January 12, 2013
Infection rates mixed at hospitals
Report shows Cortland below state averages, Cayuga Medical Center above
Infection rates in 2010 and 2011 were below state averages at Cortland Regional Medical Center, while the opposite occurred at Cayuga Medical Center, according to the state’s annual Department of Health Hospital Infection report.
The study shows that in 2011 CRMC had 15 cases of clostridium difficile, out of 21,917 patient days in the hospital. Otherwise known as “C.diff,” the infection causes severe diarrhea and can lead to other serious intestinal issues.
C.diff is most common in elderly people and those who have recently taken a course of antibiotics, according to the state Department of Health.
That rate of infection is up 1.7 percent from 2010, when the hospital had 17 cases out of 24,692 patient days, but the figure is still below the state average.
Overall, the rate of infection for the state was 8.5 infections per 1,000 patient days.
“There are many ways that can contribute to or cause a hospital acquired infection,” said Dr. Robert Karpmann, vice president of medical affairs at CRMC. “Contaminated gear, improper hand washing, hospital visitors — the list goes on. The way to deal with it is to continue to make sure all procedures are followed.”
He said that it is something the hospital routinely focuses on, adding that he thought the hospital “fared very well” in the state’s report, which tracks three categories of infections: C.diff, central line-associated blood stream infections and surgical site infections in three types of operations.
The fifth annual report was released in December.
CRMC’s colon surgery infection rates also were below the state average. The hospital had one case in 2010 out of 36 procedures — 2.5 percent rate, according to the report. There was one infection out of 33 cases — a rate of 3 percent — in 2011.
The state rate was 4.8 in 2010 and 4.9 the following year.
There were zero infections for hip surgeries and there were no procedures in the third surgical category, coronary artery bypass graft.
In contrast, Cayuga Medical Center did not fare well in colon infection rates, being categorized in the report as “significantly higher than the state average.”
In 2010, Cayuga had seven infections out of 55 procedures — 12.7 percent — and nine out of 67 procedures — 13.4 percent — in 2011.
In C.diff cases, Cayuga had six out of 28,834 patient days in 2010 and 13 cases in 29,650 in 2011. That works out to 0.02 percent in 2010 and 0.04 percent in 2011.
Dr. David Evelyn, vice president of medical affairs at Cayuga Medical, said the hospital did not do as well as it had hoped. He said the hospital now tracks infections “very closely” and has taken action.
“We have made changes to our processes,” he said in a phone interview. “We looked at the way we deliver antibiotics, as well as many other factors.”
He said that so far, there were “only seven cases of infection in 2012.”
Karpmann said no matter what figures are released, the hospital is constantly working on new ways to prevent patient infection.
“I think we did very well overall,” he said. “But there is always room for improvement until we get down to zero infections across the board.”
He said doctors at the hospital must wash their hands before and after entering any patient rooms. He also said that the hospital has discovered through internal studies that lab coats and other clothing worn by hospital staff can lead to contamination.
With blood stream infections, CRMC had two central line infections out of 802 days in the intensive care unit in 2011 and no infections the prior year. A central line is a long, thin tube that is placed into a large vein in the body, usually in the neck, chest, arm or groin, and is used to give patients fluids, medications and to monitor the patient’s condition.
Cayuga had two central line infections out of 1,310 ICU days in 2011 and zero the prior year.
“We closely monitor our infection rates, implementation prevention and control interventions, measure the effectiveness of those interventions and make improvements as needed,” said Maria Whitaker, CRMC infection preventionist.
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