By Frank James
It's often said that if you're sick, one of the last places you want to be is the hospital because that increases your chances of picking up an infection from the germs there, especially after surgery.
For years, hospitals have made it a top goal to reduce the rate of what are called nosocomial or hospital-acquired infections. They have infection control programs, and officials and committees. The washing of hands between patients has been stressed to doctors and nurses.
Still, the results are significantly less than experts have hoped for, according to the latest data from the Health and Human Services Department.
According to a report by the Health and Human Services Department's Agency for Healthcare Research and Quality, hospital-acquired infections were up in a range of areas last year. An excerpt from the agency's press release:
Improvements in patient safety continue to lag, according to the 2009 National Healthcare Quality Report and National Healthcare Disparities Report issued today by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.
Very little progress has been made on eliminating health care-associated infections (HAIs), according to a new section in the 2009 quality report. For example, of the five types of HAIs in adult patients who are tracked in the reports:
Rates of postoperative sepsis, or bloodstream infections, increased by 8 percent. Postoperative catheter-associated urinary tract infections increased by 3.6 percent. Rates of selected infections due to medical care increased by 1.6 percent.
There was no change in the number of bloodstream infections associated with central venous catheter placements, which are tubes placed in a large vein in the patient's neck, chest, or groin to give medication or fluids or to collect blood samples.
However, rates of postoperative pneumonia improved by 12 percent.
In addition, although rates are improving incrementally, blacks, Hispanics, Asians, and American Indians are less likely than whites to receive preventive antibiotics before surgery in a timely manner.
"Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access," said AHRQ Director Carolyn M. Clancy, M.D. "Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals."
Over 100 participating hospital intensive care units in Michigan have been able to keep the rates of central line-associated bloodstream infections to near zero, 3 years after adopting standardized procedures. The project, conducted by the Michigan Health and Hospital Association Keystone Center, involved the use of a comprehensive unit-based safety program to reduce these potentially lethal infections. Last year, AHRQ announced new funding that has expanded the project to all 50 states, Puerto Rico, and the District of Columbia.