NEW YORK — Bradley Moore of Washingtonville, New York, was taken to the hospital with a head injury. He managed to survive swelling and damage to his brain, but while he was in the hospital he contracted an infection. “It was the infection that killed him,” Patricia Moore explained, after burying her son. “I am only one voice, one mother, but I know that hospitals can lower their infection rates by implementing simple practices such as handwashing. This problem has been ignored too long.”
Ignored? Kept secret is more like it. You’ve seen the advertisements imploring you to use this hospital or that hospital because it has the best doctors, or the latest equipment. The one fact you don’t see advertised is the number of patients who get an infection while there. Hospitals are doing their best to prevent their infection rates from being disclosed. It’s no wonder. Every year, more than two million hospital patients in the U.S. contract infections, and nearly 100,000 die from them. The death toll is higher than from AIDS, breast cancer, and auto accidents combined.
Statistics don’t convey the suffering. Patients who manage to survive a serious infection sometimes go through months of pain and repeated surgeries to cut out infected tissue. That’s what happened to Eunice Babcock of Connecticut, who went in for bypass surgery and got a staph (staphylococcus aureus) infection. She was so close to death that doctors had to surgically remove her sternum, leaving her disfigured and unable to stand up ever again.p> Doctors’ Dirty Hands br> This suffering is tragic, because infections are largely preventable. No scientific breakthrough is needed. The single most effective way, according to the federal Centers for Disease Control and Prevention (CDC), is to get doctors and other caregivers to clean their hands in between treating patients. Doctors clean their hands before treating a patient only 48 percent of the time, on average, research shows. “Even at the best hospitals” the rate is only 60-70 percent, points out Dr. Beth Raucher, an infection expert at Beth Israel Medical Center in New York City. It’s not unusual to be able to trace the bacteria in a patient’s wound directly to the bacteria on a particular health care worker’s hands, she explains. /p>
Patients “are dying from germs their physicians and nurses give them,” warns Elizabeth Norman, head of New York University’s doctoral program in nursing and an outspoken critic of the poor hygiene in hospitals.
Contaminated equipment, such as wheelchairs, bedrails, stethoscopes, and blood pressure cuffs also allow dangerous bacteria to be transmitted from one patient to another. Patients with staph actually shed the bacteria in little flakes from their skin that are then carried on equipment and floor dust. Intravenous (IV) and urinary tract catheters — tubes that enable liquids to enter or leave the body — are also extraordinary transmitters of infection.
A few hospitals in the U.S. are showing how possible it is to reduce infection. Latter Day Saints Hospital in Salt Lake City, which already had an infection rate below the national average, reduced its rate by 50 percent, largely by improving pre-surgical procedures. Mercy Hospital in Oklahoma City lowered the risk of infection after cardiac, colon, and hysterectomy surgeries by 78 percent. Forty-four hospitals in the Pittsburgh region have reduced catheter-related bloodstream infections by nearly half, and a pilot program at the V.A. Hospital there has virtually wiped out a deadly type of infection, methicillin resistant staph.
Yet the overall hospital infection rate in the U.S. is at least as high as it was three decades ago, and there is some evidence that it may actually be increasing. Most hospitals are dirtier places than they used to be. New York University’s Elizabeth Norman remembers that in the mid-20th century, when she and nurses of her generation trained, her hands were red and raw from scrubbing, and cultures were routinely taken from underneath the fingernails of hospital staff to make sure bacteria were not being spread. Sadly, she has “watched the abandonment of simple practices that were once routine.”
A liberal reliance on antibiotics has replaced scrupulous attention to hygiene. That has led to new danger: infections that almost no drugs can cure. One of the most feared infections is MRSA (methicillin-resistant staphylococcus aureus) because most antibiotics do not tame it. Yet it can be virtually eradicated. Hospitals in Holland and Denmark have done it by insisting on hand hygiene, decontaminating equipment such as beds and wheelchairs after patient use, and isolating patients who carry the germ — precautions people assume are taken everywhere. In addition, non-emergency patients in these two countries are tested for MRSA before coming into the hospital, and those who test positive are treated to eliminate the bacteria — a process that keeps new germs out of the hospital.
These precautions are not taken by many American hospitals. The result? A frightening 57 percent of hospital staph infections in the U.S. are antibiotic resistant (up from 2 percent in 1974), and the problem is spreading. Denmark and Holland have brought that figure down below 1 percent.p> Drugs or Hygiene?
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