Patient education may be key to reducing hospital-acquired infections

Despite a nation-wide effort to increase adherence to hand-washing, hospitals continue to be a breeding ground for dangerous, preventable infections.

Earlier this month a young woman from Bangor, Maine, died after contracting a rare flesh-eating infection days after childbirth. And a new report shows 198 patients acquired new infections while being treated at New Hampshire hospitals last year. The Centers for Disease Control and Prevention reports hospital-acquired infections cost $30 billion and lead to nearly 100,000 deaths each year. 

And though healthcare experts say patients have to take on some of the responsibility for ensuring hospital workers wash their hands, it's up to hospitals to educate patients about the need to have this important, albeit awkward conversation with their doctors and nurses.

"What I think is particularly effective is when healthcare providers say, 'Hey, by the way, if you ever see me forget to do hand hygiene, would you remind me?'" William Bornstein, M.D., chief quality and medical officer of Atlanta's Emory Healthcare, told the [Minneapolis] Star Tribune.

The walls of Emory hospitals are plastered with flyers that state, "We encourage you to ask your health care providers if they have cleaned their hands."

Nurse-initiated conversations with patients about hand hygiene, along with handwritten notes on white boards, helped Sentara Healthcare, a nonprofit health system that includes 10 acute care hospitals and covers 2 million residents in Virginia and North Carolina, increase compliance with hand-washing.

Nurses encourage patients to remind providers to wash their hands and if they forget, hold them accountable, Gene Burke, Sentara vice president and executive medical director of clinical effectiveness, previously told FierceHealthcare in the special report, How one hospital system changed hand hygiene compliance. 

But Robert Wachter, M.D., a professor at the University of California, San Francisco and a leading patient safety expert, told the Star Tribune that putting the onus on patients to ensure providers wash their hands sends the wrong message. The conversation is awkward and doctors can't possibly monitor everything that goes on in the hospital room, he said.

"In some ways it says to patients, 'This is your responsibility for us to do things safely for you, including hand hygiene,' " he said. "Why should it be the job of the patients or family members to make sure everybody cleans their hands? That's the job of the system."

However, Kathy Day, a former nurse who lives in Bangor, told the Bangor Daily News that public pressure may be the only way all hospital workers will do everything they can to prevent hospital-acquired infections. She has worked to raise awareness about debilitating and deadly infections after a "superbug" sickened her elderly father following a hospitalization for a minor ankle fracture in 2008.

Hospitals aren't always responsible for infections that appear in their facilities, she said in the article, but hospital administrators need to understand their role in preventing potentially disabling and deadly infections.

"As long as [hospitals] can convince people that they couldn't have done anything more, they couldn't have done anything different, or it couldn't have been prevented, basically what they're saying is it's part of doing business," she told the Bangor Daily News. "As long as they can get people to accept that, they can continue on and not really put their money where their mouth is with prevention and precautions. The public pressure is what's going to make the difference."

To learn more:
- read the Star Tribune article
- here's the Bangor Daily News piece
- check out the article on the New Hampshire hospital report

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