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HOSPITAL INFECTIONS: How many people enter the room?

The number of people who enter a patient’s hospital room, the length of time that  they are in the room, and what they touch when they are there were recorded in this observational study conducted in three hospitals.   Here are some of the findings (these are medians):

  • 5 room entries per hour (adult patients)
  • 8.5 room entries per hour (pediatric patients)
  • 3 to 3.5 different people entering the room per hour
  • 3 minutes spent in the room

There is also an interesting breakdown of what is touched in the room according to the type of person doing the touching — for example, nonclinical staff primarily touch the patient’s environment only.  Physicians are the most likely to touch nothing in the room.  The authors commented that the having numbers of people in and out of the patients’ rooms can have benefits for patients, in that patient needs can be more quickly identified, but that there is also the possibility that the patients may be at higher risk of contracting a health care-associated infection (HAI).

Source: Cohen, B., and others.  Frequency of patient contact with health care personnel and visitors: implications for infection prevention.  The Joint Commission Journal on Quality and Patient Safety;38(12):560-565, Dec. 2012.  Click here for text:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531228/pdf/nihms421967.pdf  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Sustained zero CLABSI is achievable

A study published in the Archives of Internal Medicine examined central line-associated bloodstream infection (CLABSI) data for intensive care units of hospitals located predominantly in Michigan. The hospitals all participated in a targeted quality improvement iniative known as the Comprehensive Unit-based Safety Program, or CUSP, that was implemented through the Michigan Keystone ICU Project. The researchers found that 60 percent of the 80 ICUs evaluated were infection-free for a year or more, and 26 percent achieved two years or more. In the study, smaller hospitals sustained zero infections longer than larger hospitals.

Source: Lipitz-Snyderman, A., and others. The ability of intensive care units to maintain zero central line-associated bloodstream infections. Archives of Internal Medicine. 171(9):856-858, May 9, 2011. http://archinte.ama-assn.org/cgi/content/extract/171/9/856

Posted by the AHA Resource Center, (312) 422-2050 rc@aha.org

 

Hospital-acquired infections: benchmarks and statistics

About 13 percent of high-risk adult patients developed healthcare-acquired infections (HAI) in 2000, according to the (Roberts, et al. 2010)  study of 1,253 patients.  The total costs attributable to HAI ranged up to $21,000 per patient and an increase in length of stay of about 6 to 10 days was found.  Healthcare-acquired infection was found to double hospital cost.  In a study based on a review of the published literature, (Scott, 2009) concluded that the direct medical cost to the nation of HAI ranges from about $28 billion to $34 billion each year.  The (Edwards, et al. 2009) article reports data from a large-scale study of the prevalence of central line associated bloodstream infections, urinary catheter-associated urinary tract infections, and ventilator-associated pneumonia.  This article, out of the National Healthcare Safety Network, provides mean, median, and percentile rates for these HAIs for different types of units within hospitals.

Sources:  Roberts RR, and others.  Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methodsMedical Care;48(11):1026-1035, Nov. 2010. 

Scott, R.D., II.  The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention.  U.S. Centers for Disease Control and Prevention, Mar. 2009.  Free full text here: http://www.cdc.gov/ncidod/dhqp/pdf/Scott_CostPaper.pdf

Edwards, J.R., and others.  National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009.  American Journal of Infection Control;37:783-805, Dec. 2009.  Free full text here: http://www.cdc.gov/nhsn/PDFs/dataStat/2009NHSNReport.PDF

Statistical brief on hospital-acquired infections

A new AHRQ statistical briefing examines hospital-acquired infections based on an analysis of 2007 data from the Healthcare Cost and Utilization Project [HCUP]. Some quick highlights from the report indicate:

  • Over 42,000 adult patients acquired infections during their hospital stay in 2007.
  • Hospital patients with infections due to medical care had an average length of stay 19.2 days longer than patients without infections.
  • A patient with one of these infections cost nearly $43,000 more to treat than non-infected patients
  • The adult infection rate was 2.03 per 1000 hospital stays for medical and surgical discharges in 2007, an improvement from a 2.30 rate in 2004 and 2005.
  • The highest infection rate [2.58 per 1000] occurred in the 45-64 year age group, while the highest volume of patients [nearly 19,000] were in the age 65 and over range.
  • Septicemia was the most common diagnosis for a hospital stay with a healthcare acquired infection.

Source: Lucado J and others. Adult hospital stays with infections due to medical care, 2007. HCUP Statistical Brief [Healthcare Cost and Utilization Project/Agency for Healthcare Research and Quality] #94, Aug. 2010.