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Format: 04/16/2014
Format: 04/16/2014

News

Executive Healthcare Management: Journey to Zero

Wednesday, September 2nd, 2009

Healthcare-associated infections have recently sparked a media storm, despite the fact that figures are down across the US. Allegheny General Hospital’s Jerome Granato tells Natalie Brandweiner why the fight against HAIs is far from over.

Jerome Granato’s recent presentation at the APIC conference addressed the continuing concerns of catheter-related bloodstream infections. During an hour’s discussion, the Medical Director of the Coronary Care Unit at Allegheny General Hospital highlighted the infection-control work being done at his hospital and the methods that achieved have the department’s success in virtually eliminating infections from their patient population.

“In the US there are nearly two million of these healthcare-associated infections each year,” explains Granato. “That represents around four percent of all hospital admissions, so the scope of the problem is quite large. Of those two million people who get healthcare infections, there are about 100,000 deaths directly attributable to healthcare-associated infections.

“If you look at the 100,000 people who die, the healthcare-associated infections come in five categories. The most common cause of death from a healthcare-associated infection is ventilator-associated pneumonia. That’s then followed by catheter-related bloodstream infections. Then followed by urinary tract infections and surgical site wound infections.

“We also include in that, though it’s not necessarily attributed to a cause of death, but when we talk about healthcare-associated infections, we frequently talk about a C. difficile diarrhea, which is an important cause of hospital morbidity and increased stay. We are also looking carefully at the concept of MRSA transmission in patients who come to the hospital, which both of those are not included in the statistics that I’ve spoken to just now. But ventilator-associated pneumonia, catheter-related bacteremia, nosocomial urinary tract infection and surgical site infections really represent the burden of healthcare-associated infection,” he says.

Granato advises that understanding as to how the infections are transmitted provides insight into understanding how to combat the problems and find the best solutions. They are infections attained from being inside the hospital, rather than the patient bringing in with them; he notes that it was originally thought that these healthcare-associated infections were one of the hazards of being in the hospital itself, but that’s no longer the case.

“If you look at catheter-related bloodstream infections, which is what we’ve really focused on at our institution, those infections are brought into the body from bacteria that reside in the skin. They’re brought in when you puncture the skin and drag bacteria into the bloodstream through the puncture site, and so it makes sense that understanding how you cleanse the skin, how you care for the catheter, what type of training and education the staff have with respect to these infections will impact on the rate of infection. That concept of the staff introducing infection, or the staff having activities or playing a role in the transmission of this type of infection, really extends across all of those infections we’ve spoke about whether it be ventilator-associated pneumonia, urinary infection or surgical site infections,” says Granato.

To read more, visit the Executive Healthcare web site.
 

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