How Clean is Your Hospital? 15 Eye-Opening Facts

Hospital-acquired infections, also known as “noscomial” infections, have been recognized as a critical problem affecting the quality of healthcare and a principal source of adverse healthcare outcomes. Among all of the major complications that occur during hospitalization, nosocomial infections account for more than 50 percent. Until 2006, hospital administrations were not transparent about their infections, cleanliness, and hospital-acquired infection rates. However, this lack of transparency is dissipating — and with it comes some startling numbers. The bottom line is that hand washing is lax, creating more infections and costing patients more money when infected. This list is just a quick glimpse into the horrifying facts — issues that can be prevented with more care and attention to cleanliness.

    Blood Smear

  1. In a CBS article published in 2009, it was reported that more than 75 percent of all hospitals have been cited for serious cleanliness and sanitation violations. Hospital cleaning and janitorial staffs are overwhelmed and inadequately trained, resulting in unsanitary rooms or wards where germs have thrived. And payroll cutbacks have gutted staffs devoted to reducing infections.
  2. Hospital-acquired infections are one of the leading causes of preventable death in the developed world today, with 100,000 people in the United States alone dying every year from bugs they catch as patients in the hospital, according to the World Health Organization. The old and very young are at an especially high risk of infection from resistant bacteria that can spread like wildfire. But these superbugs may have met their match, thanks to a genetically engineered cleaning solution developed in Israeli laboratories.
  3. The problem of methicillin-resistant Staphylococcus aureus (MRSA) initially appeared in patients being treated in hospitals but more recently has become a problem in the community as well. However, this isn’t a spill-over of the hospital problem as community-acquired MRSA seems to have developed quite separately, involving different strains of S.aureus. In addition, community-acquired MRSA often causes infections in previously healthy individuals who don’t have the risk factors that hospitalized patients do.
  4. In 2008, this study showed that urinary tract infection (UTI) was the most common hospital-acquired infection in the United States, and that no national data exist describing what hospitals in the United States were doing to prevent this patient safety problem. UTI accounted for almost 40 percent of all nosocomial infections. Most hospital-acquired UTIs are associated with urinary catheters, a commonly used device among hospitalized patients. Up to 25 percent of hospitalized patients have a urinary catheter placed during their stay.
  5. Norovirus took the top spot for infection outbreaks in U.S. hospitals from 2008 to 2009 and also was responsible for most closures of hospital departments, a study finds. “Four organisms caused the majority of outbreaks: norovirus, which causes severe gastroenteritis (18.2 percent), Staphylococcus aureus, which causes food poisoning, pneumonia and skin infections (17.5 percent), Acinetobacter spp, a bacterium common in hospitals (13.7 percent), and Clostridium difficile, or C. diff, a bacterium that can cause colon inflammation and diarrhea (10.3 percent).”
  6. Serious infections like Klebsiella pneumoniae carbapenemase, or KPC, a bacteria that causes ventilator-dependent pneumonia, wound infections and meningitis, has recently developed resistance to most of the antibiotics used to fight it. The mortality rate for patients infected with KPC-producing bacteria has been estimated to be as high as 50 percent. KPC-bacteria often grow on medical equipment such as catheters and ventilators in hospitals.
  7. Infection

  8. In one study, of the 9,080 patients meeting study entry criteria, ventilator-assisted pneumonia (VAP) developed in 842 patients (9.3 percent). Patients with VAP had a significantly longer duration of mechanical ventilation. Development of VAP was also associated with an increase of $40,000 USD in mean hospital charges per patient. This study demonstrates that VAP is a common nosocomial infection that is associated with poor clinical and economic outcomes. While strategies to prevent the occurrence of VAP may not reduce mortality, they may yield other important benefits to patients, their families, and hospital systems.
  9. Clostridiuim difficile, a bacteria that causes diarrhea, colitis and other intestinal conditions, and is one of the most common infections in hospitals and long-term care facilities. About three to five per cent of healthy adults carry C. difficile around in their bowels and something like 50 per cent of infants. Antibiotics kill off the good bacteria in the bowel and allow the C. difficile to flourish and produce toxins that cause illness.
  10. Across Pennsylvania, about 25 percent of health care-associated infections in 2009 were surgical-site infections. Urinary tract infections were the second-most common at about 22 percent, with gastrointestinal infections coming in third at about 18 percent, according to the council’s report. Bloodstream infections and pneumonia came in as the fourth- and fifth-most common infections, respectively.
  11. Department of Health and Human Services (HHS) estimates that over three years, reducing hospital-acquired conditions by 40 percent would result in an estimated 1.8 million fewer injuries to patients and save more than 60,000 lives. Reducing preventable hospital readmissions by 20 percent would result in 1.6 million patients recovering without a complication that requires another hospital stay. The health care system could save as much as $35 billion.
  12. According to the Centers for Disease Prevention and Control (CDC), in hospital wards (non-ICU), approximately 23,000 bloodstream infections occurred in patients with central lines (a tube that goes into a large vein of a patient’s body — usually chest or neck) to give medicine. While some improvement in keeping those infections at bay has occurred, the report also shows that many infections still happen to patients in medical settings, including ICUs, hospital wards and outpatient dialysis centers. Each year, 1 in 20 patients gets an infection in the hospital.
  13. While 28 Oregon hospitals reported zero bloodstream infections associated with central line catheters, others reported infection rates more than double the state average. Hospital experts and state analysts don’t know why surgical site infections after heart bypass surgery rose 8 percent in 2010. But Oregon’s rate remains about 20 percent lower than the national rate. Oregon hospitals reduced the rate of surgical site infections after knee replacement by 13 percent.
  14. Sterile Gloves

  15. Hand hygiene (HH) is the single most important factor in the prevention of health care-acquired infections. The three most frequently reported methods of measuring HH compliance are: (1) direct observation, (2) self-reporting by health care workers (HCWs), and (3) indirect calculation based on HH product usage. This article presents the results of a 12-month multicenter collaboration assessing HH compliance rates at US health care facilities by measuring product usage and providing feedback about HH compliance. Results show that HH compliance at baseline was 26 percent for intensive care units (ICUs) and 36 percent for non-ICUs in 2009.
  16. The Centers for Medicare and Medicaid Services has published the infection rates at Hospital Compare, where the government already publishes data about patient satisfaction and some other types of medical errors in order to help consumers choose quality hospitals. The information is updated quarterly, and will eventually show infection rates for a full year.
  17. Since 2006, 14 states have passed laws requiring hospitals to report information about infections to the public. The federal government’s push to increase people’s awareness of their health care spending goes hand-in-hand with getting hospitals, physicians and health insurance companies to share more price information. More people have a reason to know what they spend on health care, due in part to the increasing popularity of high-deductible health insurance. Learn more about those legislative efforts at the National Conference of State Legislatures (NCSL).