Specter of infection

Dr. Jeremy Reeves marks a spot on Julius 'Tony' Washington's back before the patient went into the operating room for kidney related surgery on Wednesday at MUSC. Reeves will monitor Washington after the surgery.

S.C. hospitals join fight against patient complications

Two years ago while living in the Midlands, Jo-Ann Pinel lost her next-door neighbor and close friend to a central line infection.

Now a clinical manager for the operating room at Roper Hospital, Pinel recently sat in front of a video camera and recalled in four emotional tapings the 26-year-old mother's battle.

Central lines are placed in large veins to allow fluids or medication to be given for a long period of time. These lifelines can turn fatal when a microbe finds its way to the catheter and traces a path directly to the heart and lungs.

Unintended physical injury occurs at a rate of 40,000 instances per day in U.S. hospitals, according to the Institute for Healthcare Improvement. The Centers for

Disease Control and Prevention counts surgery site infections, drug reactions and bedsores among the complications that affect 2 million people annually.

Medicare announced in August that it will not pay for eight kinds of hospital errors beginning Oct. 1, 2008. Private insurers might follow suit and leave hospitals to pick up the bill. With mounting economic pressure, hospitals across the state are joining safety campaigns or beginning their own.

In December, the Institute for Healthcare Improvement launched the national 5 Million Lives campaign, sponsored primarily by America's Blue Cross and Blue Shield health plans. All 67 hospital systems in South Carolina are participating and refocusing on best practices, precautions that are proven to reduce infections.

The training video featuring Pinel is shown to Roper St. Francis Healthcare staff as part of the 5 Million Lives hospital safety campaign.

"It's important for (staff) to personalize a case," Pinel said. One out of five patients who get a central line infection dies.

The simplest example of a best practice is doctors washing their hands thoroughly, said Dr. Mike Schmidt, professor of microbiology and immunology at Medical University of South Carolina.

A patient ill in a hospital bed might pick up a microbe from a health care worker, family member or visitor. Because the patient is unhealthy, an infection can develop, Schmidt said.

To reduce the probability of infection, MUSC swabs the nose of every patient for drug- resistant bacteria. "That's what we're most scared of — whether we'll acquire it from a patient," he said.

Chief Medical Officer of Roper St. Francis Healthcare, Steven Shapiro, oversees quality initiatives. "We don't want you to be any more harmed coming out of our hospital," he said. "We are trying to develop a culture of safety where everyone does the right thing."

Roper St. Francis Healthcare recently hosted visitors from the 5 Million Lives campaign who want to use the hospital system as a mentor hospital for its initiative.

In the spirit of collaboration, representatives from state hospitals meet quarterly in Columbia to share prevention techniques. "We look at hospitals with the most success and see what they're doing well," said Dr. Rick Foster, senior vice president for quality and patient safety with the S.C. Hospital Association.

Finding information about hospitals' infection rates is not easy. Last year South Carolina joined the handful of states that require the reporting of infections.

The state started to receive infection data in July but will not make the information public until 2009. The reason for the delay is to allow the state time to gather year-to-year comparison data so people can put the numbers in context, Foster said.