Hospitals inadequate at infection control

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Hospitals inadequate at infection control

 

 

By Carol Hilton

 

KINGSTON, ONT. – A national survey on infection control has found that as many

as 80% of Canadian hospitals fall short in preventing patients from acquiring

infections while in their care.

 

The survey was conducted before last spring's SARS outbreak in Toronto, which

resulted in 43 deaths and hundreds being sick.

 

Dr. Dick Zoutman, lead author of the study, an epidemiologist at Queen's

University here, director of infection control services at Kingston General

Hospital and chairman of the Ontario SARS Scientific Advisory Committee, said

the findings are disturbing.

 

" The results clearly show we need to be doing a lot more to prevent

hospital-acquired infections, " he said in a press release.

 

" Our hospitals are not safe enough. "

 

Researchers mailed the survey, Resources for Infection Control in Hospitals, to

all Canadian hospitals with more than 80 acute care beds. Of 238 hospitals, 172

(73.2%) responded.

 

The survey used the landmark Study on the Efficacy of Nosocomial Infection

Control (SENIC) from the U.S. as a guideline for effective programs. It

identifies four components as being essential: one full-time equivalent

infection control practitioner (ICP) per 250 beds; a physician trained in

infection control; intensive surveillance; and intensive control.

 

Of the responding hospitals, 42% had fewer ICPs than recommended by SENIC, and

80% did not meet current Canadian standards. As well, 40% did not have

physicians or doctoral professionals with infection control training to lead the

programs. Most ICPs (88%) were nurses.

 

Recording infections

 

In terms of surveillance and control activities deemed important by SENIC, 23%

of hospitals scored less than 50 on the surveillance index, indicating they were

conducting fewer than half of recommended activities such as recording the

number of infections in the hospital. For control initiatives, 21% of hospitals

scored less than 50 on the control index, which includes such activities as hand

washing and educating staff about outbreaks.

 

The study also found ICPs and physicians were spending far less than the

recommended 50% of their time for infection control or surveillance. Although

SENIC recommended reporting surgical site infections directly to the surgeon to

reduce infection rates, only 36.8% of hospitals did this.

 

Larger hospitals tended to have better control scores than smaller facilities,

and teaching hospitals had better control and surveillance scores than

non-teaching hospitals.

 

Nosocomial infection

 

Published in the August issue of the American Journal of Infection Control, the

study authors noted that based on estimates from U.S. data, Canadian hospitals

in total can expect to have 220,000 occurrences of nosocomial infection

resulting in more than 8,000 deaths annually.

 

" Current estimates are that between 30% and 50% of nosocomial infections are

preventable, but to realize this level of prevention the resources must be put

in place at each hospital, " they wrote. " The cost/benefit in terms of patient

outcomes, morbidity and mortality as well as indirect economic costs, are well

established and strongly support investments in infection control

infrastructure. "

 

The survey is the first assessment of infection surveillance and control

programs in Canada in 20 years. It was conducted in the fall of 2000 by the

Canadian Hospital Epidemiology Committee, a group of medical specialists who

head infection control programs in 30 hospitals across the country.

 

In a commentary accompanying the study, Dr. William Jarvis, director of the

CDC's Office of Extramural Research at the National Centre for Infectious

Diseases, said recent events highlighted the value of infection control

initiatives.

 

" The emergence and transmission of SARS was a wake-up call, telling us the

importance of our infection control programs. . . . The impact of infection

control programs, in terms of years of life saved, is greater than most other

interventions or treatments we provide in medicine and public health. "

 

 

 

 

 

 

 

 

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