Hospital infections often kill

Lawmaker sponsors full-disclosure bill

By GARY HABER, The News Journal

Posted Sunday, February 11, 2007

When state Rep. Deborah Hudson's father checked into a Florida hospital two years ago, she thought he'd be home in a few days.

Registered nurse Kristin Sianni washes her hands to lessen the chance of infecting a patient. An estimated 2 million patients a year get an infection while hospitalized. About 103,000 of those patients die. The News Journal/CARLA VARISCO

Hudson never dreamed that her father would develop a potentially deadly staph infection, turning a routine hip replacement into a medical roller-coaster ride that would keep him hospitalized for months.

"You assume the hospital is sanitary," Hudson says. "It's shocking that your loved one could acquire something in the hospital that could be fatal."

The experience prompted the Fairthorne Republican to introduce House Bill 47, "The Hospital Infections Disclosure Act."

The bill would require Delaware hospitals to collect data on hospital-acquired infection rates and submit the information to the state Department of Health and Social Services. The agency would then make the information public each year, allowing Delaware consumers to compare infection rates among hospitals for the first time.

A similar bill was introduced in the previous legislative session, but didn't make it to the floor for a vote.

If the bill passes, Delaware would join more than a dozen states, including Pennsylvania and Maryland, that make hospital-acquired infections rates public.

"Secrecy has allowed this problem to fester for too long," says Betsy McCaughey, a former New York lieutenant governor, and the founder and chairwoman of the New York-based Committee to Reduce Infection Deaths.

McCaughey's group is part of a national effort among hospitals, insurers, governments and consumer groups to reduce the chance that patients develop an infection while in the hospital.

Hospital-acquired infections are a massive problem for the nation's health care system. They endanger patients' lives, lengthen hospital stays and add more than $30 billion a year in extra costs for patients, insurers, and hospitals.

A costly problem

Each year, an estimated 2 million Americans acquire an infection while hospitalized. The infections kill about 103,000 of them, more than 5 percent, according to the Committee to Reduce Infection Deaths.

Much of the problem can be reduced if caregivers routinely do some common-sense things like scrubbing their hands or sanitizing equipment, like blood-pressure cuffs and stethoscopes, between patients, says Fran Griffin, a director of the Institute for Healthcare Improvement in Cambridge, Mass.

"There's a huge gap between what we know should be done and what actually happens," says Griffin, whose group is spearheading a "5 Million Lives Campaign" to cut down on infections and other hospital hazards over the next two years.

A report by the Pennsylvania Health Care Containment Council illustrates the scope of the problem in just one state.

The agency looked at surgical-site infections, urinary-tract infections, pneumonia and bloodstream infections. According to a report issued in November, there were 19,154 hospital-acquired infections in 168 Pennsylvania hospitals in 2005, and 2,478 patients died.

Patients who developed an infection while in the hospital had a higher death rate -- 12.9 percent -- compared with 2.3 percent for patients who didn't have an infection.

Patients who acquired an infection spent more time in the hospital -- an average of 20.6 days compared with 4.5 days for other patients, and their hospital stays cost six times more -- $185,260 compared with $31,389.

"If a hospital-acquired infection can be avoided, it benefits everyone," says Dr. Cary Gutbezahl, interim vice president for medical affairs at St. Francis Hospital in Wilmington.

Fighting germs

Area hospitals' efforts to fight infections are taking place on a number of fronts, some visible and others behind the scenes.

Visitors to Christiana and Wilmington hospitals can ask for a free "respiratory etiquette bag" with a mask, tissues, hand sanitizer and a brochure on hygiene.

They would also be hard-pressed to miss the large posters installed near the entrance to each hospital, asking them to wash their hands with soap and water -- "long enough to sing the 'Happy Birthday song' twice" -- or use alcohol-based hand-sanitizer.

The two hospitals are also making less-visible changes.

Nurses are elevating the heads of patients who are on ventilator machines -- an effort that has reduced ventilator-associated pneumonia by more than 90 percent, hospital officials say.

Patients, meanwhile, are encouraged to ask doctors and nurses if they've washed their hands before a procedure.

Patients aren't shy about asking, says Kathy Wroten, Christiana Care's manager of infection control.

"The public is so much more knowledgeable," Wroten says. "They're learning to ask questions of their doctor and be more proactive."

At Bayhealth Medical Center's two hospitals, Kent General and Milford Memorial, roving infection-control nurses encourage hand-washing and glove-wearing by handing out little hand-shaped pins as part of the hospitals' "We've Got to Hand it To You" program.

Kelly Gardner, Bayhealth's manager of infection control department, calls it "positive reinforcement for doing the right thing."

Efforts like these are helping change a medical culture that once considered infections inevitable, says McCaughey, the founder and chairwoman of the Committee to Reduce Infection Deaths.

Reducing hospital infections is not only good for patients, but also something that can save hospitals money, McCaughey says.

Now that it's been shown that hospital-acquired infections are avoidable, hospitals that don't change their ways could find themselves facing class-action lawsuits, according to McCaughey.

"Hospital infections are the next asbestos," she says.