Dealing with Infection Control Issues Head-On

By John Richter

The transmission of microorganisms--which can reside on many types of surfaces in medical settings--can cause a variety of health-related problems. According to a June 28, 2007, report on New Hampshire Public Radio, hospital-acquired (or nosocomial) infections affect approximately 2 million people each year, resulting in the deaths of nearly 100,000 people annually. This makes nosocomial infections the 10th leading cause of death in the U.S.

What's more, the costs of such illnesses can be staggering. The same report estimated that the costs to treat these diseases range from $7 billion to as much as $27 billion annually.* In fact, the monetary implications of such infections are becoming such a concern that the U.S. Centers for Medicare and Medicaid (the federal agency that administers Medicare, Medicaid, and other health-related programs) is now taking action. The organization now plans to begin collecting data on illnesses that patients contract at hospitals while under treatment for other conditions. This may eventually mean that the government will stop paying hospitals for treating the hospital-acquired illnesses of Medicare and Medicaid patients, placing the financial burden for such individuals on the facilities instead.

Many infection control practitioners are well aware of this problem. One survey found that nearly a third of infection control specialists surveyed believe that infection control 'remains a top priority' in U.S. hospitals. Almost as many also believe that the current technologies and techniques used to combat the spread of hospital infections are in serious need of modernization.**

Similarly, a December 2004 survey revealed that infection control specialists at not-for-profit U.S. hospitals and health-care systems believe one in three hospitals needs to improve its infection control systems, funding, staffing, and prevention. The respondents also think considerably more attention must be placed on preventing the spread of infection through hygienic cleaning, specifically in surgical areas, and that hand hygiene is not adequate.***

Locating the Problem

The critical challenge many hospitals and health-care administrators face when it comes to stopping the spread of nosocomial diseases is, very simply, finding the culprit. The germs, bacteria, and pathogens that can cause disease are typically invisible to the human eye. And as most astute cleaning professionals know, surfaces that 'look' clean may not necessarily be clean and healthy--especially in medical settings.

This is why many health-care facilities are turning to ATP (adenosine triphosphate) rapid-monitoring systems to help locate potentially harmful microorganisms on surfaces and to identify surfaces that need cleaning attention. ATP is a nucleotide found in all living cells. Although ATP detecting systems do not indicate which specific pathogens are present, the presence of significant amounts of ATP on surfaces such as counters, floors, etc., is typically viewed as a 'red flag' that health-threatening germs and bacteria are also present.

ATP technology was first developed during the 1970s. Compared to taking swabs from potentially contaminated surfaces and using a petri dish to see if any organisms grow from those samples--the only comparable technology available at the time--these systems were much more precise at detecting the presence of surface contaminants. However, although ATP technology was faster than the use of petri dishes, the early models were still relatively slow; also, the computerized equipment they used was expensive, and typically a trained technician had to be involved with the entire testing procedure.

In recent years, just as computers have become much faster, smaller, and less expensive, ATP systems have also become much smaller. Most are now hand-held devices about the size of a remote control. They are also much more cost effective and easy to use. Most significant of all, they provide results in less than 15 seconds.

For hospitals and medical facilities, this is very good news. Instead of waiting days to find out where germs lurk and cleaning 'any and all' surfaces in an attempt to stop the spread of disease, hospital cleaning personnel can locate problem areas relatively quickly and take steps to make sure that such areas are cleaned thoroughly and hygienically.

Although it may be impossible to totally eradiate hospital-associated illnesses, we are becoming better and better at locating potential cross-contamination sites and taking appropriate cleaning action. Not only does this mean a healthier environment for patients and staff, it also has the potential to help control health-care costs – something we are all hearing a great deal about at the moment.

*Figures vary depending on the particular study consulted; figures also vary because it is often difficult to determine if an illness was actually acquired during a hospital stay.

**Conducted by Harris Interactive® in August 2003 and reported in January 2004.

***Conducted by VHA, Inc., a health-care alliance made up of 2,400 health-care organizations throughout the U.S.