An Avoidable Killer

When you go to a hospital, odds are you don't expect to come down with problems you didn't have before.

But, experts say, one out of every 20 hospital patients in the United States, some 2 million in all, comes down with an infection each year. And an estimated 103,000 of them die.

Infections contracted in hospitals are the fourth largest killer in the U.S., causing as many deaths as AIDS, breast cancer and auto accidents combined.

Former New York Lt. Governor Betsy McCaughey, who founded the Committee To Reduce Infection Deaths (RID), tells The Early Show co-anchor Harry Smith Wednesday that such infections are getting more dangerous, but they're preventable.

She adds that most states allow hospitals to keep their infection rates secret, so you don't know how clean a hospital is before checking in.

The single most important way to reduce hospital infection, according to the federal Centers for Disease Control and Prevention, is for doctors and other health care workers to clean their hands in between treating patients. Research indicates that doctors clean their hands before treating a patient only 48% of the time, and the rate is significantly worse at some hospitals.

Hospital infections add $28 billion to $30 billion to the nation's health costs each year.

McCaughey says the danger is growing because, increasingly, these infections can't be cured with commonly used antibiotics. One of the most dangerous germs is methicillin-resistant Staphylococcus aureus, or MRSA, which doesn't respond to most drugs.In 1974, only two percent of staph germs were MRSA. By 1995, 22 percent were, and now that number is over 60 percent, and still rising. Patients who survive these drug-resistant germs sometimes have to spend months in the hospital and go through many surgeries to cut out infected tissue.

Patients are frequently told there's always a risk of infections in hospitals but, McCaughey points out, Denmark, Holland, Finland and a few hospitals in the U.S. have shown that's not true.

Denmark, Holland, and Finland also faced soaring MRSA rates, but brought them down below one percent, through rigorous enforcement of hand washing rules, meticulous cleaning of rooms and equipment after each patient, the use of gowns and disposable aprons to prevent doctors and nurses from spreading deadly germs on their own clothing, and testing all patients coming into the hospital and isolating those carrying the germ.

Too few hospitals in the U.S. have taken these precautions, McCaughey notes, but those that have are proving they work. The University of Virginia Medical Center totally eradicated MRSA, and the Veterans Administration Hospital in Pittsburgh has reduced it 85 percent.

Dirty hands, unclean rooms, inadequately cleaned equipment, contaminated uniforms, and lax procedures cause the infections, McCaughey explains.

Doctors and nurses fail to wash their hands in between patients more than half the time. And don't be misled by gloves, McCaughey suggests. If caregivers put their gloves on without washing their hands first, the gloves are contaminated, too.

Three quarters of patients' rooms have MRSA, studies show, because hospitals don't clean rooms adequately between patients. Stethoscopes and blood pressure monitors are contaminated with live bacteria.So what can people do to protect themselves?

A detailed list of suggestions appears on the RID Web site but, in a nutshell, McCaughey says you should ask your doctor to wash his or her hands, make sure medical equipment is sterile, use antibacterial soap before surgery, don't shave any body parts and make sure your doctor gives you antibiotics prior to surgery, and ask to limit the number of people in the operating room.

Hospitals "absolutely" can afford to take precautions as well, McCaughey says. In fact, they can't afford not to. When a patient develops an infection after surgery, it doubles the cost of care. If it's a staph infection, the cost is tripled. Hospitals rarely get paid for the extra weeks and months a patient has to stay in the hospital after getting an infection. Infections wipe out hospital profits. They are also adding $28-$30 billion a year to the nation's health care costs.

Most states allow hospitals to keep their infection rates secret, McCaughey laments, but RID is pushing hard to get every state to require hospital infection report cards. You can find out if your local deli or restaurant has been cited by the state health department for a violation, but you can't find out which hospitals have an infection problem, she observes, calling it "ridiculous.:

In England, McCaughey says, infection rates are posted at the entrance to hospitals. Americans deserve the same information. In the last year, four states have passed laws that will eventually provide for hospital infection reporting: Illinois, Florida, Pennsylvania and Missouri.