According to a recent study by Randy W. Loftus, MD, from Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, the contaminated hands of anesthesia providers are a significant source of patient contamination in the operating room.  The study was published in the January 2011 issue of Anesthesia & Analgesia.
“As anesthesiologists, we like to think that the surgical drapes protect the patient from tens of trillions of microorganisms that are in and on our bodies,” said editor-in-chief of Anesthesia & Analgesia Steven L. Shafer, from Columbia University in New York, NY, in a news release. “Nope! These studies provide evidence that our bacterial flora contribute to surgical site infections.”
“Although we know that hand-washing is an important step, our compliance is poor, and there is little excuse for hospitals not implementing systems that facilitate compliance with hand-washing guidelines,” Dr. Shafer said. “However, as [this report suggests], it is time to look at additional measures to protect our patients from the biofilm that we take into the operating room every day.”
Read more about the results of Dr. Loftus’ study.

On March 25, health officials reported that an “antibiotic-resistent superbug” is spreading through Southern California healthcare facilities. The findings of the report will be presented at this year’s Society for Healthcare Epidemiology of America (SHEA) on April 3rd in Dallas, TX.

This infection, nicknamed CRPK, is “brand new” and “the most dangerous superbug to-date. “Cipro, Zosyn and Penicillin, the most powerful antibiotics, are ineffective against this healthcare associated infection.

The CDC has been tracking it across 35 states since 2009. Dr. Richard Besser, ABC News chief health and medical editor, says that the real cause for the spread of these infections is the lack of handwashing by doctors and nurses as they administer care to various patients:

“Hands touching [other] hands is how superbugs are spread. They’re spread from patient to patient by doctors and nurses who have unclean hands. The doctors are the worst offenders. Theyre washing their hands less than half of the time going between patients,” he says. “Ask your doctors to use [the alcohol gel] and you could save a life!”

Read more about the CRPK superbug and its impact on our healthcare system.

With 2011 well underway, we can expect to see a heightened focus on decreasing healthcare associated infections (HAIs).  According to Janet Corrigan, president and CEO of the National Quality Forum, HAIs are a patient safety issue and reducing these infections will continue to be a priority in 2011.  Corrigan also acknowledges that HAIs are one of the issues in the healthcare delivery system where big improvements can be made. 

According to Corrigan, there is now an increased focus on “maximizing the value of healthcare” and “bringing cost and quality together.”  Proventix aims to add value to healthcare by creating a link between quality and cost through hand hygiene. Healthcare workers can provide higher quality of care through hand hygiene, which will ultimately result in cost savings. HAI incidence will decrease, as will unnecessary costs associated with these infections. 

Read the article “2011 Outlook: Quality – Forging a link to costs” on Healthcare Business News here.

BBC News reported in December that a team led by World Health Organization researchers found that poorer countries had much higher infection rates than the developed world.

They reviewed 220 previous studies and found that infection rates were three times higher in underdeveloped countries than in the US.

What’s more, the report notes that the issue has been going largely unnoticed. One of the lead researchers, Professor Didier Pittet, said that the primary reason for this is that developing countries’ healthcare systems are “blitzed with other issues that higher-income countries have dealt with…long ago.”

Researchers assert that simple, low-cost measures like better hand hygiene, surveillance and staff education could make a big difference.

I recently read an article on FierceHealthcare about an elderly woman who was admitted for observation after a fall incident, only to be placed in hospice care one week later. The woman, Yolanda Robles, was only supposed to be hospitalized for 24 hours. Upon her admittance, Ms. Robles was given incorrect medication. It was not discovered the nurse had mistaken Ms. Robles for another patient until Ms. Robles’ daughter informed the nurse her mother was not a diabetic when the nurse tried to give her insulin. Ms. Robles’ story is just one example of how medical errors can lead to poor patient outcomes.
 
The experience I read about rings true to some of my own experiences. My grandmother was recently hospitalized, and contracted pneumonia and a staph infection during her stay. Although it was a combination of health issues that contributed to her passing, having multiple healthcare-associated infections at once made her time in the hospital even more difficult than it should have been. A few years ago, her sister went to the hospital for a knee operation and died a few weeks later due to a staph infection she contracted during the procedure which subsequently spread into her bloodstream.

According to a report issued by the Inspector General earlier this week, an estimated 180,000 people are killed each year because of medical errors. Medical errors and healthcare-associated infections should not be an accepted part of hospital stays. Hospitals are where people should get healthier and become stronger, yet medical errors and infections patients contract during their stay impede the ultimate goal of hospitals: make patients better. 

The use of information technology could offer one solution to enable healthcare workers to provide timely, better quality care to their patients. Whether it is a system that encourages hand washing, decision support systems that help physicians make decisions about medications, or electronic medical records that allow healthcare workers to be on the “same page” regarding a patient, all of these things can help improve patient outcomes, and when combined, have the ability to make a big difference. As the use of information technology in the healthcare setting becomes more widespread, hopefully we will see patient outcomes improve.

http://www.youtube.com/watch?v=O1zZvpdPEJQ&feature=related

Pam tries to give employees of The Office hand hygiene tips by demonstrating the “vampire cough.” Dwight argues that the exposure to germs should be intentional so that the immune system can develop antibodies…

We can’t say we agree with Dwight, but it’s a funny skit, and very cool to see hand hygiene so prominently discussed!

Clean hands matter…