Infection Control

Healthcare infections – particularly those caused by multi-drug resistant organisms – post a serious healthcare threat. One of the first defenses against harm to patients caused by infections acquired in healthcare settings is proper hand washing. The Institute for Healthcare Improvement (IHI) in collaboration with the Centers for Disease Control and Prevention [CDC], the Associations for Professionals in Infection Control and Epidemiology, and the Society of Healthcare Epidemiology of America” published a “How-to Guide: Improving Hand Hygiene . The Washington State Hospital Association (WSHA) provides information on their website for eliminating hospital acquired infection and a video on how to practice proper hand hygiene. WSHA has also suggested standardized isolation precaution signs (which are available for order) for its member hospitals. The Joint Commission, a not for profit organization that accredits and certifies health care organizations and programs in the United States also has a number of Infection Control Initiatives.

There is mandatory reporting of some infections to the Washington State Department of Health, to the Centers for Medicare & Medicaid Services (CMS), and to the public. In Washington State, HB 1106 (passed in 2007) requires hospitals to publicly report selected hospital-acquired infections. These include:

1. Central line associated bloodstream infection rates in ICU
2. Ventilator associated pneumonia rates
3. Surgical site infection rates for deep sternal wounds resulting from cardiac surgery (including coronary artery bypass grafts), hip and knee replacement surgery, and hysterectomy.

The data for a number of infectious diseases can also be found on the Washington State Department of Health website.

Surgery (with surgical site infections) is one of the common causes of hospital acquired infections. IHI publishes several “How to” guides for preventing surgical site infections. Their case for improvement in the rates of these infections states: ”An estimated 2.6 percent of nearly 30 million operations are complicated by surgical site infections (SSIs) each year. Infection rates, up to 11 percent, are reported for certain types of operations. Each infection is estimated to increase a hospital stay by an average of 7 days and add over $3,000 in charges (1992 data). Appropriate preoperative administration of antibiotics is effective in preventing infection.”

As part of the effort in Washington State to decrease surgical site infections, the Surgical Care and Outcomes Assessment Program (SCOAP), a program of the Foundation for Health Care Quality, was established. In January of 2009, many Washington State Hospitals came together to develop and implement a standardized Surgical Checklist for Ambulatory Care as well as a Surgical Checklist for Acute Care.