The number of hospitals who have been able to report zero infections to a national safety watchdog has gotten worse, according to a new analysis.
Castlight Health, a healthcare pricing transparency company, analyzed data from The Leapfrog Group's Hospital Survey and found that the number of hospitals reporting zero infections for each of the five conditions it measures has decreased significantly since 2015.
For example, 25% of the nearly 2,000 hospitals that responded the survey in 2015 reported zero central line-associated bloodstream infections. That number was close to 13% in 2017.
More than 30% of hospitals reported no methicillin-resistant Staphylococcus aureus (MRSA) infections in 2016, compared with about 15% in 2017. In addition, about 22% of hospitals reported zero catheter-associated urinary tract infections in 2016, compared to about 11% in 2017.
"I think it's far too easy to let something slip, so it's clear that there really needs to be a renewed focus on getting back to zero," Erica Mobley, Leapfrog's director of operations, told FierceHealthcare in an interview. "We do still see some hospitals that are getting to zero, so it's clearly possible."
For the remaining two conditions measured by Leapfrog, the decreases were less dramatic but still present. Close to 23% of hospitals reported no surgical site infections following colon surgery in 2016, compared to about 19% in 2017. In 2016, about 5% of hospitals reported zero Clostridium difficile infections, while that number decreased to about 3% in 2017.
The report's findings aren't all bad, Mobley said. The analysts examined infection rates based on the standardized infection ration, a methodology developed by the Centers for Disease Control and Prevention that compares actual infection rates to what CDC would predict for a given facility. The majority of hospitals, the study found, have lower than expected infection rates for the five included conditions.
"Even though there are fewer getting to zero, we still do see the majority of hospitals doing better than expected on these infections," Mobley said.
Mobley said hospitals that see this data and want to right the ship should focus on the most basic element of an infection control policy: hand-washing.
Hospital rooms should be designed to place the sink or hand sanitizer stations in the main pathway, as a direct reminder to clinicians to stop and wash their hands, she said. And patients should feel empowered to speak up if they see a member of care team skip hand-washing.
"Providers should be receptive to that," she said. "If a patient asks them [wash their hands], they should be willing to comply with that request."
The report also encourages patients to ask questions about their care; for example, asking why a catheter is required following a procedure, and checking in with the care team on the issue regularly. Patients also need to be clearly educated on postsurgical wound care, to prevent SSIs, and have clear directions on medications, the report suggests.