ERD50, you have brought up a very important subject. Hosptialized patients are sicker nowadays and they have far more foreign bodies in them (central IV lines, ventilator tubes, etc). They are also being treated with multiple antibiotics, which encourage resistant bugs. Hence the rise of MRSA (multiple resistant staph aureus) and VRE (vancomycin resistant enterococcus). While "nosocomial" infections (those acquired in hospital) are not completely preventable, there are many opportunities for improvement and there is a real need to properly implement the basic tenets of infection control.
There is no universal requirement for hospitals to publish their own infection data. What you will find, in scientific papers and in presentations at forums like IHI (see below) are data from specific centres on specific populations of patients. Because the susceptibility to hospital acquired infections is quite different in (say) 35 year old truckdrivers versus 26 week premature infants versus 80 year old patients having colonic resection, we have to compare apples with apples.
Benchmarking one doctor against another is also prone to fallacy, unless you are looking at a specific surgical procedure performed without much associated hospital care. We know, for instance, that giving antibiotics just prior to opening the abdomen reduces the chances of a wound infection. But for a complex patient in intensive care, who may or may not have had a surgical operation, the factors that will reduce infection rates include whether the nurse elevates the head of the bed, whether the patient is weaned from sedation and ventilation daily, whether everybody who comes in washes their hands properly and/or uses hand cleansers, the distance between beds, which antibiotics are used, the patient's age, immune status, nutritional status, etc, etc. So there are many "system" factors at play. We have discovered that packages or "bundles" of interventions, such as the central line bundles shown on the CPSI website below, are key in preventing such infections.
The good news is that intensivists like myself actually do "get it" and we are working collaboratively to raise the bar against these infections. With considerable success, I might add. There are now multiple collaboratives of intensive care units involving hospitals across the US and Canada all working together on this problem. I'm heavily involved. And our efforts are paying off.
So what can you do, as a patient, to protect yourself?
Ask your doctor or health system whether it is involved in the
IHI's 100,000 lives campaign or the new
5 million harms campaign, or, if you are in Canada, the
Safer Healthcare Now! campaign. Ask what measures they are taking to prevent infections. Put pressure on them!!! When you visit the hospital, look out for bottles of hand cleanser, use them yourself, and watch how many staff do also. If they don't wash their hands before and after giving you care, politely request that they do. Read before you need admission and be prepared to ask about the antibiotics you will receive before surgery, what they will do to prevent infection in your central line, and how you will be mobilized quickly.
And make sure you get out of the hospital as fast as possible once you are at the convalescent stage. You are much safer at home!
Here are some relevant websites:
From the
Centers for Disease Control:
http://www.cdc.gov/ncidod/eid/vol7no2/wenzel.htm
http://www.cdc.gov/ncidod/dhqp/nnis_pubs.html
From the
Institute of Healthcare Improvement:
http://www.ihi.org/IHI/Programs/Col...PACTICReducingHospital-AcquiredInfections.htm
From the
Canadian Patient Safety Institute:
http://www.saferhealthcarenow.ca/Default.aspx?folderId=82&contentId=184
