Sunday, July 29, 2007

Swabs on Admission

A Simple But Effective Innovation

Since 1968, when MRSA (Methicillin Resistant Staphyloccus Aureus) organisms were first identified, hundreds of thousands of hospital patients have died from MRSA infections. This is now such a problem that a few hospitals across America have resorted to routinely swabbing the nasal passages of all patients being admitted. Those identified as + carriers are confined to isolation rooms with a red line outside. A sign outside warns of the dangers of infections and the necessity to wear gowns and gloves. Used BP cuffs are discarded, and each room has its own stethoscope.

This simple but effective approach has reduced infections by 78% at the Pittsburgh VA. The infection control program costs the VA $500,000 a year, including tests kits, three workers’ salaries, and $175 per patient for gloves, gowns, and hand sanitizers. The hospital, which has a $431 million budget, says it saves $900,000 due to the fall in infections. This and other hygiene measures – such as changing urinary and vascular catheters often, cleaning the mouths of ventilator patients, and no shaving surgical sites – may become routine in hospitals across America. Several European countries, Finland and the Netherlands, have virtually eliminated MRSA infections through aggressive infection-control measures. Several states have passed legislation requiring hospitals to test high risk patients. But the problem is that sometimes deaths result form what started as a routine procedure.

Innovations to make health care better, safer, less expensive, and more effective need not be complicated, they can be breathtakingly simple – like constantly reminding people of the importance of hand hygiene and treating all patients as a possible carrier of MRSA organisms.

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