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Hospitals get good marks for infection control

December 28, 2006|by JENNIFER FITCH

CHAMBERSBURG, Pa. - A visit to hospitals in Franklin and Fulton counties is less likely to result in a hospital-acquired infection than elsewhere in Pennsylvania, an independent state agency has reported.

In 2005, Chambersburg Hospital had a rate of seven hospital-acquired infections per 1,000 cases, Waynesboro Hospital had 2.2 per 1,000 and Fulton County Medical Center had 3.3 per 1,000, according to the Pennsylvania Health Care Cost Containment Council report.

The state average was 12.2 per 1,000 cases, according to the report.

"Overall, we have a very, very low rate of hospital-acquired infections," said Ericka Kalp, infection control manager at Chambersburg Hospital. The rates fluctuate and typically peak during influenza season, she said.

Chambersburg and Waynesboro hospitals, both part of the Summit Health system, have ongoing and new initiatives to further reduce the rate of hospital-acquired infections, officials said.

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Kalp's office handles prevention education for visitors and staff, and makes daily rounds to ensure carts of gowns, gloves and masks are fully stocked.

"We've sort of revamped the entire infection control program," Kalp said. "We're trying to get everyone on the same page with infection control here."

Urinary tract infections served as the primary type of hospital-acquired infection at Fulton County Medical Center and Chambersburg and Waynesboro hospitals in 2005, according to the council's report.

Dr. Mohammed Z. Ali, who specializes in infectious diseases, said the Franklin County hospitals are trying to perform fewer catheterizations, which are the vast contributors to urinary tract infections contracted in the hospital.

Urinary tract infections develop from contaminated bladder tubes or germs that are on the genitals and pushed into the bladder, Ali said. Hand hygiene is key in preventing urinary tract infections, he said.

Infections also can develop from surgery, doctors said.

Written protocols for Summit Health divide surgeries into three categories, each with a different risk of infection. Those categories are clean, clean-contaminated and contaminated, and they vary mostly by whether the surgery is performed within the body.

Antibiotics given before, during and after surgery reduce the risk of infection.

Timing is very important in administering those antibiotics, Ali said. Antibiotics usually are started within 30 minutes of the first incision and stopped within 24 hours of the end of surgery, he said.

Ali said that while studies have been done to determine the origin of bacteria that causes surgical-site infections, there is no clear answer. Much could be from the patient's sweat glands, he said.

Dr. Thomas Anderson, vice president of medical affairs, urged following doctors' instructions for surgery preparation, including showering.

Diabetics are more apt to infection, Ali said. Reasons include narrow blood vessels that don't carry enough oxygen to deliver oral antibiotics to extremities and increased levels of sugar, which feeds bacteria, in the body.

"We have started recently to start an insulin drip for everyone with diabetes," Ali said.

Anderson said Summit Health participates in a VHA Inc. program seeking to eliminate Methicillin-resistant staphylococcus aureus with hand washing and isolation. VHA, in a press release, estimated the antibiotic-resistant bacteria causes 50,000 of the 90,000 deaths each year that result from hospital-acquired infections in the United States.

Kalp said staff members in Summit Health's hospitals are taught to divide isolated patients with infections into four categories - contact, droplet, airborne and reverse - to reduce the risk of spreading infection to other patients.

Contact diseases, spread primarily through infectious diarrhea, require that staff wear gowns and gloves. Gowns are not required for droplet and airborne diseases.

Airborne diseases include tuberculosis, chickenpox and measles. Those patients are put in a negative air pressure room, meaning infected air goes through a high-efficiency particulate air (HEPA) system and releases outside.

Droplet diseases include bacteria meningitis and influenza, which can be inhaled and affect the lungs.

"When they sneeze or cough, the droplets can travel within 3 feet," Ali said.

Visitors to Chambersburg and Waynesboro hospitals now are greeted with literature from the "Protect our Patients" program launched by The Clorox Co. and the Association for Professionals in Infection Control & Epidemiology Inc. The pamphlets, signs and quizzes urge visitors to "Share Your Care - Not Your Germs" and list means by which to control the spread of infection.

"We need to make everyone aware of it," Kalp said, noting the goal is what it always has been - zero infections.

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