Tri-City hospitals controlling infections

Tri-City hospitals are doing well when it comes to controlling certain types of infections patients can catch in the hospital, state statistics show.

For 2011, Kennewick General Hospital and Pasco's Lourdes Medical Center each reported no central line infections in adult medical and surgical patients in their intensive care units.

Kadlec Regional Medical Center in Richland had an average of 0.31 infections for the same category when calculated at a rate per 1,000 central line days.

Fran Petersen, a Lourdes nurse specializing in infection control, said a central line is a tube inserted into a major vein to deliver fluids or medication to a patient -- similar to an IV, but it can stay in a patient longer.

However, the risk is that the longer a central line is used, the higher the risk of infection.

"The goal is to get them out as soon as possible," Petersen said.

The Department of Health website explains that the rate of central line infections is calculated by having hospitals count the number of days they have patients with central lines and dividing that by the number of infections patients experience during those days. That result is multiplied by 1,000 to get the average rate of infection per line day.

David Birnbaum, program manager for the Healthcare Associated Infection Program at the Department of Health, said that calculation allows for more meaningful comparisons between hospitals than a straight number of infections, which could look very different for a hospital that has a lot of patients with central lines but only for short times and for hospitals where only a few patients have central lines, but are on them for longer periods.

For example, Auburn Medical Center had a central line infection rate of 28.57 per 1,000 line days in 2011 for patients in its neonatal intensive care unit with birth weights between 3.5 and 5.5 pounds. On the face of it, that's a number that raises a red flag -- and is expressed in red in the state's data table because it's outside the norm -- but a footnote explains that's accounted for by a small number of days when a central line was used and just one infection during that period.

Birnbaum said rates are provided for a variety of types of ICU scenarios and patients because not all are equal and some medical conditions -- such as serious burns -- are more susceptible to infection than others.

Infection rates are published on the Department of Health's website so patients can be armed with information about the hospitals they choose, he said.

"There's also the argument that if hospitals are telling everyone what their rates are, there will be an incentive to do better," he said.

If a hospital has a higher-than-average rate, the department can offer resources to help the hospital bring its rates down.

Dr. Jimmy Chua, an infection control specialist for KGH, told the hospital board during a recent presentation that infections acquired in hospitals are an important issue in health care because they account for about 99,000 deaths each year in the United States.

Infections acquired in hospitals cost the health care system between $28 billion and $34 billion annually nationwide, and the country could save $5 billion to $7 billion by preventing 20 percent of infections, Chua said.

Hospitals use guidelines published by the federal Centers for Disease Control to try to prevent infections whenever possible.

Chua said strategies include being vigilant in looking for infections, good hand hygiene practices such as hand-washing and use of germ-killing hand gels after touching a patient, decontaminating equipment and the hospital environment and using checklists to make sure all steps are followed.

Correct diagnoses of infections and appropriate use of antibiotics also is important, he said.

"We don't want to overtreat (an infection) or it causes resistance. It has to be just right," Chua said.

Little things like making sure hospital employees aren't at work when they're sick or making sure they keep their nails trimmed -- to avoid giving bacteria a place to hide -- also help in the battle, he said.

KGH has a policy against letting employees wear artificial nails for that reason, Chua added.

w Look up infection rates for Washington hospitals at http://bit.ly/infectionrates.