Simple Interventions Save Lives

A new Health Affairs study tested three relatively simple and inexpensive interventions on a hospital unit to prevent the kinds of hospital-acquired infections that cause the deaths of an estimated 99,000 patients each year. Principal investigator Bradford Harris, MD, and colleagues conducted the research on a pediatric ICU at the University of North Carolina at Chapel Hill School of Medicine, finding that patients admitted after these interventions were implemented left the hospital on average two days earlier, at lower cost, and with a 2.3% lower death rate. Study authors projected annual savings of $12 million for a single PICU.¹

The simple measures include strict enforcement of standard hand hygiene policies; guideline-recommended measures for ventilator patients, such as elevating the head of the hospital bed; and compliance with guidelines for maintaining central line catheters, along with educational posters and the use of oral care kits.

A recent article in the “Cleveland Plain Dealer” describes efforts in that city’s hospitals to enforce proper hand hygiene.² MetroHealth Medical Center hired four employees it calls “infection prevention observers,” whose entire job is to make sure that every caregiver who comes near a patient washes his or her hands. They openly appear on the units carrying clipboards and filling out sheets tracking non-compliance.

The hospital’s hand hygiene compliance rate has reached 98% on all medical units (nationwide, the rate is around 50%), while bloodstream infections have dropped to one-third of what they were in 2010. Cleveland Clinic and University Hospitals achieved similar compliance by employing secret observers of staff hand-washing.

CDC epidemiologist and hand hygiene expert Kate Ellingson, MD, told the newspaper that while awareness of the importance of hand hygiene has long been understood, it is difficult for healthcare workers to follow. But hospitals that use employee monitors, post data, and implement other hand hygiene initiatives tend to show strong compliance.

References

1. Harris BD, Hanson H, Christy C, et al. Strict hand hygiene and other practices shortened stays and cut costs and mortality in a pediatric intensive care unit. Health Affairs. 2011;30(9):1751-1761.
2. Tribble SJ. Cleveland MetroHealth Medical Center increases hand washing, reduces infections. “Cleveland Plain Dealer” website. Available at: http://www.cleveland.com/healthfit/index.ssf/2011/09/metrohealth_increases_hand_was.html. Accessed Oct. 15, 2011.