Infections in Hospitals a Dirty Little Secret

Unsafe medical care is a major cause of death throughout the world. According to the estimates of the World Health Organization (WHO), one in 10 patients is harmed while receiving hospital care in developed countries.

In U.S. hospitals alone, almost two million patients suffer from health care-associated infection (HAI) each year and 99,000 of them die. Every year, health care-associated infections incur $33 billion in excess health care costs says Centers for Disease Control and Prevention (CDC) February 2009 report.

Methicillin-resistant Staphylococcus aureaus (MRSA) is one of the most common infections, especially in intensive care units. MRSA is highly resistant to antibiotics and one of every 20 of 368,600 patients treated in 2005 in U.S. hospitals for Staphylococcus aureaus died according to Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project data. In addition, about 85% of all MRSA infections were contracted in health care settings.

More than 2 million mothers and babies die from childbirth complication every year worldwide, 1.3 million people die because of unsafe injection practices and healthcare-associated infections are affecting 1.4 million people at any given time says WHO.

It is estimated that approximately 5% to 10% of all the patients admitted to the hospitals in developed countries and 10% of patients in acute care setting experience an adverse drug event.

In 2002, Member States of WHO agreed on World Health Assembly resolution on patient safety. In 2004, the World Alliance for Patient Safety was established and in May 2009, a list of 50 global priority areas for patient safety research was compiled.

In developed countries, organizational failures, lack of communication, poor safety culture, adverse drug events due to drugs or medication errors, inadequate safety indicators and care of the elderly are the major patient safety concerns. Patient safety issues during surgeries account for half of the avoidable adverse events resulting in disability and death says WHO.

Worse, in developing countries, 50% of medical equipment is unusable or not used because of the lack of skills resulting in procedures and treatments not being performed at all. In some countries, the proportion of injections administered with needles that are reused without any sterilization is as high as 70%. Each year, 1.3 million people die because of unsafe injections, mostly due to transmission of hepatitis B virus, hepatitis C virus and HIV. The risk of health care-associated infections in developing countries is 20 times higher than in developed countries.

Infections acquired in hospitals and related medical expenses, as well as litigation expenses including lost income, have cost some countries $6 to $29 billion a year.

Agency for Healthcare Research and Quality issued recommendations for patients to reduce risks and get safer health care. When in hospital, patients should make sure that their wristband has the right name on it, they should understand what will happen if they need surgery, they should ask questions, have the relative or friend with them, tell their health care providers which medicines and dietary supplements they are taking as well as get a second opinion about all the treatment options.

John Hopkins University funded by Agency for Healthcare and Quality developed "Keystone Project" which reduced the rate of bloodstream infections from intravenous lines by two-thirds in intensive care units throughout Michigan within 3 months. "Keystone's" checklist to prevent infections, among others, reminds doctors that before they put intravenous lines into patients they wash their hands and put on sterile gowns.

Source: WHO, CDC, Agency for Healthcare Research and Quality