News -12-02-05 Fatal Bacterial Illness Spreading (CBS News) "A deadly bacterial illness commonly seen in people on antibiotics appears to be growing more common — even in patients not taking such drugs, federal health officials warned Thursday." "The bacteria are Clostridium difficile, also known as C-diff. The germ is becoming a regular menace in hospitals and nursing homes, and last year it was blamed for 100 deaths over 18 months at a hospital in Quebec, Canada." "Recent cases in four states show it is appearing more often in healthy people who have not been admitted to health-care facilities or even taken antibiotics, according to Centers for Disease Control and Prevention." 12-05 Hospital Infections Fourth-Leading Cause of Death (ABC News) "It turns out hospital infections are the fourth-leading cause of death in the United States." "Pennsylvania is one of only six states that has passed a law requiring the reporting of infections. Experts say public disclosure forces hospitals to reduce infection rates. Dr. Rick Shannon, chief of medicine at Allegheny General Hospital in Pittsburgh, looked at the data on patients in the hospital's intensive care units. He was stunned." " 'Fifty-one percent of everyone who got these infections died. Half the people who got one died,' he said. Dr. Shannon wasted no time. He gave an order to the ICU staff. Reduce hospital infections to zero — in just 90 days." 10-05 Papers -08-20-08 Don't Let a Hospital Kill You (CNN News) "According to the Centers for Disease Control and Prevention, Josh is one of 99,000 people who die each year because of infections acquired in the hospital. As Betsy McCaughey, the former lieutenant governor of New York, put it, 'You don't often come across such a big problem that you can prevent.' " 08-08 -Hospital-Acquired Infections - Legislation to Reveal Rates (Consumer's Union) "More Americans die each year from hospital-acquired infections than from auto accidents and homicides combined. Even though the problem is well-documented, the risks for getting hospital infections have steadily increased during recent decades." "Post-operative sepsis, a serious hospital infection, adds more than ten extra days and an average of $57,000 to your hospital bill. On average most types of hospital-aquired infection add thousands to your hospital bill." "A few states are now taking action against this deadly problem by giving consumers information about how well their local hospitals control infections. In most states, these infection rates are secret." "With your help, we're hoping to change that. Send a message to your legislators to require hospitals to report their infection rates to the public. That way, you can choose the safest hospital, and hospitals have a strong incentive to improve." 3-05 -Hospital-Acquired Infections Prevention by Improving Hand Hygiene (Centers for Disease Control) "Improved adherence to hand hygiene (i.e. hand washing or use of alcohol-based hand rubs) has been shown to terminate outbreaks in health care facilities, to reduce transmission of antimicrobial resistant organisms (e.g. methicillin resistant staphylococcus aureus) and reduce overall infection rates." "The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Gloves reduce hand contamination by 70 percent to 80 percent, prevent cross-contamination and protect patients and health care personnel from infection. Handrubs should be used before and after each patient just as gloves should be changed before and after each patient." "Alcohol-based handrubs significantly reduce the number of microorganisms on skin, are fast acting and cause less skin irritation." "As part of these recommendations, CDC is asking health care facilities to develop and implement a system for measuring improvements in adherence to these hand hygiene recommendations. Some of the suggested performance indicators include: periodic monitoring of hand hygiene adherence and providing feedback to personnel regarding their performance, monitoring the volume of alcohol-based handrub used/1000 patient days, monitoring adherence to policies dealing with wearing artificial nails and focused assessment of the adequacy of health care personnel hand hygiene when outbreaks of infection occur." "Alcohol-based hand rubs take less time to use than traditional hand washing. In an eight-hour shift, an estimated one hour of an ICU nurse's time will be saved by using an alcohol-based handrub." Editor's Note: Why not ask your physician how many alcohol-based hand rubs his clinic or hospital uses per thousand patients?" If he or she does not know, refer him or her to this article. Also the patient can ask if it is clinic or hospital policy for staff and physicians to wash their hands after seeing each patient. 3-05 -State Legislation to Reveal Rates of Hospital-Acquired Infections (Consumer's Union) Provides information on state laws that require the state to study and then reveal the rates of hospital-acquired infections by hospital. This information will help patients to choose the safest hospitals and avoid the least safe. The information may also encourage hospitals to improve their infection prevention practices, such as policies on hand hygiene. 3-05 Alcohol-Based Hand-Rubs and Fire Safety (Centers for Disease Control) "Alcohol-based hand sanitizers are an important strategy for improving healthcare personnel hand-hygiene practices, reducing healthcare-associated infection and improving overall patient safety. Alcohol-based hand-rubs have been used safely for more than 30 years in European hospitals." Existing national fire codes permit hand-rub dispensers in patient rooms, but prohibit their installation in egress or exit corridors." 3-05 Emergency Room Waits Increase (MSNBC News) "The average time that hospital emergency rooms patients wait to see a doctor has grown from about 38 minutes to almost an hour over the past decade, according to new federal statistics released Wednesday." "The increase is due to supply and demand, said Dr. Stephen Pitts, the lead author of the report by the Centers for Disease Control and Prevention." 