Thursday, February 20, 2014

Lack of Compliance Costs Money and Lives

By E’Louise Ondash, RN

Uh oh.

Shame on us.

According to new research from Columbia University School of Nursing, we are not doing our job and following the rules when it comes to infection control.

It’s not that nurses don’t know what to do. We all recognize the problem of health care-associated infections and why they occur, but we aren’t following through with proven preventions, like posted checklists. Despite all we know, the study found that 10 percent of hospitals lack these checklists to prevent bloodstream infections, and 25 percent lack checklists to help avoid pneumonia in ventilator patients.

And this may be the worst part: Even when checklists exist, only about half of hospital workers follow them.

This costs lives.  Sources vary on the numbers, but between 5 percent and 10 percent of all hospital patients in this country develop infections annually.

The Centers for Disease Control and Prevention estimates that 1.7 million people contract infections in U.S. hospitals each year (some argue that the number is higher), and that these infections kill an estimated 90,000 to 100,000 patients annually. In the past 20 years, the incidence of healthcare-associated infections  has increased by 36 percent, according to the Institute of Medicine.

Our failings also cost money. Lots of it. Estimates vary widely; they run from $28 billion to $45 billion annually, according to the National Institutes of Health. Even if the lowest estimate is the correct one, it’s a lot of money that could be spent on other health care needs.

According to a press release from the university, the school of nursing’s “comprehensive review” (1,653 ICUs at 975 hospitals) focused on three of the most common preventable infections: central line-associated bloodstream infections (CLABSIs); ventilator-associated pneumonia (VAP); and catheter-associated urinary tract infections (CAUTIs).

The authors suggest two solutions for infection prevention that most hospitals are not yet employing: electronic monitoring systems (only one-third of hospitals have them), and full-time certified clinicians to supervise compliance.

But bedside nurses must play their part, too. We have to wash our hands before procedures and in between patients, and we can’t put off those dressing changes when materials get wet or dirty. Something as simple as keeping patients’ heads elevated can help prevent pneumonia in those who are on ventilators.

If there are reasons that these measures are difficult to do or can’t be done, we need to speak up.

“This study shows we still have a long way to go in compliance with well-established, life-saving and cost-saving measures that we know will lower infection rates,” said lead researcher Patricia Stone, PhD, MPH, RN, FAAN, Centennial Professor of Health Policy at the school of nursing,
The findings of the study were published in the American Journal of Infection Control.

Does your workplace have established protocol or checklists for infection prevention?

If so, do you think there is a high level of compliance?

Tell us about it.

1 comment:

Summit Nursing PC said...

Study reveals that about 50% out of 168 hospitals allocated a budget for hand-hygiene training. When hospitals failed to focus on hygiene, that puts patients at unnecessary risk for preventable health care related infection. One study also revealed that significant number of hospitals and medical facilities don’t have hand sanitizer and lapses in staff training in terms of hand hygiene.