Hospitals are thought to be sterile, safe environments where sick people get better, not sicker. But that's not always the case according to a new investigation by Consumer Reports into hospital-acquired infections.
Consumer Reports has expanded its hospital Ratings and, for the first time, includes information about two common and deadly infections: MRSA (methicillin-resistant staphylococcus aureus) and C. diff (clostridium difficile).
Every year an estimated 648,000 people in the U.S. develop infections during a hospital stay and about 75,000 die, according to the Centers for Disease Control and Prevention (CDC). That's more than twice the number of people who die each year in car crashes.
The latest hospital Ratings are included in the report, "How Your Hospital Can Make You Sick," available at ConsumerReports.org/cro/hospitalinfections2015. This is the second piece in a three-part investigative series focused on America's antibiotic crisis. The introductory article explained how the overuse and misuse of antibiotics is leading to the rise of superbugs. The final installment will examine the role antibiotics play in the U.S. meat supply.
"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. The MRSA and C. diff Ratings are now part of Consumer Reports' hospital Ratings, which also include central-line associated blood stream infections, surgical-site infections, and catheter-associated urinary tract infections. These scores, in addition to the new data for MRSA and C. diff, make up a larger composite infection score for individual hospitals.
Consumer Reports' Ratings reflect how hospitals performed in a snap shot of time, based on data hospitals reported to the CDC between October 2013 and September 2014, the most recent public data available. The data are updated quarterly.
To earn Consumer Reports' very 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, showing it is possible. Hospitals distinguish themselves when they earn high ratings against both infections: 105 succeeded in that.
Several high-profile hospitals got lower ratings against MRSA, C. diff, or both, including the Cleveland Clinic (OH), Johns Hopkins Hospital (MD), Mount Sinai Hospital (NYC), and Ronald Reagan UCLA Medical Center (CA).
Only nine hospitals received higher Ratings in avoiding not only MRSA and C. diff infections but also for avoiding the other infections included in Consumer Reports' Ratings: Northwest Texas Healthcare System (TX), Jupiter Medical Center (FL), White County Medical Center (AR), Centennial Hills Hospital Medical Center (NV), Biloxi Regional Medical Center (MS), Johnston Memorial Hospital (VA), Lima Memorial Health System (OH), Western Arizona Regional Medical Center (AZ), and South Baldwin Regional Medical Center (AL).
Twelve hospitals earned lower scores for avoiding all five infections: Brooklyn Hospital Center (NY), Decatur Memorial Hospital (IL), Floyd Memorial Hospital and Health Services (IN), Fremont-Rideout Health Group (CA), Little Company of Mary Hospital and Health Care Centers (IL), Mercy St. Anne Hospital (OH), Riverview Medical Center (NJ), Rockdale Medical Center (GA), St. Petersburg General Hospital (FL), The Charlotte Hungerford Hospital (CT), UF Health Jacksonville (FL), and Venice Regional Bayfront Health (FL).
"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. But 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.
While it is important for hospitals to do their part in preventing infections, patients can also be their own advocate. That entails doing the following:
- 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.
SOURCE Consumer Reports