An infectious groove…
This article is based on a study released by the Leapfrog Group, on the infectious disease prevention practices of hospitals in the United States. The stinging conclusion of the study has been that 87% of the hospitals surveyed (total 1255) failed to adhere to the infection prevention policies laid down by Leapfrog. The author notes that the health care system has continuously failed to prevent hospital acquired infections inspite of evidence based policies and threat of state regulation.
The study by Leapfrog examined five areas of concern which they felt were the major sources of infection: aspiration and ventilator associated pneumonia, central venous catheter related bloodstream infections, surgical site infections, staff vaccination against flu and hand hygiene. Clinical reports have shown that about 2 million people contrat hospital acquired infections (preventable?), and almost 90000 of these die. Not only is mortality and morbidity a major factor, but hugely elevated hospital bills are another major issue.
These are preventable, as some people believe. Goldmann, Senior VP of the Institute for Health care improvement, believes that zero infection rates are indeed possible, and this should be the goal of all hospitals. Often the campaign needs an initiative to kickstart like the 100,000 Lives Campaign by the CDC. Emory Healthcare, Atlanta following IHI compliance measurements has seen significant reductions in infections, but notes that often the various policies from different organizations is a proving to be the bane. Another issue is that often these suggestions are theoretical, with emphasis on “what should be done”, rather than the way it “should be done”.
The Joint Commission has taken it onto itself to not only maintain compliance standards, but also recognize institutions that perform successfully.
Institutions require evidence based practice regulations to implement more successfully these measures, but it is the education of the staff which has so far been neglected. A greater emphasis needs to be laid on staff education, regarding OT procedures, asepsis in invasive procedures, ward protocols, etc. There is an urgent need to change the mindset that “infections were always there and are a part of Medicine”; it has been shown that zero infection is possible. Some states are now moving towards forcible acceptance of regulations by introduction of disincentives for the hospital, and increasing reliability of reporting , by giving greater regard to patient reporting. Such a procedure may appear harsh, but if a tailored approach towards different health care institutions is suggested, there is no reason for noncompliance.
Though the hospitals are willing to put into force safety and prevention regulations, ti appears that the large number of agencies with their often disparate list of regulations are proving to be a hindering factor. Whether disincentive policy is an alternative is debatable, but if the various agencies like Leapfrog and others can come onto a common platform and bring out a single consolidated list of regulations, they would be much easier to follow and monitor. In addition different health care set ups need different set of policies, as there is no cookbook approach. Such an action should and must be acceptable, after all hospitals are in the business of saving lives