infection rates and to give health care consumers vital information about whether their local hospitals are doing enough to protect their health.
While a few states have already passed similar legislation, Pennsylvania is the first to release the hospital data to the public. The findings from that state may foreshadow those that will come to light in New York.
PENNSYLVANIA STORY
In January 2004, Pennsylvania hospitals began to report data on their hospital-acquired infection rates as required by state law. The report published last month by the Pennsylvania Health Care Cost Containment Council (PHC4) from the collected 2004 data show that hospitals reported 11,668 hospital-acquired infections or 7.5 per 1,000 patients admitted to the state's general acute care hospitals.
Of the affected patients, 15.4 percent or 1,793 patients died. An additional 205,000 additional hospitals days were associated with these cases, resulting in $2 billion in additional hospital charges.
The seriousness of the threat is clear when you consider that the mortality rate for patients who did not contract a hospital-acquired infection was only 2.4 percent, compared to the 15.4 percent who did contract infections, an additional 1,510 additional deaths according to the study.
Among the 11,668 patients with reported hospital-acquired infections,1,317 contracted surgical site infections, 6,139 contracted urinary tract infections, 1,335 contracted pneumonia and 1,932 contracted bloodstream infections.
Of the reported patient deaths, 446 resulted from bloodstream infections, 423 from urinary tract infections and 393 from pneumonia.
PHC4 report authors suggest that nosocomial infections were probably underreported in 2004, the first year such data had to be compiled. Among the discrepancies noted by PHC4 was that the infection data provided by the hospitals did not match the larger number of infections that were billed for by the hospitals, according the report.
Study authors estimated the actual number of nosocomial infections could have been as high as 115,631 compared to the hospital-reported figure of 11,668.
Similar in scope to New York's pending law, Pennsylvania requires reporting on hospital-acquired surgical site infections, catheter-associated urinary tract infection, ventilator-associated pneumonia and central line-associated bloodstream infections. Beginning January 2006 hospitals will be required to submit data on all nosocomial infections.
DOUBLE THREAT
The CDC has made hospital-acquired infections a priority to improve patient safety but also because of the rapid spread of antibiotic-resistant infections in hospital and nursing home settings.
Public health care officials view the problems of drug-resistant bacteria and hospital-acquired infection as the same problem because more than 70 percent of the bacteria that cause nosocomial infections are resistant to at least one of the drugs commonly used to treat the disease.
Examples of such infections include Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE), both of which now frequently cause severe infections in hospitals - and, especially, nursing homes - and are extremely difficult to treat.
CDC's Campaign to Prevent Antimicrobial Resistance relies on four strategies: prevent infection; diagnose and treat infection effectively; use antimicrobials wisely; and prevent transmission.
The campaigns twelve-step educational programs are designed to inform clinicians about how to prevent the infection risks to the specific patient populations with whom they work. Guidelines target, for example, dialysis patients, surgical patients, long-term care patients and hospitalized children and adults.
Many of the practices recommended to health care professionals are as simple as improving hand hygiene, in other words, hand washing, one of the most effective ways to prevent the spread of germs from one patient to another. Other guidelines include more careful consideration of antimicrobial drugs are used, effectively diagnosing and treating infection and isolating infectious patients.
Removing medical devices from patients in a timely manner is a key CDC recommendation.
Catheter insertion and removal is an example of one of the procedures in which proper attention might prevent hospital-acquired infections. Hospital-acquired urinal tract infections too frequently occur because doctors forget to give orders to remove a patient's catheter after it is no longer needed. A recent study by the University of Michigan Health System found that simply having hospital personnel use reminders to notify them when to remove a patient's catheter reduced the amount of time catheters remained in patients and therefore the risk of the patient contracting infection.
INFORMED CONSENT
If implemented and publicized properly, the pending hospital reporting law could provide New York state residents with the information they need to make sound decisions about where they will go to seek hospital treatment for non-emergent procedures.
The publicity should also go far to encourage hospitals to adopt, if they have not already, more stringent infection control practices.
New York's proposed legislation was sent to Pataki in early July for his signature.++
.
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