Hygiene Is Shown to Cut Hospital Blood Infections

WSJ.com
By ZACHARY M. SEWARD

Common-sense safety and hygiene practices, often overlooked by doctors, can almost wipe out a dangerous type of blood infection that kills thousands of patients each year in U.S. hospitals, according to a study.

The steps include making sure doctors and nurses wash their hands and wear protective clothing. The study, published in today's New England Journal of Medicine, focused on central-line catheters, which deliver drugs and nutrition to patients through a vein in the neck, chest or groin.

Researchers examined Michigan hospitals that agreed to use the safety procedures in their intensive-care units, where catheters are most commonly used. After strictly adhering to the practices, hospitals nearly eliminated catheter-related blood infections. Previously, the hospitals had a median rate of 2.7 catheter-related blood infections for every 1,000 days patients had the devices in place.

"Imagine if this was done in all hospitals," said Peter Pronovost, lead author of the study and medical director of the Center for Innovation in Quality Patient Care at Johns Hopkins University. "We could practically eliminate this type of infection."

As many as 28,000 patients die each year from blood infections caused by central-line catheters, according to a federal estimate. The infections can lead to acute respiratory-distress syndrome, kidney failure, shock and other ailments. Treatment costs an average of $45,000 per patient.

State and federal health agencies want to reduce catheter-related infections in the wake of several studies that showed little progress in the matter. On average, U.S. patients in ICUs spend about half their time with central-line catheters in place, according to a 2004 federal report.

Following the study, U.S. hospitals will face pressure to fortify their hygiene and safety practices when treating patients with central-line catheters, government officials said.

Carolyn Clancy, director of the federal Agency for Healthcare Research and Quality, said safety measures would be emphasized in similar, ongoing programs at the Defense Department and the American Hospital Association that are aimed at improving patient safety.

"Hospitals are really hungry for very concrete things they can do to make health care safer," said Dr. Clancy.

Beyond practicing proper hygiene, such as disinfecting the catheter site, the hospitals in the new study were instructed to remove unnecessary catheters more quickly and to avoid placing catheters in the femoral vein, which is near the groin and more susceptible to infection. Researchers said just calling attention to the problem may have cut down infections.

Dr. Clancy also suggested that patients ask their doctors if they have washed their hands before inserting a catheter or performing any sort of procedure. She said that one "nonconfrontational" way of doing so would be to mention medical studies about the importance of hand washing.

Source:
http://online.wsj.com/article_print/SB116725628874460877.html
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