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Why hospitals are making patients sicker

Cdiff_400pxConsumers expect hospitals to be sterile, safe environments where sick people get better, not sicker. However, an analysis by Consumer Reports shows many hospitals have problems curbing infections.

Consumer Reports is expanding its hospital ratings to include information about two common and deadly infections: methicillin-resistant staphylococcus aureus or MRSA and clostridium difficile or C. diff.

Each year about 648,000 people in the United States develop infections during a hospital stay and about 75,000 die, according to the Centers for Disease Control and Prevention.  That’s more than twice the number of people who die each year in car crashes.

“High rates for MRSA and C. diff can be a red flag that a hospital isn’t following the best practices in preventing infections and prescribing antibiotics,” said Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center. “The data show it is possible to keep infection rates down and in some cases avoid them altogether.”

MRSA infections claim the lives of more than 8,000 patients each year in the U.S. and sicken almost 60,000. C. diff is even more prevalent. Each year, about 290,000 Americans develop a C. diff infection in a hospital or other health care facility and at least 27,000 of them die, according to the CDC. 

To develop ratings for MRSA and C. diff, Consumer Reports analyzed information hospitals reported to the CDC. It added that information to data on central-line associated blood stream infections, surgical-site infections, and catheter-associated urinary tract infections for composite infection score. 

Consumer Reports’ ratings reflect how hospitals performed between October 2013 and September 2014. The data are updated quarterly.

To earn Consumer Reports’ top rating in preventing MRSA or C. diff, a hospital had to report zero infections – 322 hospitals across the country were able to achieve that level in the MRSA ratings, and 357 accomplished it for C. diff. Only 105 reported having neither infection.

Several high-profile hospitals got lower ratings for MRSA, C. diff, or both, including the Cleveland Clinic, Ohio: Johns Hopkins Hospital, Maryland; Mount Sinai Hospital, New York City; and Ronald Reagan UCLA Medical Center, Los Angeles.

“Hospitals are directly responsible for many of these infections and should be able to prevent them,” said Lisa McGiffert, director of Consumer Reports’ Safe Patient Project. “While sick patients should not be expected to have to advocate for safe treatment, speaking up can help to protect them from superbug infections.”

Good hospitals focus on the basics: using antibiotics wisely and keeping their facilities clean. These practices combined with federal mandates for public reporting of some infections have already led to reduced rates of certain infections, McGiffert said. 

However, Consumer Reports believes hospitals need to do more including:

  • Consistently follow established protocols for managing superbug infections, such as ensuring that all staff use gowns, masks, gloves, and other protections appropriately.
  • Being held financially accountable, including covering all costs for treating infections patients pick up during their stay, even costs after discharge.
  • Have an antibiotic stewardship program. That should include mandatory reporting of antibiotic use to the CDC.
  • Accurately report how many infections patients get in the hospital. And, the government should validate those reports.
  • Promptly report outbreaks to patients, as well as to state and federal health authorities. Those agencies should inform the public so that patients know the risks before they check in.

Consumer Reports suggests patients also be their own advocate and:

  • Question the use of antibiotics. Talk to doctors about only using antibiotics when necessary and, when needed, prescribing drugs that are appropriate for their specific infection.
  • Insist on a clean hospital room. If it looks dirty, ask for it to be cleaned.   Patients should ask anyone entering their hospital room to wash his or her hands.
  • Consult Consumer Reports’ hospital ratings when making healthcare decisions for themselves and others.

The report is the second in a three-part series by Consumer Reports on America’s antibiotic crisis. The first report described how the overuse and misuse of antibiotics is leading to the rise of superbugs. The final report will examine the role antibiotics play in the U.S. meat supply.

McGiffert said Consumer Reports is committed to helping wipe out “superbug” infections. Go to #SlamSuperbugs on Twitter for more information. 

Copyright 2015, Rita R. Robison, Consumer Specialist

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