Thorough controls help UC Davis limit hospital-acquired infections
Through a rigorous and coordinated infection prevention program, UC Davis Medical Center has achieved a strong record among hospitals nationwide for limiting the incidence of hospital-acquired infections.
The medical center's infection-prevention and control program is designed to protect patients, health-care workers and visitors. The program aims to thwart a variety of potential infections, including tuberculosis, influenza and infections caused by pathogens resistant to antibiotics. The surveillance program incorporates measures recommended by leading authorities, such as the Centers for Disease Control and Prevention, the Association for Professionals in Infection Control and Epidemiology, and the Joint Commission.
A national problem
Each year, hospital-acquired infections in the United States sicken nearly two million people, killing about 99,000 of them, according to the Centers for Disease Control and Prevention. The most common health-care-associated infections are urinary tract infections (32 percent), surgical site infections (22 percent), pneumonia, (15 percent) and bloodstream infections (14 percent).
At UC Davis Medical Center, patient safety is the top priority, and the medical center works diligently to eliminate all possible cause of health-care-acquired infections, with the goal of eliminating them completely.
Despite the medical center's efforts, its patients do occasionally get infections, as they do in all hospitals. Infection can occur in many different ways, both inside and outside of the hospital. Infections that occur within 30 days of surgery are treated as a hospital-acquired infection, even though the exact source may be unknown.
Low rate of serious infection
The medical center reports its health-care acquired infections and rates to independent organizations. It does so to compare itself with other institutions and to provide a great level of public visibility to the medical center's conditions and processes. For example, patient data from the medical center is submitted to the University HealthSystem Consortium, an alliance of academic medical centers and their affiliated hospitals in the United States.
UC Davis uses the consortium to track, trend and compare its performance with 89 other university hospitals in more than 60 key performance measures and to supplement its internal continuous quality improvement efforts. Measures range from mortality rates and post-operative sepsis (the most serious kind of infection) to bleeding and respiratory failure.
Within the consortium, UC Davis had among the lowest post-operative sepsis rates for 2007, ranking 12th among the 89 members for the year. In addition, UC Davis ranked the best (with a zero sepsis rate) for October through December 2007, the most current period for which data is available.
Above national average for appropriate antibiotic use
UC Davis also is a full participant in the Hospital Quality Alliance, a partnership between the Joint Commission and the Centers for Medicare & Medicaid Services to increase public transparency and improve care in 45 critical measurement areas.
Performance information, including factors that have an impact on infection, is publicly available on the Hospital Compare Web site. Data collected on the appropriate use of antibiotics before and after surgery for the Surgical Care Improvement Project specifically relate to infection.
UC Davis ranks above the national average in both of these areas. It has a rate of 96 percent compared to 82 percent nationally for the use of antibiotics before surgery, and a rate of 85 percent compared to 78 percent nationally for the use of antibiotics after surgery.
For the past 22 years, UC Davis also has been a voluntary member of the National Health Safety network, developed and conducted by the CDC.
Infection control essentials
UC Davis' infection prevention and control program aims to prevent the transmission of resistant organisms. It includes:
- A rigorous hygiene program in which health-care providers clean their hands before and after contact with patients.
- Limiting contact with those who have antibiotic resistant infections through the use of gloves and gowns, and by separating these patients from other patients.
- Cleaning and decontamination of the facilities and equipment, especially items close to patients, such as bedrails and bedside equipment.
- Monitoring the cleaning, disinfection and sterilization of instruments and equipment used for patient care to ensure they are free of drug resistant bacteria.
- Regular testing of patients who are most at risk to acquire drug resistant strains of bacteria, including those with weakened immune systems.
- Educating staff on how to prevent the transmission of resistant organisms, as well as how to identify risky practices that could result in transmission.