When a family member or loved one goes to the hospital for medical treatment, we expect them to get better, not worse. However, hospital infections are a very real and very dangerous problem. Illinois recently published information showing infection rates at Illinois hospitals in an attempt to increase transparency about safety and also hold medical institutions accountable.
You can check your hospital’s infection rate at the Safe Patient Project website, or the Illinois Hospital Report Card. (See “States Move to More Transparency Regarding Medical Malpractice & Hospital Errors”) Many of the same infections that pose serious problems at hospitals are also problems at nursing homes.
Research is showing that many hospital infections can be prevented through proper procedures. Dangerous germs and pathogens can be transferred from many sources (patient’s skin, doctor’s hands, clothing, scrubs, coats, the medical equipment itself) to the patients or to medical equipment including catheters. This research is spurring hospitals to make improvements, with the rates of some common hospital infections being cut in half.
Infections involving central lines (a catheter or tube that is placed in blood vessels to deliver medication and fluids) are one common hospital infection. These infections can be fatal. In the United States, about 80,000 hospital patients suffer infections involving their catheters every year, and about 30,000 of these patients actually die. (See “Never Event #2: Infection in Central Venous Catheters”)
Despite these numbers, there is some hope. The Johns Hopkins Hospital published research in 2005 showing that over 100 ICUs in Michigan almost eliminated CLABSIs by following a list of simple procedures. These procedures included: focusing on patient safety, medical staff working closely together, washing hands, using gloves, masks, and gowns, draping patients with coverings, and cleaning sites where catheters were inserted.
Simple steps such as fully draping the patient as opposed to only draping the area where the catheter would be inserted decrease the infection rate. The culture at hospitals also needs to change so nurses and other staff members feel able to speak up if the checklist is not being followed. This is a dramatic change for many hospitals where nurses fall much lower in the hierarchy.
The Illinois Hospital Report Card and Consumer Guide to Health Care provides information on hospital infections, including central line-associated bloodstream infections (CLABSIs). Last year in Illinois, 44 hospitals list zero CLABSIs in their ICUs, while some hospitals still listed high infection rates (see Table showing central-line infections). The state tracks the number of bloodstream infections associated with central lines or catheters used in medical, surgical, or combined medical/surgical intensive care units (ICUs).
In Illinois, nine hospitals displayed high infection rates in 2009, which calls into doubt whether patients at these hospitals are receiving adequate care. Thorek Memorial Hospital in Chicago had 22 CLABSIs, which is the highest of all medical centers in Illinois, with an infection rate 13 times higher than the U.S. average. The hospital’s administration said that the hospital is conducting an independent review and has taken steps to reduce infections.
- Swedish American Hospital in Rockford had 15 infections
- Norwegian American Hospital in Chicago had 12 infections
- St. Bernard Hospital & Health Care Center in Chicago’s Englewood neighborhood, also had 10 infections
- Mercy Hospital & Medical Center in Chicago had 9 infections
- St. James Hospital and Health Centers had 7 ICU medical/surgical ICU infections
- Skokie Hospital had 5 infections in 2009.
Many of these hospitals are increasing training and taking steps to reduce infections. However, we will have to wait until next year to see whether these steps result in fewer infections.
On the other end of the spectrum, are several Chicago-area hospitals that have reduced their number of central line infections to almost zero. These numbers show that some area hospitals are doing something right. However, it also raises more questions about what are the other hospitals doing wrong? The following hospitals had zero ICU infections in 2009:
- Adventist Bolingbrook Hospital
- Adventist GlenOaks Hospital
- Adventist Hinsdale Hospital
- Trinity Regional Health System.
While several other hospitals had very low infection rates:
- Central DuPage Hospital in Winfield had 1 infection in one of their ICUs and 0 in their other ICU
- Loyola University Medical Center in Maywood had 2 infections
- Northwestern Memorial Hospital had 1 surgical infections and 6 medical infections
- Adventist La Grange Memorial Hospital had 3 medical/surgical ICU infections.
Nursing home residents are also susceptible to many of the same infections that are common in hospitals. (See “MRSA in Nursing Homes on the Rise Amongst Residents and Staff” and “Nursing Homes – The Perfect Breeding Grounds for MRSA”) Nursing home residents might even be at higher risk for infections, especially central line infections because they require more frequent and longer-term use of central lines because of the high incidence of serious health problems. Still, there are steps that you can take to reduce the risk of infection at a hospital or nursing home:
- Require that caregivers wash their hands or wear sterile gloves before touching catheters or the area around catheters
- Ask how long the catheter or central line needs to be in place, then ensure that they are removed when no longer necessary
- Notify a nurse or doctor if bandages come off or get dirty
- Tell a nurse or doctor if the skin around your catheter becomes sore or red
- Do not let anyone touch your catheter or central line unless medically necessary
- Ask questions
- Use hand sanitizer when entering and leaving a facility
Hospitals and Nursing Homes with high infection rates raise questions about the quality of care. Hopefully, with increased reporting of infections and accountability, these numbers will go down. Nursing homes should take the same steps to reduce infections as hospitals have done in order to protect the health and safety of their residents. If you or a loved one suffered from a preventable infection at a hospital or nursing home, you may be entitled to compensation.
Thanks to Heather Kiel, J.D. for her assistance with this Nursing Homes Abuse Blog Entry.
For laws related to Illinois nursing homes, look here.