| If you've ever had the sneaking suspicion hospitals | | | | drug-resistant infections. Hospitals are perfect |
| aren't doing all they can to prevent infections, you | | | | environments for these super bugs to develop -- |
| may be right. According to three studies published in | | | | decreased immune systems, open surgical wounds, |
| the American Journal of Medical Quality, most | | | | plenty of victims in close proximity, and a plethora of |
| hospital-acquired, or nosocomial infections, arise as a | | | | antibiotics in which to mutate in response. The most |
| result of hospital procedures, not from the level of | | | | prominent one of them, methicillin-resistant |
| patients' illness. Inadequate hand-washing and | | | | staphylococcus aureus (MRSA), accounts for 63% of |
| insufficient donning of sterile clothing by busy | | | | hospital staphylococcus infections, up from 22% in |
| healthcare workers are believed to be major | | | | 1998. That's a dramatic jump in less than ten years. |
| contributing factors. | | | | MRSA can be asymptomatic, making it difficult to |
| The Veterans Affairs hospital in Pittsburgh, PA | | | | recognize and, once recognized, difficult to treat. |
| thought more could be done and began an | | | | Simple screenings would identify most cases of |
| experimental program six years ago, utilizing simple | | | | MRSA, but only one-quarter of hospitals |
| sanitation and isolation techniques to cut the infection | | | | methodologically screen for bacterial colonies. Terri |
| rate by 78% in their surgical care unit. The plan was | | | | Gerigk Wolf, director of the Veterans Affairs |
| simple and cost-effective, slashing hospital expenses | | | | Pittsburgh Healthcare Systems, believes a certain |
| by $900,000 overall. | | | | element of denial is in place. "People don't believe it's |
| Richard P. Shannon, who headed a similar program at | | | | in their institution, and that if it is, that it's too big to |
| Allegheny General Hospital in Pittsburgh to reduce the | | | | do anything about. But we have shown you can do |
| number of catheter infections, concurs. Shannon | | | | something about it." |
| showed that the average infection cost the hospital | | | | State legislatures other than Texas' are also stepping |
| $27,000, and that health insurance reimbursements | | | | in. Eighteen states now require hospitals to publish |
| for weeks of treatment could not keep pace with | | | | infection rates; New Jersey and Illinois are the first to |
| actual expenses. Basic hand sanitation was a major | | | | require hospitals to test all intensive-care patients for |
| emphasis of his program. | | | | MRSA. In Pennsylvania, Governor Edward G. Rendell |
| Such programs could be crucial for Texas healthcare | | | | signed a bill requiring MRSA screening of certain |
| systems, a state that is already overburdened with | | | | high-risk patients, though he did not win efforts to |
| less-than-adequate numbers of qualified physicians, a | | | | test all patients for drug-resistant infections. |
| flood of rural residents rushing to the larger cities of | | | | Critics, such as Dr. John A. Jernigan, question the |
| Dallas, Austin, and Houston to seek care otherwise | | | | necessity of such programs, believing improving |
| unavailable or inaccessible to the uninsured, and 25% | | | | hygienic and surgical practices alone may yield similar |
| of its population going without any kind of health | | | | results. It's "a legitimate scientific debate," said |
| insurance whatsoever. Lawmakers in Texas are | | | | Jernigan, about whether hospitals should take the |
| already pushing for change, and in May, the state | | | | time and expense of screening every patient. Other |
| House passed Bill SB288, requiring hospitals in Texas | | | | critics wonder if isolating infected patients will result in |
| to publicly disclose certain infection rates developed | | | | lower quality care. Statistically, patients in isolation are |
| by patients in the course of treatment. | | | | seen half as often, and suffer more falls, bed sores, |
| Veterans Affairs' methods are rudimentary enough: | | | | and stress. Understaffed hospitals may also be an |
| test all incoming patients for drug-resistant bacterial | | | | issue; blaming healthcare workers who are already |
| infections and isolate those with positive results, | | | | overburdened, while simple enough, might not be a |
| being sure healthcare workers don sterile gloves and | | | | real solution. Hiring more staff, so that workers have |
| gowns before entering those areas; equip every | | | | more time to do all "the little things" that make such |
| room with separate stethoscopes, and every room | | | | a difference, could have dramatic results. |
| and corridor with hand sanitizer dispensers; discard | | | | The American Hospital Association recommends |
| blood pressure cuffs after each use. Total cost of | | | | trying methods other than universal screening, and |
| the program? Around $500,000 per year, including | | | | testing all incoming patients only when those methods |
| test kits, salaries for three workers, and the | | | | are unsuccessful. But, to the former lieutenant |
| $175-per-patient expense of gloves, gowns, and hand | | | | governor of New York, Betsy McCaughey, that is |
| sanitizer. The program was so successful that the | | | | simply unacceptable. The agency "is largely to blame," |
| hospital began phasing it in at each of their 140 | | | | she said for failure to contain these infections. "their |
| acute-care centers in March, and several European | | | | lax guidelines have given hospitals an excuse to do |
| countries have all but eliminated certain resistant | | | | too little." |
| infections through similar regimens. | | | | Sad, but perhaps true, is an age-old adage: "An ounce |
| The Centers for Disease Control projected that 1.7 | | | | of prevention is worth a pound of cure." In other |
| million patients in this country will contract a | | | | words, try not getting sick so you won't end up |
| hospital-acquired infection this year, and that tens of | | | | getting even sicker. |
| billions of dollars will be spent treating them. | | | | Being aware of the current state of healthcare |
| Ninety-nine thousand will die from these infections, | | | | reform is an important aspect of taking care of |
| killing seven times as many people as HIV, and more | | | | yourself, but so is watching out for your health on an |
| than diabetes and Alzheimer's disease. Tragically, | | | | everyday basis. How you take care of yourself will |
| many of these fatal infections will result from | | | | certainly affect you as you age, and eventually your |
| relatively routine procedures. | | | | wallet, as well. |
| The primary problem is not just infections, but rather | | | | |