Infection control controls costs

Aside from blogging, SRxA duties, and volunteering as an EMT, once a month I teach infection control to Fire and Rescue personnel.  During classes I stress the importance of the basics – training, hand-washing, good hygiene While most students probably forget the more scientific aspects of my lectures, they all remember the advice “if it’s wet, sticky and it’s not yours, don’t touch it!”

I was therefore interested, but not altogether surprised, to read a new study published in the September 2011 issue of Health Affairs, which showed that simple infection control measures could save thousands of lives and billions of dollars.

According to the U.S. Department of Health and Human Services at any given time, one of every 20 hospital patients has a hospital-acquired infection. This leads to an estimated 99,000 deaths in the U.S. each year and up to $33 billion in preventable health care costs.

The study, undertaken by researchers at the University of North Carolina at Chapel Hill, tested three interventions aimed at preventing and reducing hospital acquired infections.

The first intervention was strict enforcement of hand hygiene practices. All health care workers were expected to wash their hands with soap and running water or an alcohol-based rub on entering and leaving a patient’s room, before putting on and after removing gloves, and before and after any task that involves touching potentially contaminated surfaces or body fluids.

The second intervention was aimed at preventing ventilator-associated pneumonia and included measures such as elevating the head of the patient’s bed while the patient was on a ventilator, giving the patient daily breaks from sedation to assess whether or not the patient is ready to come off the ventilator, and providing daily oral care (teeth brushing, mouth washes, etc.) with a long-lasting antiseptic.

The final intervention was ensuring compliance with guidelines for the use and maintenance of central-line catheters. Examples included using sponges impregnated with an antiseptic, using catheters impregnated with antibiotics whenever possible, and performing two assessments per day of whether patients with central-line catheters still needed them.

Results showed that patients admitted after these interventions were fully implemented got out of the hospital an average of two days earlier, their hospital stay cost about $12,000 less and the number of patient deaths were reduced by two percentage points.

The costs for implementing these measures were modest – less than $22 / patient/day. However, adoption of the three interventions could potentially save thousands of lives and billions of dollars each year and improve the care of all patients.  Proving once again, it’s sometimes the simple things in life that are the most effective.