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ON May 23rd, 2008, the French Ministry of Health launched a national hand cleanliness campaign targeting health care workers, patients, and the general public. The campaign emphasizes that proper hand hygiene is the key element in preventing and controlling nosocomial infections.
It is critical that a through cleansing of one’s hands with a liquid alcohol solution containing an emollient to protect the skin precedes all health care treatments, no matter where they are carried out. All health care establishments throughout the country should see to it that these solutions are available at patient’s bed. Health care workers would also be required to carry a small bottle of disinfectant in the pockets of their uniform. |
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Growing concern in the United-States |
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Written by Christine Besson
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Thursday, 26 May 2005 |
.png) More and more articles appear in the American daily
press revealing a growing concern for the problem of hospital-acquired
infections particularly associated to MRSA.
Health Grade Inc., a healthcare quality ratings and services company, released
a report in May 05 on the state of patients' safety in American hospitals.
According to the Institute of Medicine (IOM) statistics - 2001 to 2003 - every
six months more Americans died in hospitals than during the entire Vietnam War.
Amongst these patients' safety incidents (medical errors etc), hospital-
acquired infections affect over 2 million patients per year and of those,
90,000 die. The Health Grade report indicates that the rate of these infections
worsened significantly in the last four years, especially antibiotic-resistant
bacterial infections: harmful bacteria are surviving to more antibiotics, thus
arising the fear of a "superbug" resistant to all existing
antibiotics. " It is scary to think about a superbug that could be
resistant to every antibiotic we have available which is a definite
possibility" says A. Wong-Beringer, Pharm.D. associate professor of
clinical pharmacy at the USC School of Pharmacy.
Dr. M. Foltzer, director of
infectious diseases at Geisinger Medical Center explains that controlling
bacteria in hospitals requires sustained and long- term effort. He also
explains that with patients being transported between hospitals and long-term
facilities, the spreading of these bacteria has increased the risk of infection
and "that it is crucial to address the problem not to rely on new drugs".
Geisinger Medical Center has created a consortium to work with a network of
hospitals and nursing homes to cut down on the transfer of bacteria and hospital-acquired infections
Researchers at Baylor College of Medicine and Texas Children's Hospital conducted a three-year study on S.
aureus infecting children. Over the preceding three years, the number of
MRSA (methicillin resistant Staphylococcus aureus ) infections acquired in the
community had more than doubled. Sheldon Kaplan, MD, lead author of this Texan
study, says:This very dramatic
increase should raise a red flag for health workers everywhere"
Hospital-acquired infections increase
the length of hospitalisation and the rate of death, as well as the financial
and social costs.
The over use of antibiotics
contribute to the problem (50 million antibiotic prescriptions are written per
year). Patients often demand antibiotics regardless of their illness. But
physicians should be more vigilant before prescribing antibiotics.
Measures to reduce complication and save lives, such as basic hands'
hygiene, are already known and extremely well documented. However, they are not
constantly and rigorously applied. A 2004 study showed that an astonishing 57%
of physicians do not wash their hands between patients and 67% of these
physicians thought it "too difficult"!
The report states that if 10% of the less
performing hospitals had adopted measures to lower their hospital acquired
infections rate to the level of the top hospitals, approximately 2500 lives
would have been saved over one year and 700 million$.
Hospital-acquired infection
rates could be used to evaluate overall patients' safety.
The CDC National Nosocomial
Infections Surveillance (NNIS) system has identified hospital-acquired
infections as a major problem in American hospitals.
Hopefully, due in particular
to the impact of pay-for-performance incentives and national campaign, progress
should be made during the next five years. Public awareness and demand for
improvement will also create pressure on hospitals.
A New York Public Interest
Research Group is lobbying for several pieces of legislation that would
require hospitals to publicly disclose information regarding their rate of
infections.
"From our position, the devastation caused by hospital-acquired
infections needs to be addressed", says Blair Horner, director of NYPIRG.
Making hospitals responsible would cut down on hospital-acquired infections.
Legislation - Senate Bill 391
- is currently in a committee sponsored by Democrat Jeanne Lucas of Durham.
That bill would require hospitals to disclose to the public their rate of
hospital-acquired infections using the CDC method of gathering information.Consumers
Union, an independant non profit testing and information organisation
serving only consumers, has launched a campaign to inform people and
pressure legislators througout the different states.Their web site "stop hospital-acquired infections" is a well documentated source of information and an inpiration for action. For more information:
http://www.healthgrade.com
Health Grade Report
Infectious Diseases Society
of America:
Consumers Union "Stop hospital-acquired infections" site: clik here
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