HOSPITALS TAKING OUNCES OF PREVENTION

Patients have come to expect doctors and nurses to wear gloves and masks to control the spread of germs, but they may not realize that infection control procedures at local hospitals are in place from the lobby to the surgical unit, from the laundry room to patient rooms, from the kitchen to X-ray.

"There's no department in the hospital that doesn't follow infection control procedures, even in the business office," said Pam Joggerst, infection control coordinator at Southeast Missouri Hospital.

The procedures, in place at both Southeast and St. Francis Medical Center, are there to make sure patients and visitors don't leave with an infection they didn't come in with and that employees don't contract illnesses from patients, Joggerst said.

Most hospitals share the same infection control procedures set by the Centers for Disease Control and the Occupational Safety and Health Administration.

Education, however, is the real key to prevent infections from spreading in a hospital, said Debbie Long, infection control nurse at St. Francis Medical Center.

"Procedures won't be effective unless staff members are educated in their use," Long said.

The more educated staff members are about infections, the fewer problems there are with infections, said Joggerst, and that means reduced costs.

"If patients get an infection, whether they contract it at the hospital or after they go home, it can require longer hospitalization and increased costs," Joggerst said.

CDC statistics say nearly $5 billion is added to U.S. health costs every year from infections patients get while they are hospitalized for other health problems, and nearly 2 million patients annually get an infection while being treated for another illness or injury.

That's 6 percent of the 31.8 million patients admitted to U.S. hospitals in 1998, reported the American Hospital Association, and nearly 88,000 die as a direct or indirect cause of their infection.

But hospitals are getting better at preventing such infections.

The CDC reported the rate of such infections fell by nearly 44 percent in the 1990s.

Both St. Francis and Southeast have full-time infection control coordinators responsible for ongoing training of employees in infection control procedures.

Many of the procedures involve simple but effective infection control techniques like washing their hands and wearing gloves, Long said.

"Hand washing is the number one issue," Joggerst said. "It's one of the most important steps in preventing the spread of infection."

Gloves and masks are required when doing procedures that involve contact with blood or bodily fluids, she said.

The procedures are to protect the staff as well as the patient, Long said.

"If employees stay well and their hands stay clean, then it protects the next patient," Long said.

In addition to regular in-service sessions to remind staff about the importance of infection control procedures, Long and Joggerst said both hospitals do all they can to make following those procedures as easy as possible.

Long said St. Francis recently put in patient rooms and in the hallways dispensers of waterless hand-washing gel, which is used as an added precaution to regular soap-and-water hand washing.

"The more convenient you can make something, the easier it is to use, the better it is," Long said.

Isolation of patients who have communicable diseases is another means of infection control, Joggerst said.

"Every disease that can be passed is assigned a certain type of isolation, depending on how the infection is spread," she said.

For instance, a patient with an airborne illness like tuberculosis would be placed in a private room with a certain type of air-filtration system and certain face masks would be required for entering that room.

Vaccinations are also used as an infection control, including encouraging hospital staff members to take flu shots and requiring food service personal to get hepatitis A vaccines, Joggerst said.

The infection control coordinators said they are constantly on the lookout for new products to control infection.

There are now intravenous lines coated with an antimicrobial that inhibits the growth of bacteria, Long said. These are used on intravenous central lines, which are used for long-term therapy where the risk of infection is increased.

Infection control even extends to cleaning crews, which follow certain guidelines on the type of disinfectants that should be used and how they should be used, Long said.

Infection control really extends to all areas of the building, Joggerst said.

"It affects construction, airflow, plumbing, waste disposal, everything," she said.

Long said hospitals have come a long way in emphasizing infection control since she became a nurse in 1973.

"Infection control" wasn't even a term nurses were taught when Long was a nursing student in the early 1970s, she said.

AIDS caused infection control efforts to be stepped up during the 1980s when it became standard procedure for health care workers to wear gloves.

"But it really went beyond AIDS to all kinds of infections," Joggerst said.

"We are constantly looking at ways to limit infection," Long said, adding that patients are more knowledgeable about infection control, too.

"The public is very aware of the possibility of spreading infection," Long said, and this keeps the staff on its toes. Patients will often ask if staff members have washed their hands after they handled the last patient.