Hospital Acquired Infections Linked to Catheters

<"">Hospital acquired infections are being caused at an alarming rate by lax catheter policies.  The situation is so serious, that apparently, one of the best ways to get an infection in the hospital is to have a urinary catheter installed.  Astoundingly, nearly half of all  hospital acquired infections  are in the urinary tract and most of these are linked to catheters.  Yet, despite the well-established danger and prevalence—and even though hospitals nationwide are being pressured to reduce infection rates—a new study finds that they are doing very little to reduce infection risks from catheters.  The report, which is to appear in the January 15th issue of Clinical Infectious Diseases, says that even the most basic steps to make catheters safer—such as tracking those patients fixed with them—are often not taken.  Dr. Sanjay Saint of the Veterans Affairs Ann Arbor Healthcare System and the University of Michigan led the study.

The research team surveyed hundreds of hospitals nationwide regarding their catheter policies and found that over half had no system for monitoring which patients had catheters; even more did track for how long catheters remained in the patients.  There was also insufficient use of those types of catheters that are less likely to cause infection and of portable bladder-scanning devices that confirm for doctors whether or not a patient really needs to be fitted with a catheter.  Most hospitals did not even have a system to remind their staff that a patient has a catheter in his/her body, the study found.  “Despite reasonable evidence supporting the use of urinary catheter reminders,” the researchers wrote, “fewer than one in 10 hospitals in this country used this simple and economically attractive method for preventing unnecessary catheterization.”

Developing infections in hospitals is not new in this country.  In 2006, 94,000 Americans developed MRSA with most of them infected in healthcare facilities.  Recent deaths included five school children, players from four NFL teams, and some NYC firefighters.  Center of Disease Control estimates place the 2006 MRSA death toll at 19,000 Americans.

But infections are not the only hospital risk reported in recent days.  A study published last week revealed that nearly one-third of all patients experiencing misfiring or quivering hearts in U.S. hospitals do not receive life-saving defibrillator shocks within the critical first two minutes of cardiac arrest.  This, despite the fact that The American Heart Association recommends that stopped hearts be shocked within the first two minutes.  The study confirming the importance of the two-minute period for survival was published in the New England Journal of Medicine, which also ran an accompanying editorial piece indicating a person might be better off suffering cardiac arrest in a casino rather than a hospital.  Researchers from 369 hospitals in the National Registry of Cardiopulmonary Resuscitation found that being black or having a cardiac arrest outside of regular weekday working hours also significantly delayed the time it took for hospital workers to shock the heart.  “We now have to develop systems of care within the hospital to improve defibrillation times nationally,” said Paul Chan of the Mid-America Heart Institute in Kansas City, Missouri, who led the study in the New England Journal of Medicine.

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