Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety.

Interventional patient hygiene (IPH) has been defined as a comprehensive evidence-based intervention and measurement model for reducing the bioburden of both the patient and health care worker. The components of IPH are hand hygiene, oral care, skin care/antisepsis, and catheter site care. This practice form will provide evidence-based information for each of the components of IPH model and provide a strategy for the development, implementation, and monitoring of IPH protocols.

The effect of random voice hand hygiene messages delivered by medical, nursing, and infection control staff on hand hygiene compliance in intensive care.

Hand hygiene (HH) compliance in the intensive care unit has been studied extensively, with short-term, nonsustained compliance often because of lack of ongoing reinforcement. HH messages delivered by health care workers responsible for overseeing staff in the intensive care unit provided continuous reinforcement of HH. Compliance measured through product usage and reported as HH/bed-days increased by 60% for soap and sanitizer combined and 25% for sanitizer usage (P < 001).

Consumer attitudes about health care-acquired infections and hand hygiene.

Mandatory reporting and disclosure of health care-acquired infections have resulted in controversy over the perceived notion that consumers will not understand how to interpret data and that such information may negatively influence utilization of hospitals. The objective was to determine consumers' attitudes about health care-acquired infections, hand hygiene practices, and patient empowerment. A telephone survey based on a random digit dialing sample of all households in the United States was conducted. Consumers were asked about choosing a hospital, hand hygiene practices, and health care-acquired infections. Some 94% of respondents rated environmental cleanliness as very important. Hospital infection rates would influence decision making for 93% of consumers. Four in 5 consumers said they would ask their health care worker to wash and sanitize his or her hands. Our findings strongly suggest that (1) consumers will use infection data in selecting and/or leaving a hospital system and (2) consumers are ready to be empowered with information to ensure a positive outcome.

A descriptive review of malpractice claims for health care-acquired infections in Philadelphia.

BACKGROUND: Philadelphia's rate of malpractice filings per population is just over double the national median. Plaintiffs prevail in 44% of verdicts in Philadelphia compared with 20% for all US jury verdicts, with 24% of awarded verdicts in excess of $1 million. OBJECTIVE: To determine patient and procedure demographic data for malpractice claims involving health care-acquired infections (HAIs) in Philadelphia. METHODS: Risk managers representing 60 acute care hospitals, members of Pennsylvania Trial Lawyers Association, and a random sample of 560 lawyers representing plaintiff and defense cases obtained from the Philadelphia Court of Common Pleas database (1996-2002) were surveyed. The survey included the following: number of HAI cases by specialty, body site, isolate, and outcome. RESULTS: Overall response rate was 25% (n = 154 cases). The highest numbers of cases were in the specialties of orthopedics (69), general surgery (20), and cardiothoracic (20). Sites infected most often were as follows: knees (26), back (26), sternum (18), and harvest site (10). Methicillin-resistant Staphylococcus aureus (MRSA) was responsible for 45 of cases, S epidermidis for 27, methicillin-susceptible S aureus (MSSA) for 14, and Pseudomonas for 16. Twenty-seven of the cases were withdrawn, 27 settled, 11 pending, 9 plaintiff verdict, and 5 defense verdict. CONCLUSIONS: Although 72% of HAI malpractice cases in Philadelphia were either withdrawn or settled, when brought to trial, the plaintiff was more likely to succeed with a verdict. Our findings also suggest that the most frequent type of infection (class I-surgical site) and isolate (MRSA) are more likely to be seen as preventable HAIs because of National Nosocomial Infection Surveillance data showing lower infection rates for this class of surgery and therefore seen as easier for the plaintiff to show that the defendant failed to adhere to the standard of care for infection control.