Hand Hygiene: Are We Still Failing in Healthcare Facilities?

The Leapfrog Group, an advocate of transparency in quality and safety of care in U.S. hospitals, requests that adult general acute care and pediatric hospitals voluntarily complete a survey that will result in data reported publicly on issues that concern healthcare purchasers and consumers. The reported data includes hospital-acquired infections.

Leapfrog includes measures that are aligned with and endorsed by the National Quality Forum (NQF) as well as the Center for Medicare and Medicaid Services (CMS) and The Joint Commission.

Several studies relating to hand-hygiene practices of clinicians show varied results. Consequently, Leapfrog asks hospitals to report on the availability of in-place hospital policies and accountability requirements necessary to achieve overall compliance.

Leapfrog developed 10 recommended "safe practices" for the purpose of effective hand hygiene, including hospital-wide education, report/record keeping and submission to relevant hospital committees and board of directors, and policy and procedure implementation.

The results of the 2014 study (pdf) reveal that while progress is being made in the hand-hygiene compliance arena, hospitals still have a way to go despite an increase in the percentage of hospitals meeting all 10 of Leapfrog’s hand-hygiene practices. In 2013, 69% of hospitals reportedly met all 10 practices, while in 2014, that number was 77%. Amongst other data, the study showed that urban hospitals outshine rural facilities.

The data also showed that Florida was one of the top performing states in the country. The top five states were:
1. Oregon (with 100% of hospitals complying with handwashing regulations)
2. New Jersey (94%)
3. Florida (93%)
3.  Nevada (93%)
5.  Tennessee (90%)

The bottom five states were:
50. Wyoming (44%)
50. Wisconsin (45%)
48. Arizona (50%)
48. New Mexico (50%)
46. Missouri (59%)

Hospitals are encouraged to continue striving towards 100% hand-hygiene compliance as the nation works together to prevent harm, including death from hospital-acquired infections.

Phenelle Segal
Jun 18, 2015

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Hospital-Acquired Infections in Florida: CDC Data

The federal government has gained strength over the years in promoting transparency within hospitals with respect to many patient safety factors that include prevention of infections. Mandates for public reporting have been in effect for several years nationwide and the Centers for Disease Control and Prevention (CDC) has the responsibility for tracking six frequently occurring healthcare-acquired infections including, but not limited to, certain surgical site infections (resulting from colon and hysterectomy operations), central line-associated bloodstream infections and catheter-associated urinary tract infections. One in 25 patients develops an infection while receiving inpatient care and one in nine patients who develop an infection will die.

A December column in the Miami Herald reported that "The CDC collected the data on infections from 4,683 hospitals around the country, including 179 in Florida, between October 2012 and September 2013." The article highlights that seven Miami-Dade hospitals fell below national standards for combating infections acquired by patients in hospitals, and patients at one hospital in Miami were more likely to develop infections than patients at any other hospital in South Florida, according to the data. This hospital did worse than benchmarked hospitals in four different categories of healthcare-acquired infections. Only one other hospital in Northern Florida, a teaching hospital, underperformed in more than two categories, and a total of only seven hospitals in the nation underperformed in four categories.

The article notes that "As a whole, Florida hospitals are performing significantly better than national benchmarks in three areas: bloodstream, urinary tract and colon infections, according to CDC data released in March."

A representative from the Florida Hospital Association, a trade group, added that overall, "hospitals in the state were working together to find effective strategies for reducing infections and other hospital-related injuries like falls and medication overdoses. Patients and providers would benefit from focusing on the problems because hospitals have higher treatment costs when patients develop complications under their care."


To read the Miami Herald's in-depth report, access the column by clicking here.

Phenelle Segal
Jan 5, 2015

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