Healthcare Industry News

Strict Hand Hygiene And Other Practices Shortened Stays And Cut Costs And Mortality In A Pediatric Intensive Care Unit
Efforts to reduce infections acquired during a hospital stay through improvements in the quality of care have had measurable results in many hospital settings. In pediatric intensive care units, the right quality interventions can save lives and money. We found that improving practices of hand hygiene, oral care, and central-line catheter care reduced hospital-acquired infections and improved mortality rates among children admitted to a large pediatric intensive care unit in 2007–09. In addition, on average patients admitted after the quality interventions were fully implemented spent 2.3 fewer days in the hospital, their hospitalization cost $12,136 less, and mortality was 2.3 percentage points lower, compared to patients admitted before the interventions. The projected annual cost savings for the single pediatric intensive care unit studied was approximately $12 million. Given the modest expenses incurred for these improvements—which mainly consisted of posters for an educational campaign, a training “fair,” roughly $21 per day for oral care kits, about $0.60 per day for chlorhexidine antiseptic patches, and hand sanitizers attached to the walls outside patients’ rooms—this represents a significant return on investment. Used on a larger scale, these quality improvements could save lives and reduce costs for patients, hospitals, and payers around the country, provided that sustained efforts ensure compliance with new protocols and achieve long-lasting changes.
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Studies Show Hand Hygiene Correlates with Decreased Risk of Transmitting Infection
The hand hygiene practices of health care workers (HCWs) have long been the main vector for nosocomial infection in hospitals. The purpose of this study was to examine influences on risk judgment from the individual differences in knowledge levels and health beliefs among US HCWs. Knowledge levels were assessed by questions taken from published questionnaires. The health locus of control scale was used to characterize internal health beliefs. HCWs assessed the risks of pathogen transfer in situations that varied according to the surface touched and the person doing the touching. HCWs reported lower risk assessments for touching surfaces compared with touching skin. Risk assessment was influenced by individual differences, including in knowledge level and internal health locus of control. Our data describe the individual differences of HCWs related to hand hygiene in ways that can be used to create targeted interventions and products to improve hand hygiene.
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Raising Standards While Watching the Bottom Line: Making a Business Case for Infection Control
While society would benefit from a reduced incidence of nosocomial infections, there is currently no direct reimbursement to hospitals for the purpose of infection control, which forces healthcare institutions to make economic decisions about funding infection control activities. Demonstrating value to administrators is an increasingly important function of the hospital epidemiologist because healthcare executives are faced with many demands and shrinking budgets. Aware of the difficulties that face local infection control programs, the Society for Healthcare Epidemiology of America (SHEA) Board of Directors appointed a task force to draft this evidence‐based guideline to assist hospital epidemiologists in justifying and expanding their programs. In Part 1, we describe the basic steps needed to complete a business‐case analysis for an individual institution. A case study based on a representative infection control intervention is provided. In Part 2, we review important basic economic concepts and describe approaches that can be used to assess the financial impact of infection prevention, surveillance, and control interventions, as well as the attributable costs of specific healthcare‐associated infections. Both parts of the guideline aim to provide the hospital epidemiologist, infection control professional, administrator, and researcher with the tools necessary to complete a thorough business‐case analysis and to undertake an outcome study of a nosocomial infection or an infection control intervention.
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Study shows that Handwashing can Influence 40% of all Intensive Care Unit Infections
Handwashing is widely accepted as the cornerstone of infection control in the intensive care unit. Nosocomial infections are frequently viewed as an indicator of poor compliance of handwashing. The aim of this review is to evaluate the effectiveness of handwashing on infection rates in the intensive care unit, and to analyse the failure of handwashing. A literature search identified nine studies that evaluated the impact of handwashing or hand hygiene on infection rates, and demonstrated a low level of evidence for the efforts to control infection with handwashing. Poor compliance cannot be blamed as the only reason for the failure of handwashing to control infection. Handwashing on its own does not abolish, but only reduces transmission, as it is dependent on the bacterial load on the hand of healthcare workers. Finally, recent studies, using surveillance cultures of throat and rectum, have shown that, under ideal circumstances, handwashing can only influence 40% of all intensive care unit infections. A randomised clinical trial with the intensive care as randomisation unit is required to support handwashing as the cornerstone of infection control.
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New Study Finds MRSA on the Rise in Hospital Outpatients
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Study Finds That Infections are Common in ICUs World-Wide
An international study that examined the extent of infections in nearly 1,300 intensive care units (ICUs) in 75 countries found that about 50 percent of the patients were considered infected, with infection associated with an increased risk of death in the hospital, according to a study in the December 2 issue of JAMA.
Read full release at the JAMA website >

WHO Issues Updated Guidance on Clinical Management of H1N1 Infection
Publication Date: November 2009

Summary
This guidance provides updated information for health care providers managing patients with suspected or confirmed pandemic (H1N1) 2009. It incorporates knowledge gained about clinical features of pandemic influenza through international consultations.

Key Topics:

• Risk factors for severe disease
• Signs and symptoms of progressive disease diagnosis
• Treatment, both outpatient and in hospitals
• Clinical care for resource-poor settings

Download Clinical management of human infection
with pandemic (H1N1) 2009: revised guidance (304 KB)