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Four infants died of a bacterial outbreak at Westchester Medical Center in New York state last month. The investigation is ongoing, but Harvard Medical School pediatrician Don Goldmann told a newspaper that in most outbreaks "it’s concluded that the organism was transmitted from baby to baby or patient to patient because the hand hygiene was not perfect."
It’s this simple.
Not perfect? Fact is, "soap" remains a four-letter word among doctors and other health-care workers. Surveys consistently show that less than half routinely wash up, even though "Clean hands are the single most important factor in preventing the spread of dangerous germs and antibiotic resistance in health-care settings," according to the U.S. Centers for Disease Control and Prevention. Further, it says, "Each year nearly two million patients in the United States get an infection in hospitals, and about 90,000 of these patients die as a result."
Horrified? So is my Hudson Institute colleague, Betsy McCaughey, a health policy expert and former lieutenant governor of New York. She has just launched the Committee to Reduce Infection Deaths. RID has already recruited groups and individuals as diverse as Johnson & Johnson, the New York Business Group on Health, parents of children who succumbed to hospital infections, journalists Morton Dean and Tina Brown, and ESPN commentator Jeremy Schaap, whose famous journalist-father, Dick Schaap, died from a hospital infection.
McCaughey, who can be reached at www.hospitalinfectionrates.org, notes that hospital infections kill more than twice as many Americans as breast cancer or motor-vehicle accidents, and almost six times as many as AIDS.
"Any patient who goes into the hospital – or is born in one – can become a victim," she notes, "no matter who you are or how good your health insurance."
RID is not out to bash the bastions of the best health-care system in the world. Rather, the organization will educate patients and potential patients (meaning you) on low-tech ways to protect themselves and also pressure hospitals to adopt infection-fighting procedures.
For example: Ask hospital staff to clean their hands before treating you. And by the way, gloves protect them from you – not vice-versa.
Make sure you receive a preventive dose of antibiotics within an hour before surgery. A disturbing study published last year in The American Surgeon found that only a third of pre-surgical child patients received antibiotics at the proper time. Incredibly, a fourth received none at all.
Babies and the elderly suffer most from hospital infections.
Insist that caregivers follow guidelines by clearing surgical areas with clippers, not shavers. The tiniest shaver nick looks like open cathedral doors to bacteria.
Now it gets tricky. "Ideally, you should choose a hospital with a low infection rate," says McCaughey. "How can you do that?" I asked. "You can’t," she said.
McCaughey notes that, according to the National Academy for State Health Policy, almost half the states collect data on infections that lead to serious injury or death. But, "Nearly every state complies with hospital industry demands to keep it secret," she says. The CDC also tracks infection data from hospitals across the nation, but "keeps it under lock and key.
"Too often government is on our backs," she says, "when it should be on our side."
Hospitals insist comparisons are unfair because those having more patients with compromised immune systems from AIDS, cancer and organ transplants will have a higher infection rate. "But the data can be risk-adjusted to make comparisons valid," says McCaughey. "What’s unfair is keeping people uninformed about hospitals that have infection epidemics."
Some organizations already require "hospital infection report cards," but McCaughey insists everyone should have access to this information. Being able to punch up a "report card" on the Web could have a powerful effect on a hospital’s practices. And individual institutions have shown they can improve infection rates – dramatically.
For example, by recently implementing new procedures, Oklahoma City’s Mercy Hospital became far more merciful. In several critical areas over the course of a single year – cardiac bypass, orthopedic surgery and colon and hysterectomy surgery – it knocked infection rates down by 78 percent.
Hospitals don’t want patients to become infected or die, but economic incentives to cut corners plus bureaucratic resistance to change kill people just the same. Time for them to come clean.