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"It's in all hospitals, on all floors," says the East Haven mom, who became a patient advocate because of her son's ordeal and now volunteers at Yale-New Haven, educating gynecologic-oncology patients about hygiene practices meant to protect them in the hospital and back at home.
Hospital-acquired infections (HAIs) kill nearly 100,000 people a year nationwide, according to the Centers for Disease Control and Prevention. Here in Connecticut, "hospitals and clinicians are taking action to ensure that the risk of infection is minimized," says Dr. Brian Fillipo, vice president of quality and control for the Connecticut Hospital Association. At the top of the list is hand hygiene.
Although it's known that many infections are transmitted by touch, some health-care workers "don't wash their hands and don't gown and glove, even when contact precautions are posted," Capasso discovered while tending to her son.
To encourage compliance, some hospitals actively monitor hand washing by employees and visitors. "This is a serious issue and the problem is, it's invisible," says Dr. Steven Schneider, vice president for medical affairs at Waterbury Hospital Health Center. "If someone threw dirt on a patient, we would all be aghast. Not washing hands before touching a patient is a subtler way of doing the same thing."
For nurses having to clean their hands 40 or 50 times a day (doing so before and after treating a patient is accepted practice), canisters of alcohol hand-rub solutions speed up and simplify the process. Yale-New Haven introduced them in 2001, hoping to overcome obstacles like "there aren't enough sinks" or "the soap makes my skin dry," according to Dr. Louise Dembry, hospital epidemiologist.
Medical progress makes for more infections, says Dembry. "As medicine advances, we do more procedures and use more devices that put patients at more risk because we are breaking through our body's natural barriers, such as skin and gut," she explains.
A recent nationwide study concluded that about 5 percent of patients in U.S. health-care facilities are infected with or colonized with MRSA, but MRSA is hardly the only danger, says Dembry. Infectious-disease specialists battle other drug-resistant organisms, as well as yeast, fungi and viruses that cause infections.
Dealing with infection prevention encompasses all departments. Scrutinizing housekeeping and equipment disinfection, avoiding unnecessary catheterization, using antibiotics appropriately and screening high-risk patients are key strategies in the microbial war zone.
At St. Vincent's Medical Center in Bridgeport, "doctors right down to the cleaning people" sit on infection-prevention committees, according to Dr. Joanne Passalacqua, hospital epidemiologist. Their efforts to halt deadly ventilator-related pneumonia are succeeding, she says, thanks to a protocol that includes elevating the bed to at least 30 degrees, providing more intensive mouth cleaning, and taking steps to remove the ventilator at the earliest possible time.
Stamford Hospital, which has reduced its overall infection rate over the last decade, screens high-risk patients for MRSA and has budgeted for a costlier but faster test to start later this year. Since many patients bring MRSA into the hospital from other health-care facilities or the community, detecting the germ in the emergency room or at the time of admission should reduce transmission, says Dr. Michael Parry, director of infectious diseases. The extra expense-$40 a test versus $6-will pay for itself in the long run, he believes.
Bonnie Capasso believes hospitals should make public their rates of hospital-acquired infections. Connecticut doesn't track them now, but beginning in October hospitals will have to monitor the incidence of bloodstream infections related to the use of central lines in intensive-care units. Eventually, other infections may be recorded, enabling consumers to comparison-shop for safer health care.
Patients, too, can take steps to protect themselves while in the hospital. Ask hospital workers if they have cleaned their hands before they examine you, advises Schneider. And ask friends and relatives with colds or other illnesses not to visit. "This only will work through a team effort," he says.
