Thursday, January 07, 2010

Infection Control As Cost Cutting Method

New studies show that better infection control can result in fewer complications and infections resulting from hospital stays. The focus of the latest studies were on the patients themselves:
But two new studies suggest relatively simple ways hospitals can prevent many infections by killing the bacteria on the patient before surgery, with methods of screening, scrubbing or pretreating the patient that many hospitals do not typically use.

“This is going to be a huge help to the infection-control crowd,” said Marcia Patrick, a nurse and board member of the Association for Professionals in Infection Control and Epidemiology, who was not involved with either study. “How can we not do this? It would truly be penny-wise and pound-foolish. And it’s the right thing to do for patients.”

The studies, published Thursday in The New England Journal of Medicine, examined infections that develop at the site of surgery, often around the incision, and afflict more than 300,000 patients a year in the United States.

While experts are increasingly trying to stop hospital-acquired infections by approaches including stepped-up hand-washing by doctors and nurses, the new studies looked at the bacteria patients may be carrying before entering the hospital, especially a common bacteria, staphylococcus aureus.

“About one-third of people at any one time carry this bacterium in their nose or on their skin,” said a co-author of one study, Dr. Henri Verbrugh, a professor of medical microbiology at Erasmus University Medical Center in the Netherlands. “It does not give them any problem, but if they go to a hospital and the skin is somehow breached, they are really prone to invasion or infection by their own bacteria.”
While the cost for the test and pretreating runs about $30 ($20 for the test alone), the savings could run to thousands of dollars for each complication averted. Considering that there are 300,000 such incidents annually, the savings can really add up.

Some hospitals continue using povidone-iodine, which is 25% the cost of an alternative, chlorhexidine-alcohol ($3 vs. $12). Yet, those treated with chlorhexidine incurred 40% fewer total infections. Those are significant findings, yet the institutional move away from povidone-iodine isn't happening on a widespread basis.

Infection control and reducing antibiotic usage are two measures that can produce improve quality of life, reduced health care costs, and do not require any government intervention. It just requires common sense and doctors improving infection control techniques to avert secondary infections that result in hundreds of thousands of complications during hospital stays annually.

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