12-05 Hospital-Acquired Bloodstream Infections (Centers for Disease Control) "Nosocomial bloodstream infections are a leading cause of death in the United States. If we assume a nosocomial infection rate of 5%, of which 10% are bloodstream infections, and an attributable mortality rate of 15%, bloodstream infections would represent the eighth leading cause of death in the United States. Because most risk factors for dying after bacteremia or fungemia may not be changeable, prevention efforts must focus on new infection-control technology and techniques." 3-05 Hospital-Acquired Infections (Centers for Disease Control) "CDC’s Division of Healthcare Quality Promotion manages the NNIS system and posts many of its publications on the Division’s website, including descriptions of participating hospitals and current trends in the types of adverse events that are monitored (see NNIS Reports at the NNIS home). A list of articles and chapters that contain information on NNIS methods and rationale for comparative rates is shown below." 3-05 Hospital-Acquired Infections (Centers for Disease Control) "This guideline updates and replaces the previous edition of the Centers for Disease Control and Prevention (CDC) “Guideline for Infection Control in Hospital Personnel,” published in 1983. The revised guideline, designed to provide methods for reducing the transmission of infections from patients to health care personnel and from personnel to patients, also provides an overview of the evidence for recommendations considered prudent by consensus of the Hospital Infection Control Practices Advisory Committee members." 3-05 Hospital-Acquired Infections (eMedicine.com) "In the US: Nosocomial infections are estimated to occur in 5% of all acute care hospitalizations. The estimated incidence is more than 2 million cases per year, resulting in an added expenditure in excess of $2 billion. The National Nosocomial Infections Surveillance (NNIS) System of the Centers for Disease Control and Prevention performed a survey from October 1986 to April 1998. They ranked hospital wards according to their association with central-line bloodstream infections. The highest rates of infection occurred in the burn ICU, neonatal ICU, and pediatric ICU." 3-05 Hospital-Acquired Infections Prevention (Centers for Disease Control) "Part II (this report) contains recommendations for environmental infection control in health-care facilities, describing control measures for preventing infections associated with air, water, or other elements of the environment. These recommendations represent the views of different divisions within CDC's National Center for Infectious Diseases and the Healthcare Infection Control Practices Advisory Committee (HICPAC), a 12-member group that advises CDC on concerns related to the surveillance, prevention, and control of health-care--associated infections, primarily in U.S. health-care facilities. In 1999, HICPAC's infection-control focus was expanded from acute-care hospitals to all venues where health care is provided (e.g., outpatient surgical centers, urgent care centers, clinics, outpatient dialysis centers, physicians' offices, and skilled nursing facilities). The topics addressed in this report are applicable to the majority of health-care facilities in the United States. This report is intended for use primarily by infection-control practitioners, epidemiologists, employee health and safety personnel, engineers, facility managers, information systems professionals, administrators, environmental service professionals, and architects. Key recommendations include"  * infection-control impact of ventilation system and water system performance  * establishment of a multidisciplinary team to conduct infection-control risk assessment  * use of dust-control procedures and barriers during construction, repair, renovation, or demolition  * environmental infection-control measures for special areas with patients at high risk  * use of airborne-particle sampling to monitor the effectiveness of air filtration and dust-control measures  * procedures to prevent airborne contamination in operating rooms when infectious tuberculosis (TB) patients require surgery  * guidance regarding appropriate indications for routine culturing of water as part of a comprehensive control program for legionellae  * guidance for recovering from water-system disruptions, water leaks, and natural disasters (e.g., flooding)  * infection-control concepts for equipment using water from main lines (e.g., water systems for hemodialysis, ice machines, hydrotherapy equipment, dental unit water lines, and automated endoscope reprocessors)  * environmental surface cleaning and disinfection strategies with respect to antibiotic-resistant microorganisms  * infection-control procedures for health-care laundry  * use of animals in health care for activities and therapy  * managing the presence of service animals in health-care facilities  * infection-control strategies for when animals receive treatment in human health-care facilities and  * a call to reinstate the practice of inactivating amplified cultures and stocks of microorganisms onsite during medical waste treatment." 3-05 Prevention of Hospital-Acquired Infections (Centers for Disease Control) Information on prevention designed for physicians. 3-05 Why Aren't Hospitals Cleaner? (U.S. News) "Restaurants and cruise ships are inspected for cleanliness. Food processing plants are tested for bacterial content on cutting boards and equipment. But hospitals, even operating rooms, are exempt. The Joint Commission, which inspects and accredits U.S. hospitals, doesn't measure cleanliness. Neither do most state health departments, nor the federal Centers for Disease Control and Prevention." 09-08

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