Nursing study: Many hospitals are ‘lax’ in infection control protocols

Hospitals have plenty of protocols in place to curb infections, but many clinicians fail to follow them, concludes a new Columbia University School of Nursing study published this month in the American Journal of Infection Control. What the study calls “lax compliance” with infection-control protocols—even in intensive care units (ICUs)—could have serious impact on what a nursing home provider inherits in a resident referral.

In the study, Patricia Stone, PhD, MPH, RN, FAAN, the Centennial Professor of Health Policy at the nursing school, investigated compliance with evidence-based policies to prevent infection in 1,653 ICUs at 975 hospitals nationwide. The study focused on three of the most common hospital infections that also plague nursing homes: central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia and catheter-associated urinary tract infections (CAUTIs).  

In one highlight from the study, researchers found that although 90 percent of hospital ICUs had a checklist of protocols in place to guard against CLABSIs, “the policies were followed only about half of the time,” noted the university release.

Hospital ICU compliance data for the prevention of CAUTIs were equally dismal; the study reported a lack of universally accepted checklists to prevent them and that “one-third of hospitals had no prevention polices in place to prevent these infections.” In addition, the study states: “Evidence-based practices related to CAUTI prevention have not been well implemented. The CDC's CAUTI guidelines were not published until 2009, and, as documented in this study, hospitals across the country are at varying stages of implementing, reinforcing, and measuring the outcomes related to this set of guidelines. Clearly, more focus on CAUTIs is needed, and dissemination and implementation studies to inform how best to improve evidence based practices should be helpful.”

Improving the protocols and their use within hospitals would benefit from infection-control certification of staff and the use of electronic monitoring systems, the study concluded.

Notes the study’s lead researcher Stone, who has published extensive research on healthcare-associated infections (HAIs) and has contributed to prevention guidelines issued by the Joint Commission: “Hospitals aren’t following the rules they put in place themselves to keep patients safe. Rules don’t keep patients from dying unless they’re enforced,” she said in a university release about the study. “We’ve come a long way in understanding what causes healthcare-associated infections and how to prevent them. This study shows we still have a long way to go in compliance with well-established, life-saving and cost-saving measures that we know will lower infection rates.”

HAIs kill an estimated 10,000 people a year nationwide, according to the Centers for Disease Control and Prevention (CDC). HAIs remain a weighty challenge for all long-term care facilities and have been brought to the forefront, following the federal initiatives for reducing HAIs issued by the CDC.

Related article:

Bloodstream infections addressed in Joint Commission toolkit

To see Patricia Stone discuss the study findings, click on the link provided by the Columbia University School of Nursing:

To see more stats and info about preventing HAIs, click here.

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