Patients should NOT receive a “complimentary infection” courtesy of their hospital stay or procedure.
I’ve been a nurse for over 20 years and worked specifically in the Patient Safety arena for over 15 of those. I attended a one-year safety fellowship sponsored by the National Patient Safety Foundation early in my training which helped shape my career and passion. Using that knowledge, and supported by a wonderful mentor and company, I’ve been part of some of the most groundbreaking work to reduce unnecessary hospital-acquired infections (HAIs) with strong clinical results to boot. Through our research efforts, we achieved over a 40% reduction in HAIs for thousands of patients using a simple, yet effective, evidence-based skin and nasal decolonization routine. (See the results: JAMA, NEJM, LANCET).
So you may ask, how big of a problem are HAIs and have the majority of hospitals adopted this proven intervention? Let’s take a look at the facts…
Houston, we have a problem… Healthcare-associated infections are said to cost the US healthcare system $45 billion annually, and this is before taking into account the anticipated rise in resistance rates over the next 30 years. This $45 billion cost represents an annual ‘hospital infection tax’ to society currently costing ~$137 for every man, woman and child living in America. Unfortunately, the HAI rates and costs in other countries are either unknown or loosely tracked. The lack of publicity of infection rates around the world is impacting the opportunity for change. As with all problems, meaningful solutions will only come when the problem and scale are truly understood (data), when resources to tackle the problem are right-sized (capital) and when the desired outcomes are properly incentivized (rewards).
But wait, there’s more… Studies suggest that up to 70% of certain healthcare-associated infections may be preventable when evidence-based interventions are consistently applied. Having seen firsthand the variability in practice across multiple countries, there’s ample opportunity for improvement. Just ask a trusted nurse in your own community if practices vary by hospital and by physician? You’ll quickly learn that while, as consumers, we “think” all hospitals are taking the same steps to reduce your risk of infection, in reality, it’s most likely, they aren’t. Why, you ask? Let’s dive one layer deeper to understand part of the problem.
The literature suggests it takes an average of 17 years for research evidence to reach clinical practice. That means as new evidence is published, it may take up to 17 years to trickle down to your local hospital, unless you are the lucky patient admitted to the hospital that discovered the new evidence. Why does it take so long? One of the issues has to do with the concept of “generalizability”. That means the ability to achieve the same results with a different group of patients, or to see the same outcomes among patients in your community. Most hospitals don’t simply adopt a new practice without conducting their own research. Despite the fact an intervention may have been published in multiple top tier peer-reviewed journals, most hospitals want to study the intervention among their own patients which can take years to get administrative buy-in, research approval, patient participation, nursing support, biostatisticians, and the list goes on.
Imagine, a new life saving technology or intervention is published today, you along with your children may not benefit depending on how quickly the practice is identified and adopted locally.
This lag from the time new evidence is discovered to actual clinical practice wouldn’t be tolerated in other industries. Imagine if computer and mobile device makers took this long to adopt new discoveries. Apple, Microsoft, Google and others wouldn’t be world leaders today.
How many more “17 years” do we have? Adoption of best practices and evidence-based guidelines needs to be a top priority for hospitals, physicians, and nurses in order to reduce harm, healthcare waste, and improve clinical outcomes! Evidence needs to be disseminated more quickly to make this happen.
How do you become an advocate and reduce the lag time from discovery to bedside practice?
- First, read the published papers from leading journals on the benefits of skin and nasal decolonization. The concept is fairly simple, if I reduce the number of bacteria on my skin and in my nose that cause HAIs, I reduce my risk of infection. Yes, it’s that simple. The only difference between this and what we do to remove germs on a day-to-day basis are the products used on your skin and in your nose.
- Next, once you understand the benefits, share the articles with specific surgeons and nurses who care for the types of patients who may benefit (orthopedic, cardiovascular, spine, ICU, etc.). By sharing the articles, you not only become an educated consumer, you raise the bar for healthcare providers in your community.
- Finally, talk with your local hospital administrators and share the evidence. Ask them, “if you were the patient, wouldn’t you want this simple, inexpensive and effective treatment for yourself or loved one?”
Jason Hickok, RN, MBA with 15 years of infection prevention experience and responsible for establishing the first infection prevention program for the largest for-profit US healthcare system. I am also co-author on multiple research publications evaluating the effectiveness and benefits of skin and nasal decolonization among various patient populations.