Is it too much to ask that your hospital be clean?

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by James Horwitz
The New Haven Register

October 31, 2007

For years hospital and nursing home administrators have said there was little they could do to keep their facilities clean and that hospital-acquired infections (HAIs) were essentially unpreventable. But that claim appears to be wrong.

Hospitals in the Scandinavian countries have all but eliminated HAIs and a VA hospital in Pittsburgh reduced its post-surgical infection rate by 78% in just a few years. Medicare now considers most hospital infections “preventable” and will refuse to reimburse hospitals for treatment for some of these infections beginning next year.

As a result of the passive attitude of some hospital and nursing home administrators in Connecticut and throughout the nation, these institutions have become breeding grounds for infection. Patients literally take their lives in their hands every time they enter a hospital, even for minor procedures.

Some studies put the risk of death from all hospital-acquired infections at an almost incomprehensible 100,000 per year – ultimately costing about 1% of the nation’s health care budget.

In addition to the high rate of infection from garden-variety bacteria and the spiraling death rate, the hospitals' lax approach to infection control has spawned new, lethal, antibiotic-resistant bacteria such as MRSA -- methicillin-resistant staphylococcus aureus.

According to the Journal of the American Medical Association, nearly 19,000 people died in the United States in 2005 from MRSA - double the rate researchers had previously attributed to this germ. A total of 94,000 became infected. In Connecticut, the state Department of Public Health says that 733 cases of MRSA have been reported so far in 2007. Nearly 900 were reported in all of 2006.

MRSA was virtually unknown in the past but now accounts for over 60% of all staph infections. For the most part, these deadly bugs are born and bred in hospitals and nursing homes – and contracted by patients hospitalized for completely unrelated medical issues.

Though hospital administrators blame the overuse of antibiotics as the cause for the proliferation of the new bug, that is only part of the story. More important is the fact that hospitals in this country are filthy and have been remiss in their approach to eradicating infection-causing bacteria. The result is that many of us -- in schools and businesses -- have become carriers, without ever being in a hospital.

There is good news.

If hospitals are forced to implement sensible infection control measures, the problem can be resolved. These measures are as simple as requiring health workers and doctors to wash their hands! Studies of American health workers show that in spite of hand-washing rules at hospitals the mean rate of compliance is just 40%, with some hospitals being as low as 10%. Where infection control measures are truly enforced the rate of hand washing would be 100%. The problem is lax enforcement.

Other methods found effective include taking nasal swabs from health workers and then separating infected workers and patients from other patients. Infected patients can then be effectively treated and others spared the agony and cost of prolonged hospital stays.

The bottom line is that the overwhelming percentage of hospital infections is preventable.

If the legislature truly wants to protect the public, it will amend the Patient’s Bill of Rights to include the “right to a clean facility” and make it apply to hospitals, nursing facilities and anywhere else where medical care is dispensed.

James Horwitz, a Woodbridge resident, is an attorney with the Bridgeport & New Haven law firm of Koskoff, Koskoff & Bieder. The firm has represented dozens of individuals with hospital-acquired infections.