Clean hands help B.C. hospitals cut infection rates

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      Walk into just about any health facility in the province and you’ll notice hand-sanitizer stations in every direction you look. They’re mounted on walls at entrances, in waiting rooms, outside elevators, and at patients’ bedsides.

      The antibacterial dispensers are a big part of preventing and controlling the spread of infections in hospitals and clinics.

      “About 70 to 80 percent of hospital infections can be attributed to direct contact with patients,” said Dr. Marc Romney, Providence Health Care’s medical director for infection prevention and control. “So if we can ensure that those hands are clean…then we are much more likely to decrease rates of hospital-acquired infections.”

      Romney, a medical microbiologist at St. Paul’s Hospital, told the Straight by phone that the emergence of a new family of antibiotic-resistant bacteria called carbapenem-resistant Enterobacteriaceae (CRE) is proving a challenge for infection-control efforts.

      Approximately 40 people have been diagnosed with CRE in B.C. since 2008, he said. But none of those cases has resulted in an outbreak, while CRE outbreaks have occurred in the U.S.

      “Despite the introduction of this new strain that appears to be very transmissible and causes severe infections...we’ve been able to contain it and keep our [infection] rates relatively stable,” Romney said.

      According to the Canadian Union of Public Employees, which represents many health-care workers, one in nine hospital patients in Canada contracts a health-care-associated infection. That represents 220,000 infections a year resulting in 8,500 to 12,000 deaths annually, CUPE says.

      The union also claims that rates of health-care-associated infection are on the rise. However, the situation in B.C. is bucking national trends.

      According to a 2011–12 report on infection control at Providence facilities—including St. Paul’s, Mount Saint Joseph, and Holy Family hospitals—infection rates for a variety of bacteria remained stable or declined.

      The report states that overall hand-hygiene compliance reached 80 percent in the last fiscal quarter, compared to an overall rate of 69 percent for the fiscal year and far above the 59-percent compliance rate for 2010–11.

      A report on Vancouver Coastal Health facilities (Vancouver General, Lions Gate, and Richmond hospitals, among others) covering the same period details similar successes. Infection rates for most strains of bacteria in VCH hospitals were stable or lower than in previous years. (One notable exception was a rise in infection rates for vancomycin-resistant Enterococci [VRE], strains that, like CRE, are resistant to some antibiotics.)

      According to the VCH annual report, hand-hygiene compliance stood at 69 percent for 2011–12.

      Bruce Gamage is manager of the Provincial Infection Control Network, which works with regional authorities. He told the Straight that while it may be a “no-brainer”, encouraging staff and patients to wash their hands is still priority number one.

      “Hand-hygiene rates of health-care providers aren’t as high as they should be, and it is something that we are really focusing on. We really are trying to work on how we change that culture, so that it becomes unacceptable not to wash your hands [before and after treating a patient].”

      To that end, Gamage continued, PICN is encouraging patients to ask health-care workers whether they’ve washed their hands before any physical interaction occurs. “There is actually a whole campaign around what’s called ‘It’s okay to ask,’ ” he said.

      Romney similarly stressed the importance of patients’ involvement, as well as the participation of visitors to health-care facilities.

      “That’s why you’ve seen that there has been increased availability of alcohol-based hand rub in high-traffic areas in the hospital, and also near patients’ rooms,” he said. “We’re trying to make it as accessible as possible, so that at every opportunity—if you’re waiting for the elevator, for example—you can use some hand rub before you go and see your family member or friend or loved one.”