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Infections Are Costly for Hospitals, Patients

Posted on: Sunday, 25 December 2005, 15:00 CST

By Andi Atwater, The Wichita Eagle, Kan., The Wichita Eagle, Kan.

Dec. 25--Hospital infections add an estimated $30 billion to the nation's hospital costs each year and kill about 103,000 people -- as many deaths as from AIDS, breast cancer and auto crashes combined, a new study says.

Every year, some 2 million people -- about one in every 20 patients -- contract hospital-borne infections, according to the National Center for Policy Analysis, a nonprofit public policy research institute.

The report says that infections are almost always preventable -- and that few hospitals consistently do all they can to minimize risk.

"The biggest news of the study was how simple in theory it is to do this, but how complicated it is in practice because it takes willpower," said Devon Herrick, a senior fellow with the center. "It takes dedication to say: 'I'm going to wash my hands after every patient. I'm going to change gloves repeatedly.' "

Wichita infection control experts said that while hospitals must take as many measures as possible to prevent infections, it's impossible to completely eliminate them.

"Infections aren't going to go away; you try to keep them at the lowest level you can," said Hewitt Goodpasture, medical director of infection control for Via Christi Regional Medical Center.

The savings to hospitals, patients and insurance companies makes fighting infections worth it. Researchers found that each time a patient contracts an infection, it adds an average of $15,275 to hospital costs.

In Wichita, most hospital administrators say they are below -- sometimes significantly -- the national average infection rate.

Preventing infections

The national center, in conjunction with the patient advocacy group Committee to Reduce Infection Deaths, is hoping the study will motivate hospitals to comply with proven methods to reduce and prevent hospital infections.

At Wichita hospitals, infection officers are constantly monitoring problems and figuring out solutions.

"The notion you can make the rate zero is not true. That's just the nature of the environment," Goodpasture said. "But hospitals do need to invest more resources in these kinds of things."

Some hospitals do better than others. The study cites a number of hospitals that adopted stringent rules for preventing certain types of infections and nearly eradicated them, doing things like repeated glove changes, constant hand washing and using disposable scrubs.

At Via Christi, a complex monitoring and response system -- as well as participation in a national improvement project -- has consistently lowered infections rates in almost all of the common areas of concern, hospital officials said.

For example, sternal wound infections -- at the surgical site of coronary bypasses -- have declined from a high of about 2 percent in 1999 to 0.7 percent through September 2005.

That's a result of focused attention to a complex set of standards for each patient, officials said.

"Paying attention to details is very important when you're trying to lower risk for people," Goodpasture said.

Hospital officials say it's hard to quantify and completely control infection rates because there are so many variables.

"We don't track all infections specifically; we look at where we're seeing problems and focus on that," said infectious disease doctor Val Creswell, medical director of infection control at Wesley Medical Center. For instance, Wesley banned artificial nails on its workers a few years ago after a rash of infections in neonatal intensive care.

"We have multi-disciplinary teams who look at all our processes and see what we can do better," she said.

Hospitals are not required to report their infection rates to the public, and most do not. Via Christi disclosed its infections data, most showing downward trends well below national averages.

"We ought to do what we can to make this transparent to people," Via Christi's Goodpasture said.

The study's supporters advocate hospital infection report cards so that patients can make an informed decision when they choose a hospital.

"Reports like this... basically shame hospitals or legislators into saying you must have clear disclosure," said Herrick of the research institute. "But it will take a little bit of time."

Working with patients

Wichita hospitals and physicians are working to educate patients on their role in helping prevent infections.

About a year go, Via Christi, Wesley and the Medical Society of Sedgwick County collaborated on an anti-infection brochure that is given to hospital patients.

"We understand we're not going to be 100 percent successful all the time because we don't get to pick our patients (who) bring their own risks," said Paula Ghazarian, infection control coordinator for Via Christi Regional Medical Center.

"We know we can manage most complications, but the main thing is to continue to just whittle away at the risk factors."

Reach Andi Atwater at 268-6642 or aatwater@wichitaeagle.com [mailto:aatwater@wichitaeagle.com].

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Copyright (c) 2005, The Wichita Eagle, Kan.

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Source: The Wichita Eagle (Wichita, Kan.)

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