Waiter, there's Staphylococcus aureus in my soup: Infection prevention is common sense

September 1, 2007

Coffee shops, restaurants and grocery stores have started getting serious about employees washing their hands to prevent the spread of germs. If the guy who steams my cafe latte remembers to scrub his hands for 30 seconds before getting behind the coffee counter, then why aren't more healthcare providers remembering to do it?

According to the Centers for Disease Control (CDC), caregiver hand washing is the cheapest, easiest way to prevent hospital-acquired infections. There are 1.7 million hospital-acquired infections annually and 99,000 deaths. Costs are estimated in the tens of billions. Granted, hand washing doesn't eliminate every infection in a healthcare setting, but it's the first line of prevention.

And let's admit it's obvious common sense.

Survival rates in hospitals are slowly increasing overall. The "100,000 Lives" campaign apparently did save 100,000 lives and then some, and a big component of the program addressed measures to reduce and eliminate hospital-acquired infections.

REPORTING INFECTION RATES

Just 19 states have laws requiring public reporting of infection rates, while several other states are watching similar bills die in their legislatures.

Most recently, New Hampshire enacted a law that expects its 26 acute-care hospitals to report three categories of hospital-acquired infections, however, the legislature allocated exactly $1 for the program in its budget.

The bill's original sponsor estimated that startup costs for an effective program would be $138,000. Opponents to New Hampshire's law say they'd rather see funds allocated to preventing the infections in the first place, not gathering the grim statistics.

Pennsylvania was the first state to adopt a public reporting law. For 2005, it reported 19,154 cases of hospital-acquired infection, 400,000 additional hospital days and at least $1 billion in added costs. Although other causes were not taken into account, 2,478 patients with acquired infections died during their hospital stays that year. The average cost for a patient with an infection was $185,000 and 23 days in the hospital, compared with $31,389 and five days for those without. Medicare and Medicaid paid for two-thirds of those costs, but private insurers forked out $59,915 per patient on average.

Several Pittsburgh hospitals have reduced their infection rates by simply implementing a standard protocol to do so. Now, Gov. Edward Rendell is proposing a statewide plan as part of his healthcare reform initiative to go beyond just reporting rates and to adopt mandatory hygiene practices necessary to prevent infections in hospital patients.

It's one of the many healthcare practices that should be happening voluntarily without legislation, but isn't. Reporting and prevention are both needed, not because a law mandates it, but because it's common sense.

Julie Miller is editor-in-chief of Managed Healthcare Executive. She can be reached at julie.miller@advanstar.com