June 6, 2012

Monday’s Wall Street Journal had an excellent article showcasing how Hunterdon Medical Center in New Jersey has made enormous strides in controlling clostridium difficile and other healthcare associated infections.

It’s definitely worth reading the whole article, but I want to highlight just how successful Hunterdon has been. From 2006 to 2011, the hospital:

  • Cut its rate of C. diff infections by 79%
  • Reduced MRSA by 66%, and
  • Dropped its vancomycin-resistant enterococci (VRE) rate by 23% last year

This is great progress that is undoubtedly saving hundreds of patients from needless suffering and even death.

These gains are not the result of luck but of concerted effort and investment by Hunterdon:

Prompting Hunterdon to overhaul its methods was a growing threat from a strong strain of C. diff in 2004. At highest risk for C. diff are patients, especially older adults, who are on antibiotics for other infections. The drugs destroy good germs that protect against infection for several months, during which time patients can get sick from C. diff picked up from contaminated surfaces or spread from a health-care provider’s hands.

The hospital began isolating patients who had contracted C. diff and asked doctors to restrict the use of the antibiotic Cipro. But it was becoming clear that spores could survive for weeks, even on a doorknob. Alcohol-based hand sanitizers didn’t kill C. diff, and hand-washing wasn’t sufficient.

So the hospital adopted new, stronger soaps containing the antiseptic chlorhexidine for staffers and patients. Cleaning crews began using bleach and a more potent form of hydrogen peroxide. Rooms were scrubbed as never before: In rooms where C. diff patients had been treated, even the curtains were taken down and cleaned.

Ms. Nash coaches cleaning staff on the importance of disinfecting “high-touch” surfaces on which germs can linger. One current focus: the remote control devices whose buttons allow patients to watch TV or call a nurse. Cleaning staff are encouraged to speak up if they feel they are being rushed to clean a room.

The visual checks traditionally done to confirm a room was clean “are no longer sufficient,” says Ms. Roye-Horn.

The Hunterdon team conducts random audits with the swabbing device on about 300 surfaces a month. Some 95% to 100% of checks get a passing grade, up from 75% when the hospital acquired the device in 2009.

Effectively combating healthcare associated infections costs money. In addition to hiring additional staff, including more cleaners, Hunterdon has spent hundreds of thousands of dollars over the past 5 years to upgrade its infection surveillance and control technology. Given than the average extended stay or readmission for an infection like C. diff can cost over $30,000, investing in prevention is increasingly seen as cost-effective.

What Hunterdon proves more than anything, is that change is possible. That smart investment in staff, training and upgraded infrastructure to monitor and prevent healthcare associated infections can stave off needless pain, suffering, and even death. And those of us who have lost someone to an HAI know you can’t put a price on that.

Behind One Hospital’s Fight Against Deadly Infection, Wall Street Journal

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