The Columbus Dispatch
Wednesday September 4,
Infections picked up in hospitals carry an enormous toll.
They drag out hospital stays, put patients in intensive care and
sometimes kill. And they come with a whopping price tag as
A study in this week's issue of Journal of American
Medical Association Internal Medicine
estimated the annual cost of five common and preventable
health-care-associated infections at $9.8 billion.
To patient advocates and those involved in quality improvement,
that isn't a shock. For years, hospitals have been under pressure
to drive down infections, from buckling down on hand-washing rules
to regulating procedures so the safest approach is used every
Efforts at national and local levels - including several efforts
in Ohio - have aimed to improve patient care and decrease
infections in the past several years and have reported success.
They're to be commended, but that's only the beginning, said Dr.
Julia Hallisy, founder of the Empowered Patient Coalition and a
California dentist who calls hospital infections an "epidemic."
Hospitals that have made strides in driving down infections to
the point they're almost unheard of are still outliers, she said,
and they need to become the norm. There also should be greater
public reporting of infection rates, Hallisy said.
"Zero is possible in some of these infections. You know, is it
possible at every hospital every day across the board? Maybe not,
but it certainly is happening at certain institutions, and they're
sustaining it," she said.
Dr. Jim O'Brien, vice president of quality and clinical services
at OhioHealth Riverside Methodist Hospital, said he's seen how
standardizing care and emphasizing hygiene can help.
Central-line infections - those that involve catheters inserted
into large veins - at OhioHealth hospitals dropped from 28 in
fiscal year 2011 to 12 the next year and to nine in the fiscal year
that just ended.
That said, maintaining optimal care can present challenges, he
said. Humans are by nature inconsistent and fallible.
"I think one of the tough things is that a lot of this is about
great attention to small details, and the immediate consequences if
you don't pay attention to those details aren't obvious," O'Brien
"It would be easier if every time you touched a patient without
washing your hands they screamed out in pain, but they don't."
A hand-hygiene initiative is one of several efforts that
hospitals here say have made a difference. "Secret shoppers" who
checked up on staff members found observation of proper techniques
go from 29 percent in August 2010 to 86 percent last November.
"The best thing to do is educate and come up with ways to
inspire people," said Carol Elder, infection-control specialist for
the Mount Carmel Health System.
Elder said Mount Carmel leaders continually look for ways to
tackle bacteria and prevent infections. Recently, the system is
using disposable antiseptic cloths to bathe intensive-care
patients. The cloths eventually could be used more widely.
Dr. Susan Moffatt-Bruce, chief quality and patient-safety
officer for Ohio State University's Wexner Medical Center,
described work there to reduce infections as "relentless."
Infection rates have come down with changes in procedures and
upgrades that include new catheters and antiseptic soap in
"I think that we need to strive for perfection," Moffatt-Bruce
That said, there are limitations to what hospitals can control,
said Ohio State infectious-disease expert Dr. Julie Mangino.
Smokers and the obese are at a higher risk for infection, for
instance. And sometimes patients don't get optimal care after they
leave the hospital, she said.
"We have to take responsibility for what we can influence, but
there are some variables where we have no impact."