Missouri Releases Report on Hospital-Acquired Infections

JEFFERSON CITY, Mo. -- The Missouri Department of Health has released a report disclosing the rate at which patients developed certain bloodstream infections in each of the state's hospitals. The report was issued in response to a state law passed in 2004

that requires public disclosure of hospital infections, a leading cause of death in the United States. Missouri is the third state in the United States to publish a report on hospital-acquired infection rates. The report is available at http://www.dhss.mo.gov/HAI.

"For too long, patients have been kept in the dark about the growing rate of hospital infections," said Lisa McGiffert, director of Consumers Union's Stop Hospital Infections Campaign (http://www.StopHospitalInfections.org). "This report will enable Missourians to see whether their local hospital is doing a good job keeping patients safe. We hope it will also spur hospitals to re-double their efforts to improve care and prevent infections."

Missouri's initial report focuses on central line-related bloodstream infections acquired by patients in the intensive care units (ICU) of the state's hospitals between July 1, 2005 and March 31, 2006. A central line is an intravenous catheter or IV placed into a large vein. Forty-eight percent of all patients in ICUs have central venous catheters and they are vulnerable to acquiring infections if proper infection control procedures are not followed.

The Institute for Healthcare Improvement estimates that nationally, approximately 14,000 people die every year from central line-related bloodstream infections, but other research suggests that the number could be as high as 28,000. The incidence of central line-related bloodstream infections could be reduced greatly if hospitals followed the strict infection control protocols recommended by the Centers for Disease Control and Prevention (CDC).

The CDC guidelines for reducing these infections involve cleaning hands between patients, using maximal barrier precautions (wearing mask, cap, sterile gown, gloves) while inserting an IV, cleaning the skin area where the IV is inserted with chlorhexidine soap, selecting the best site for insertion, and daily review to determine whether the IV is still necessary. A partnership between the CDC and the Pittsburgh Regional Healthcare Initiative resulted in a 68 percent reduction in such infections over a four-year period among a group of hospitals in southwestern Pennsylvania that followed these procedures.

In addition to central line bloodstream infections, Missouri's patient infection disclosure law requires hospitals to report the rates for certain surgical site infections and ventilator-associated pneumonia. A surgical site infection rate report is expected in mid 2007. The law allows a state advisory committee to require disclosure of other categories of infections in future years. The statute requires hospitals to report their infection rates quarterly to the state, which will help keep information timely and enable the public to see whether their local hospital is making progress in reducing infections.

"Missouri's initial hospital infection report is a good step forward that will help to focus attention on this very serious patient safety problem," said McGiffert. "Hospital infections shouldn't be accepted as an inevitable consequence of providing care to sick patients. Hospitals need to aim for zero infections if we're ever going to get this epidemic under control."

The CDC estimates that one in 20 patients -- or approximately 2 million every year -- develop various kinds of infections while being treated in the hospital. Of those, 90,000 patients die every year. Infections drive up healthcare costs because they can prolong hospital stays and result in additional surgeries and other costly treatments. The CDC has estimated that hospital infections add about $6 billion to the nation's healthcare bill.

Only 25 percent of all hospital infections are acquired in the ICU. Bloodstream infections of all kinds account for 15 percent of all hospital-acquired infections.

Missouri is one of 16 states around the country that have adopted such laws in recent years. Pennsylvania and Florida are the only other states that have produced reports on hospital infections so far. Infection reporting requirements have been adopted in California, Colorado, Connecticut, Illinois, Maryland, New York, New Hampshire, Ohio, Rhode Island, South Carolina, Tennessee, Virginia and Vermont. California will only report on the rate that hospitals perform certain infection prevention practices.

Source: Consumers Union