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In Our First Class Medical System
Note: For additional information and footnotes, please see the 3nd edition of RID's popular publication, Unnecessary Deaths: The Human and Financial Costs of Hospital Infections
Every day in hospitals across, the United States wondrous medical procedures rescue patients from the brink of death. But there's a catch. In these same hospitals, hygiene is so inadequate that one out of every twenty patients contracts an infection.

Infections that have been nearly eradicated in some countries are raging through American hospitals. In 2003, the Society for Healthcare Epidemiologists of America warned that although hospitals have infection prevention programs, "there is little evidence of control in most facilities."

The danger is worsening because hospital infections, increasingly, cannot be tamed with commonly–used antibiotics. One of the deadliest germs is methicillin—resistant Staphylococcus aureus (or MRSA). Patients who do survive MRSA often spend months in the hospital and endure repeated surgeries to cut out infected tissue. In 1974, 2 percent of Staph infections were MRSA. By 1995, the number had climbed to 22%, in 2003 an alarming 57%, and now over 60%.

Denmark, Holland, and Finland once faced similar rates, but brought them down below 1 percent. How? Through rigorous hand hygiene, meticulous cleaning of equipment and rooms in between patient use, testing incoming patients for MRSA and other drug resistant bacteria, and taking precautions to prevent transmission to other patients. Wheelchairs and other equipment used to transport patients who test positive for MRSA are not used for other patients, and hospital staff have to change their uniforms and footwear after entering the rooms of MRSA patients, before they are permitted in other areas of the hospital.

A few hospitals—too few—in the United States are proving these precautions work here too. The University of Virginia Hospital eradicated MRSA. The Veterans Hospital in Pittsburgh reduced MRSA by 85 percent in a pilot program. The University of Pittsburgh–Presbyterian Medical Center slashed MRSA by 90 percent in the medical intensive care units in a pilot program, and a Yale–affiliated hospital in New Haven, Connecticut, cut MRSA infections by two thirds in a surgical intensive care unit. Brigham and Women's Hospital in Boston reduced MRSA bacteremia 77% in intensive care and 67% hospital–wide. Twenty–nine healthcare institutions in Iowa eliminated another drug–resistant germ, vancomycinresistant Enterococcus (or VRE).

Unfortunately, most U.S. hospitals have not implemented these precautions.


Contracting infection while in the ICU adds $150,000 or more to an elderly patient's care costs and shortens their life by many years. 

September 2014

JAMA Internal Medicine

survey shows 70% of hospital leaders say public reporting motivates them to improve patient safety.


Betsy McCaughey:

"U.S. hospitals not ready for Ebola."

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