Even though most hospitals have checklists in place to ensure people don’t get infections while they are there, a new study has found that many hospitals eschew their own infection prevention measures.
The study, done by Columbia University and published in the American Journal of Infection Control, reviewed policies to prevent infections in 1,653 intensive care units (ICU) at 975 hospitals across the United States. Researchers found that preventive checklists for bloodstream infections, urinary tract infections, and pneumonia don’t meet adequate standards for safe health care, and that some hospitals don’t have any checklists at all.
Not following or having these infection prevention protocols in place costs hospitals $33 billion annually and results in 100,000 patients suffering preventable infections, the researchers say.
“Every hospital should see this research as a call to action,” study leader and Centennial Professor of Health Policy at Columbia Nursing, Dr. Patricia Stone, said in a statement. “It’s just unconscionable that we’re not doing every single thing we can, every day, for every patient, to avoid preventable infections.”
These infection prevention checklists can range from hand washing information to information on how often a patient’s catheter should be changed.
Nine out of every 10 hospitals in the study did have such protocols, but often didn’t follow them. Three-quarters of the ICUs in the study had checklists for patients on ventilators to help prevent pneumonia infections but only about half of the hospitals with checklists actually followed them. Patients with urinary catheters fared even worse, with less than a third of hospitals having bedside protocol for preventing catheter-associated urinary tract infections and among those hospitals that did have the protocol, it was followed less than 30% of the time.
“Hospitals aren’t following the rules they put in place themselves to keep patients safe,” said Stone. “Rules don’t keep patients from dying unless they’re enforced.”
The research team suggest hiring someone whose sole job is to make sure hospital staff follows the rules that are set out. More than a third of hospitals in the study had no such employee on staff.
An alternative would be for hospitals to use electronic monitoring systems that act as an honest broker for bedside staff. These systems keep tabs on which parts of the checklist have been fulfilled and which haven’t and also issue hospital staff “report cards” based on how thoroughly they follow the checklist. They have shown success in prior studies to increase hand washing rates, among other positive outcomes.
“We’ve come a long way in understanding what causes healthcare-associated infections and how to prevent them,” Stone concluded. “This study shows we still have a long way to go in compliance with well-established, life-saving and cost-saving measures that we know will lower infection rates.”