One in 25 Americans heading to the hospital will acquire some type of infection, amounting to 722,000 infections in 2011, according to the latest data from the U.S. Centers for Disease Control (CDC).
About about 11 percent of those patients, typically the elderly, will die while in the hospital.
Dr. Michael Bell, deputy director of CDC’s Division of Healthcare Quality Promotion, which is responsible for patient safety issues in healthcare facilities, spoke with reporters Wednesday morning. He said that while reductions in some of these infections show improvement, there’s still plenty of work to be done.
“Sooner or later, everyone is going to be a patient somewhere. While many of us get better, not all of us do,” he said. “Thankfully we’re finally realizing we’re all in this together.”
Improving Hospital Infection Rates
Health officials are continuing to push best practices into the healthcare setting to reduce these unnecessary infections, especially those caused by bacteria resistant to current antibiotics.
The most common types of hospital-associated infections (HAIs) include those of the blood stream, urinary tract, gut, and lungs, as well as surgical sites. The bacteria causing those infections include antibiotic-resistant C. diff, staph, MRSA, and CRE, known as the “nightmare bacteria” because no course of antibiotics on the market can treat it.
The CDC report shows varying degrees of improvement across states, infections, and strains of bacteria. Overall, there has been a 20 percent decrease in infections related to 10 surgical procedures and a 44 percent decrease in line-associated bloodstream infections.
“As it turns out, state-by-state, some are making progress on some infections and not on others,” Bell said.
One area of continued concern is catheters going into the bladder. While they typically can cause non-fatal urinary tract infections, treatment with broad spectrum antibiotics wipes out the gut’s natural bacterial flora, allowing bugs like C. diff to flourish, potentially causing untreatable diarrhea.
“You may initially have a bladder infection, but soon you’re fighting for your life from deadly diarrhea,” Bell said.
Sometimes the Patient Has to Be the Bad Guy
Bell said some problems can be prevented if the patient is his or her own best advocate. This involves asking lots of questions.
“It’s hard, but you have to ask questions,” he said.
Important questions include asking doctors if they have washed their hands thoroughly before they perform a procedure such as inserting a catheter. Others including asking how long a catheter should be in and asking every day if today is the day it should come out.
Having someone with you at major appointments can help, so you’re not always stuck questioning your doctor’s practices.
“Go with a loved one,” he said. “Take turns being the bad guy.”
Numbers Show the Need for More Funding
Dr. Daniel Diekema, president, Society for Healthcare Epidemiology of America, said the progress in reducing HAIs shows there’s more work to be done.
“As these results reveal, our greatest progress has been in the reduction of infections for which prevention approaches have been well studied,” he said. “For many other HAIs, we must still make progress in understanding what prevention approaches work. More funding for HAI prevention research is essential to make this happen.”
In the 2015 fiscal year budget, Pres. Barack Obama pledged $30 million to track antibiotic resistance, to promote best stewardship programs, and other preventative efforts.
While the push to lower hospital infections may save lives, its initial implementation was to rein in the $29 billion a year spent on medical errors.
Push to Lower Hospital Infections Spurred by Medicare Reimbursement Rates
The push to begin lowering hospital infection rates began when Pres. George W. Bush signed the Deficit Reduction Act of 2005. This required the Secretary of Health and Human Services to identify two hospital-acquired conditions that could have been avoided.
Among the top eight were urinary tract infections from catheters, vascular catheter associated infections, and surgical site infections. Hospitals that continued to have these problems faced lower Medicare reimbursements, according to a report from the National Conference of State Legislatures.
At the time, medical errors were costing on average $113,280 per negligent injury, and 70 percent of those costs were sent out to Medicare or private insurance companies, a Harvard School of Public School of Health study found.
Essentially, the government told hospitals that if they didn't clean up their act, they would face paying for their own mistakes.
In 2007, total spending on healthcare was 16 percent of the nation’s gross domestic product, and it is projected to be at 25 percent in 2025. In 2011, it was at 17.9 percent.