VA Hospitals Show Decline in Hospital Infections, Debate Continues

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After a four year effort to combat hospital acquired infections in 153 VA hospitals, a new study shows that progress is being made. According to the NY Times, the study showed a 62% drop in in the rate of infections caused by methicillin-resistant Staphylococcus aureus, or MRSA, in intensive care units over a 32-month period. There was a 45 percent drop in MRSA prevalence in other hospital wards, like surgical and rehabilitation units. While the data is impressive, a companion study in private healthcare facilities found no such progress. Both studies were published yesterday in the New England Journal of Medicine.
One VA doctor is encouraged with the results. “I think our study has shown that it is possible to make this large-scale change, even in a large system,” said Dr. Rajiv Jain, an official with the Veterans Health Administration and the study’s primary author. “If other hospitals were to follow our lead, I think it is possible to decrease these infections.”
The VA approach to curbing hospital infections employs a “bundle” approach which include screening all patients with nasal swabs, isolating those who test positive for MRSA, requiring that staff treating those patients wear gloves and gowns and take other contact precautions and encouraging rigorous hand washing.
Critics of the VA approach argue that the “bundle” approach is neither cost-effective or necessary to curb infection.
However, one issue is clear-hospitals that require and monitor certain checklist behaviors such as handwashing and the proper use of gloves are making improvements in their infection rates. According to the NY Times, “The study of intensive care units released Wednesday, for instance, found that health care workers wore gloves only 82 percent of the time when such precautions were specified, donned gowns only 77 percent of the time and washed their hands after only 69 percent of patient contacts. The lead author, Dr. W. Charles Huskins of the Mayo Clinic in Rochester, Minn., noted that those numbers were “not woefully bad,” as previous studies had found hand-washing compliance to be as low as 50 percent.”

Eva Bleich
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