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U.S. sets hospital infection control goals

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Reuters Health

Tuesday, January 6, 2009

WASHINGTON (Reuters) - Urinary infections caused by improper use and placement of catheters are the top cause of infections among hospital patients, but simple measures can prevent them, the U.S. government said on Tuesday.

The Health and Human Services Department released a plan to reduce hospital infections, which kill an estimated 99,000 people a year, affect 1.7 million patients and cost nearly $20 billion.

Besides catheter-linked urinary infections, the most common causes of infections linked with hospitals are surgical site infections, bloodstream infections from intravenous lines, and pneumonia from ventilators, HHS said in the report.

"Infections associated with Clostridium difficile and MRSA (methicillin-resistant Staphylococcus aureus) also contribute significantly to the overall problem," the report reads.

It recommended several specific steps hospitals should take to tackle the problem:

-- Use catheters only when appropriate and only as long as needed. The report said that some nursing homes improperly use catheters to manage incontinent patients.

-- Ensure that only trained people insert or maintain catheters.

-- Use sterile techniques including a cap, mask, sterile gown, sterile gloves, and a large sterile drape, for the insertion of central venous catheters.

-- Do not remove hair before surgery unless it will directly interfere with the operation.

-- Adequately control blood sugar in diabetic patients.

-- Use ventilation only as needed and non-invasively when possible.

-- Keep operating room doors closed during surgery except as needed for passage of equipment, personnel, and the patient.

-- Use steam sterilization by autoclave or wet heat pasteurization to sterilize equipment that touches mucous membranes of the lower respiratory tract.

Also on Tuesday, the Centers for Disease Control and Prevention said that failures to follow infection control practices had put more than 60,000 patients at risk for hepatitis B and C over the past 10 years.

Most commonly, health care workers re-used syringes or let blood contaminate drugs, equipment and devices, CDC experts reported in the Annals of Internal medicine.

"Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected," Dr. John Ward, director of CDC's Division of Viral Hepatitis, said in a statement.

"No patient should go to their doctor for health care only to leave with a life-threatening disease."


Reuters Health

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