Published: April 09, 2008 11:32 pm            

Area hospitals mixed on infection report

Area hospitals had mixed scores on the latest state report on hospital-acquired infections.

Somerset Hospital had a lower infection rate than other similar-sized hospitals, while Memorial Medical Center’s rate was above average among the state’s largest hospitals.

Windber, Miners and Meyersdale medical centers’ infection rates were close to the average for small hospitals.

Overall, 2006 infection rates were much higher than in 2005 – up 60 percent – but that was largely attributed to expanded reporting categories and better infection tracking, said Joe Martin, spokesman for the Pennsylvania Health Care Cost Containment Council.

Across the state, about 30,000 patients who were hospitalized in 2006 contracted infections during their hospital stays.

“Pennsylvania hospitals should be commended for their commitment to the reporting process and for their improved reports,” said David Wilderman, acting council director.

“(A fourth quarter) decline in the infection rate ... indicates that we are headed in the right direction.”

While the overall rates are useful, Somerset Hospital’s vice president for quality control says infection control must focus on each patient.

“We look at the whole number rather than the percentage,” Craig Saylor said.

Somerset reported 45 hospital-acquired infections out of 3,645 patents during 2006, for a rate of 12.4 per thousand, or 1.24 percent. Similar hospitals averaged 16.7 infections for every 1,000 patients, or 1.67 percent.

Many infections are associated with mechanical devices, Saylor noted.

For instance, patients on a Foley catheter to drain their bladders are more prone to urinary tract infections, which topped all hospitals’ lists. Somerset reported 25 urinary tract infections, or 0.69 percent.

“We participate in the Institute for Health Care’s guidelines,” Saylor said.

“They have the best practices for decreasing hospital-acquired infections.”

Following the guidelines, Somerset uses specific protocol for attaching and removing the catheter and constantly reviews each patient’s condition.

“We use stickers as a reminder: Does this patient continue to need a urinary catheter?” Saylor said.

Similar guidelines are used on central line intravenous catheters to prevent bloodstream infections and respirator care to prevent infectious pneumonia, he added.

Memorial, which has tightened its procedures with Foley catheters, has halved its urinary tract infection rate since the report was compiled in 2006, Chief Medical Officer Dr. David Carlson said.

The Johnstown hospital’s 354 urinary tract infections out of 20,722 patients reflects a 1.71 percent rate, raising its overall rate to 2.77 percent.

A total of 573 patients acquired infections while in Memorial, the report says. Similar hospitals averaged 1.06 percent urinary tract infections and 2.28 percent overall infection rate.

“Those numbers are almost two years old,” Carlson said.

“We’ve been on this. We have already corrected that. It is one-half what it was at that point.”

Memorial’s rates for other types of infection were lower than similar hospitals. At 0.2 percent, its surgical site infection rate was less than half the 0.41 average.

The hospital also follows best-practices guidelines.

Sometimes it’s little things, Carlson noted. For surgical sites, new research shows improved infection rates by clipping the patient’s hair around an incision, rather than shaving.

“The simple act of shaving the skin damages it very, very slightly,” Carlson explained.

Windber’s numbers may have been slightly skewed by its large hospice program caring for gravely ill patients, Chief Operating Officer Dr. James Eckenrode said. Its overall mortality rate, for instance, was 7.6 percent, with 148 deaths among 1,947 patients.

“If I subtract hospice (deaths), I get 1.5 percent,” Eckenrode said.

Windber’s overall infection rate of 0.98 was slightly higher than the smallest hospitals’ average of 0.85 percent, or 19 patients with infections out of 1,947.

Unsurprisingly, the report shows hospital-acquired infections increase costs and mortality rates, Eckenrode said, noting that government and private payers are looking at performance-based payment rates.

In other words, they won’t pay for the extra cost from hospitals where patients get infections.

The Pennsylvania Health Care Cost Containment Council’s report is available on the Internet at www.phc4.org.

Every state should develop similar reports, said Lisa McGiffert, spokeswoman for Consumers Union’s Stop Hospital Infection Campaign.

“Pennsylvania is the only state that is looking at the whole hospital,” McGiffert said. “It is arranged to compare with similar hospitals.

“I think Pennsylvania is the model for the nation. Pennsylvania has set the bar really high.”

        

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