The Florida Times Union reports on an unfortunate problem that area hospitals cannot seem to shake. We have four hospitals in the Jacksonville area that performed below national standards for preventing infections during patients’ stays, according to a study from the CDC. UF Health Jacksonville (Shands Jacksonville) was one of seven hospitals nationwide that performed below standards for four of the six types of infections that were analyzed in the study, including urinary tract infections from catheters and surgical infections after hysterectomies.
In an emailed statement to the Times Union, UF Health Jacksonville spokesman Daniel Leveton said the hospital is at a disadvantage in medical studies because it is a “safety-net” institution that serves a clientele with less access to care. UF Health Jacksonville is a teaching hospital that is one of the state’s largest Medicaid providers.
Of the 10 hospitals analyzed in the Jacksonville area, six performed at or above national standards in all categories. Two hospitals, Baptist Medical Center and Flagler Hospital, beat national standards in two categories.
The study evaluated hospitals by comparing their rates of infection between October 2012 and September 2013 to those of similar hospitals, according to the Center for Medicare and Medicaid Services. It took into account factors that might alter a hospital’s infection rate, such as its location and whether it’s affiliated with a medical school.
HOSPITAL INFECTIONS KILL THOUSANDS
Data from the study will be used in an Affordable Care Act program that aims to reduce the number of health problems that patients contract while in the hospital. In addition to infections, the program looks at other injuries, such as bed sores and ruptures of surgical wounds. The federal government will reduce Medicare payments by up to one percent for hospitals that rank in the bottom quarter for their rates of those injuries. Three Jacksonville-area hospitals are at risk of facing those penalties, according to a preliminary study performed in June by Kaiser Health News, a non-profit that analyzes the healthcare industry: Ed Fraser Memorial Hospital, UF Health Jacksonville and Memorial Hospital Jacksonville.
Overall, hospital-acquired infections are down in the United States, according to CDC data. Between 2008 and 2012, central line infections, which come from a tube used to deliver fluids into a patient’s vein, decreased 44 percent. Colon surgery infections fell by 20 percent, and hysterectomy infections, 11 percent. The rate of bloodstream infections from the MRSA bacterium declined 4 percent. Infections were down 2 percent for clostridium difficile, a bacterium that causes diarrhea and other intestinal conditions. There was a 3 percent rise in the rate of urinary tract infections from catheters. Statewide, Florida fared well in recent years, with most of its infection rates falling faster than the national average between 2008 and 2012. In those years, Florida’s rate of infection from central lines went down 45 percent; from urinary catheters, 16 percent; from colon surgery, 28 percent; and from hysterectomies, 4 percent. But infections still take a toll on the American healthcare system. The economic cost of infections that patients receive in American hospitals are as high as about $9.8 billion each year, according to a 2013 study published in JAMA Internal Medicine, a medical journal.
The human cost is high, too. On the average day, about one in 25 patients in American hospitals get an infection, according to the CDC. In 2011, that amounted to 722,000 infections nationwide. That year, about 75,000 patients who received infections in hospitals died during their stays. National analyses estimate that more than half of such infections are preventable.
INFECTIONS PLAGUE AREA HOSPITALS
In the CDC study, Memorial Hospital Jacksonville was above the national standard in one category, but below in two others. St. Vincent Medical Center was above the national standard for one infection type but didn’t meet the standard for clostridium difficile. Dr. Ken Rothfield, the hospital’s chief medical officer, said that the federal study doesn’t differentiate between infections that were present when patients arrived and those that were received in the hospital. He also said that larger hospitals tend to have higher rates of patients that harbor clostridium.
At Flagler Hospital, which also performed below the national standard for clostridium, administrators began taking steps to fight the bacterium before receiving the CDC data, said Bill Hepler, the director of infection prevention. He said that the hospital’s elderly clientele was part of the reason the hospital was below the standard; the bacterium usually turns into an infection when a patient is on antibiotics, which the elderly are more likely to take. The hospital has formed a team of physicians, microbiologists and pharmacists to make sure antibiotics aren’t prescribed too often, which could cause clostridium infections, he said. It has also introduced a new hand disinfectant that is geared toward killing the bacterium, and it screens incoming patients for it, he said.
The Centers for Disease Control and Prevention study analyzed the following infections:
■ Central line-associated blood stream infection: An infection that results from the use of a tube placed in a patient’s vein, usually in the arm, chest, groin or neck.
■ Catheter-associated urinary tract infection: An infection in the urinary system, including the urethra, bladder, ureters and kidney, that came from the use of a catheter.
■ Surgical site infection from colon surgery: An infection that occurs at the site of colon surgery.
■ Surgical site infection from abdominal hysterectomy: An infection that occurs after surgery to remove the uterus through an incision in the lower abdomen.
■ Methicillin-resistant Staphylococcus Aureus, or MRSA: A bacterium that can result in pneumonia and infections of the bloodstream, the skin and surgical sites. It is resistant to many antibiotics.
■ Clostridium difficile: A bacterium that causes diarrhea and intestinal conditions such as colitis. It can be passed person-to-person or through contaminated objects such as bed linens and bathroom fixtures.
Consumers who want to see how their local hospital measures up to national benchmarks for hospital-acquired infections and other patient safety data can visit Medicare’s Hospital Compare website at http://www.medicare.gov/hospitalcompare/search.html.
To read more about hospitals and what they can do to prevent hospital infections, click here: http://www.consumerreports.org/cro/2012/12/deadly-infections/index.htm