Consumers Union Report: Almost 100,000 Surgical Patients Didn’t Get the Right Infection Prevention Care During Year Studied

For Immediate Release

Contact: 

Lisa McGiffert: 512-477-4431, ext 115
Michael McCauley: 415-431-6747, ext 126

Consumers Union

Consumers Union Report: Almost 100,000 Surgical Patients Didn’t Get the Right Infection Prevention Care During Year Studied

More Hospitals Following Surgical Infection Prevention Measures, But Too Many Patients Remain at Risk

WASHINGTON - A new report released
today by Consumers Union found that hospitals have made progress
following certain surgical infection prevention practices, but that too
many patients aren't getting the right care needed to keep them safe.
At a minimum, almost 100,000 patients were left vulnerable to
developing surgical infections during the year studied because
hospitals failed to follow practices proven to reduce the risk of
infection, according to a Consumers Union estimate.

The number of patients who did not receive the correct care is
likely much higher because the estimate is based on a patient sample
reported by hospitals and not the total number of patients who undergo
surgery each year. Consumers Union found that 445 hospitals across the
country were in low compliance of following a critical infection
prevention measure.

"We've known for nearly 50 years that the appropriate use of
antibiotics before surgery can dramatically reduce the risk of
infection," said Lisa McGiffert, Director of Consumers Union's Stop
Hospital Infections Campaign. "But too many hospitals are not
protecting their patients by following these proven infection control
practices consistently. As a result, patient experiences can vary
widely within each state depending on where they have surgery."

Consumers Union's Cutting Surgical Infections web site enables
users to check on how well each hospital in the country has followed
three key surgical infection prevention measures and is based on data
collected by the Centers for Medicaid and Medicare Services (CMS).
Consumers Union's new web site provides a more detailed look at each
hospital's record than what is currently available at CMS' Hospital
Compare web site, including compliance data collected since 2005, which
allows users to track progress over time.

Research shows that the risk of surgical infections can be reduced
if patients are given an antibiotic within one hour before surgery
begins and if the appropriate antibiotic is given, depending on the
type of surgery and patient characteristics. Discontinuing antibiotics
within 24 hours after surgery ends is critical to reducing antibiotic
resistance, a major problem in treating infections. An estimated 40-60
percent of all surgical infections could be prevented by following
these and other infection prevention measures.

Consumers Union analyzed the most recent data posted on the Hospital
Compare web site, which covers surgeries conducted between July 1, 2007
and June 30, 2008, to determine how well hospitals were following these
infection prevention measures. Hospitals that followed the recommended
infection prevention measures with 95% or more of patients were
considered to be in high compliance. Hospitals that followed them for
79% or fewer of their patients were considered in low compliance.

Antibiotic Given Within One Hour Before Surgery Begins:
Giving patients antibiotics right before surgery helps boost their
ability to fight off contamination during surgery that could lead to
infection. The timing is critical. Patients given antibiotics either
more than one hour before or after the first surgical incision is made
experience higher rates of infection than those given antibiotics
within one hour before surgery. Consumers Union's analysis found:

  • 90.8% of surgical patients across the U.S. received antibiotics within one hour before surgery.
    1,099 hospitals had high compliance on this measure.
    Hospitals reported that 96,750 patients did not receive the correct
    care; the actual number is likely much larger since this number is
    based on a sample of patients reported by hospitals.
    Nationwide, 445 hospitals (13.7% of all reporting hospitals) were low compliers.
    The states with the highest percentage of low complying hospitals
    were Washington, D.C. (43%), Alaska (38%), New Mexico (35%), Nevada
    (30%), Oregon (27%), and Idaho (25%).

Appropriate Antibiotic Given to Surgical Patients:
Choosing the appropriate antibiotic is critical because it must be
effective in preventing infections caused by bacteria likely to be
present around the surgical site. Antibiotic selection varies depending
on the surgery. Consumers Union's analysis found:

  • 95.4 percent of surgical patients across the U.S. who received an
    antibiotic within one hour before surgery received the appropriate
    antibiotic.
    Nationwide, 2,095 hospitals (65% of all reporting hospitals) were high compliers.
    Hospitals reported that 49,230 patients did not receive the correct
    care; the actual number is likely much larger since this number is
    based on a sample of patients reported by hospitals.
    Nationwide, only 97 hospitals (3% of all reporting hospitals) were low compliers.
    The states with the highest percentage of low complying hospitals were Louisiana (14%), West Virginia (10%), and Oregon (10%).

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Antibiotic Stopped Within 24 Hours After Surgery Ends:
Continuing antibiotics beyond 24 hours after surgery does not offer any
additional protection. But the prolonged use of antibiotics can cause
other complications and contribute to antibiotic resistance. Consumers
Union's analysis found:

  • Antibiotics were stopped within 24 hours of surgery for 87.1% of all surgical patients in the U.S.
    Nationwide, 629 hospitals (19% of all reporting hospitals) were high compliers.
    Hospitals reported that 129,420 patients did not receive the correct
    care; the actual number is likely much larger since this number is
    based on a sample of patients reported by hospitals.
    Nationwide, 720 hospitals (22% of all reporting hospitals) were low compliers.
    The states with the highest percentage of low complying hospitals
    were Nevada (57%), Louisiana (46%), Idaho (44%), and Wyoming (40%).

More than 290,000 surgical infections occur in U.S. hospitals each
year, according to the Centers for Disease Control and Prevention
(CDC). CDC researchers have found that surgical infections occur in 2
out of every 100 surgeries and account for 20 percent of all
hospital-acquired infections. Patients who develop infections from
surgery spend, on average, an additional 6.5 days in the hospital, are
five times more likely to be readmitted after discharge, and twice as
likely to die. The CDC has noted that 8,205 patients die from surgical
infections annually and that these infections account for up to $10
billion in additional healthcare expenditures each year.

"Every year millions of Americans get infections while hospitalized
and progress towards eliminating these infections is too slow," said
McGiffert. "As lawmakers in Washington work to reform our health care
system they should require all hospitals' to report their infection
rates so consumers will be better informed and hospitals will work
harder to improve patient care. And Medicare payments should be tied to
how well hospitals follow these critical infection prevention
measures."

Twenty-five states now require public reporting of hospital
infection rates. So far, only a handful of states have issued reports.
More information on hospital infection reporting efforts can be found
at: http://www.consumersunion.org/campaigns/stophospitalinfections/learn.html

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