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HAIs Still Affecting Thousands of Hospitalized Patients

One in 25 hospitalized patients acquire healthcare-associated infections, according to a report issued last week by the Centers for Disease Control and Prevention and published in the New England Journal of Medicine.

The CDC's review of patient data collected from 183 hospitals in 2011 showed approximately 721,800 infections occurred in 648,000 hospitalized patients, with 75,000 dying as a result. Surgical site infections accounted for 22% of all infections, matching pneumonia as the most common threat. Gastrointestinal (17%), urinary tract (13%) and bloodstream (10%) infections rounded out the top 5 most common HAIs.

Additionally, the CDC says Clostridium difficile (12%), Staphylococcus (11%), Klebsiella (10%), Escherichia coli (9%), Enterococcus (9%), and Pseudomonas (7%) are the most common germs causing HAIs.

The CDC separately reports that progress is in fact being made to curb infection risks: Central line-associated bloodstream infections decreased by 44% and SSIs associated with 10 commonly reported procedures — including hip and knee arthroplasties, colon surgery and abdominal hysterectomy — decreased by 20% between 2008 and 2012. Additionally, hospital-acquired MRSA and C. difficile infections dropped by 4% and 2%, respectively, between 2011 and 2012.

The progress report notes significant improvement has been made in preventing some types of infections, but "much more work" has yet to be done because "many patients are being harmed by preventable HAIs."

"The most advanced medical care won't work if clinicians don't prevent infections through basic things such as regular hand hygiene," says CDC Director Tom Frieden, MD, MPH. "Healthcare workers want the best for their patients. Following standard infection control practices every time will help ensure their patients' safety."

Daniel Cook

A New Way to Navigate Surgery

A newly developed surgical navigation system that uses images from an ordinary mobile C-arm provides more accurate results and more efficient operation than current state-of-the-art image-guidance systems, say researchers.

The innovative computerized orientation process could improve precision and patient safety in a wide range of minimally invasive procedures, particularly spine and neurosurgery, write the Johns Hopkins University engineers in a recent issue of the journal Physics in Medicine and Biology.

Using an algorithm that the research team had previously constructed to help spine surgeons navigate vertebral levels, the system automatically matches 2D fluoroscopic images to 3D CT scans and updates them throughout the case. It can derive navigational information from images taken with an extremely low dose of radiation, exposing the patient to even less radiation than a routine intraoperative image would.

Testing the system on cadavers, the team has found that its results are consistently more precise than those of existing systems, delivering better than 2mm of accuracy as compared to a standard of 2mm to 4mm.

David Bernard

Weight Loss Sparks Joint Replacement Success

Encouraging patients to lose weight following their joint replacement surgeries can lead to much better outcomes, a new study suggests.

Investigators who reviewed the BMIs of nearly 7,000 patients in the 2 years after their surgeries found that most remained at the same weight levels, but that those who lost weight after knee replacement surgery suffered less pain, enjoyed better function and exhibited higher activity levels than those who maintained or gained weight. Weight gain also led to poorer outcomes for hip replacement patients.

"We should convey to our patients the importance of maintaining good health and an appropriate weight, and we should help them in any way we can," says the study's senior investigator, Geoffrey Westrich, MD, research director of the adult reconstruction and joint replacement service at New York's Hospital for Special Surgery.

Jim Burger

InstaPoll: Do You Let Staff Wear Personal Cloth Scrub Caps?

What's your facility's policy on cloth scrub caps? Tell us in this week's InstaPoll.

Managing staff is far and away the greatest challenge for the 342 respondents to last week's poll. Money matters are the second-biggest headache. The results:

What's your biggest on-the-job challenge?

  • Staff management 59%
  • Financial management 19%
  • Insurance contracting 11%
  • Reprocessing 6%
  • Purchasing 5%

Dan O'Connor

News & Notes
  • Stem-cell sutures speed tendon healing Repairing torn Achilles tendons with stem-cell enriched sutures delivers faster and stronger healing than conventional sutures do, say researchers who reported the results of their rat study in the March 2014 issue of the journal Foot & Ankle International. "The exciting news from this early work is that the stem cells stayed in the tendon, promoting healing right away, during a time when patients are not able to begin aggressive rehabilitation," the researchers wrote.
  • Indiana licensing anesthesia assistants Indiana has become the 16th state to authorize licensure of anesthesiologist assistants, non-physician anesthesia providers who work under the direction of physician anesthesiologists. Assistants must have graduate-school-level academic and clinical education, says the American Society of Anesthesiologists, which supports licensure.
  • "Spine surgeon" settles lawsuit Richard Kaul, MD, the board-certified anesthesiologist who performed complex spine surgeries in New Jersey surgical centers, settled a lawsuit brought by a female patient who claimed his November 2008 spinal fusion left her disabled, according to a published report. The New Jersey Board of Medical Examiners recently revoked Dr. Kaul's license and fined him $300,000 in civil penalties for performing procedures for which he had no training.