Simple techniques slash hospital infections: meeting

WASHINGTON Sat Mar 21, 2009 3:17pm EDT

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WASHINGTON (Reuters) - Jasper Palmer didn't think he was doing anything special when he balled up his paper hospital gown and stuffed it into one of his gloves. He just knew it was tidy and would stop the gown from spreading germs.

But the technique is one of the simple innovations that has reduced rates of infection with so-called superbugs at his and other hospitals by 26 percent to 62 percent, infection control experts told a meeting of the Society for Healthcare Epidemiology of America in San Diego on Saturday.

The U.S. Centers for Disease Control and Prevention estimates that 94,000 Americans get serious, invasive MRSA infections each year and nearly 19,000 die. Treating these patients costs between $3 and $4 billion a year, according to an estimate by Dr. Larry Liu of Pfizer Inc.

Reducing such costs is a goal of the just-started healthcare reform effort by President Barack Obama and Congress.

Palmer, a patient escort who wheels patients around the hospital, knew methicillin-resistant Staphylococcus aureus, or MRSA, was becoming more common and infected patients must be treated with great care so the bacteria do not spread.

Anyone who encounters a MRSA patient must wear gloves and gown, and yet the infection was spreading anyway. This is partly because hospital workers do not wash their hands as often or as thoroughly as they should, but experts know other factors are spreading germs.

"I figured that the safest way to reduce the risk of cross-contamination was to get rid of these gowns," Palmer, who works at Albert Einstein Healthcare Network in Philadelphia, said in a telephone interview. But the invisible microbes can be spread just from handling a contaminated gown.

"What I was doing was ... grabbing the outside of the gown then wrapping it up into a little ball and disposing of it inside my glove," Palmer said.

UNEXPECTED BONUS

This made a compact package that had an unexpected bonus, said Dr. Jeff Cohn, chief quality officer at Einstein.

"One of the barriers to people not doing what they are supposed to do is if they go into a patient's room and see gowns and gloves spilling out over the trash can, they say 'well if I put a gown on, there is going to be no place to dispose of it'," Cohn said.

"So if Jasper's practice winds up being everybody's practice ... then people won't have that as an excuse."

And it is working. Palmer's idea, which he has successfully taught to fellow workers, was one of three so-called Positive Deviance approaches that the CDC has found reduced infection rates at hospitals. PD is based on the premise that in any group there are natural problem-solvers.

"It is innovative activities, such as Positive Deviance, that may have a transformative impact on infection control efforts, suggesting that MRSA and possibly other drug-resistant infections need not be inevitable," Rosemary Gibson of the nonprofit Robert Wood Johnson Foundation, which helped sponsor the CDC study, said in a statement.

And having the idea come from inside the hospital's own staff helped other staffers accept it more readily, said Cohn. "Jasper, who is a patient transporter, is the one being viewed as an expert and teaching quote unquote professionals -- nurses, doctors," said Cohn. "This is flipping things on their heads."

(Reporting by Maggie Fox, editing by Vicki Allen)

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