Advanced GI surgeon Dr. Alex Rosemurgy has zero tolerance for hospital infections with his patients.
“Patients with cancer who get an infection are less likely to be cured of their cancer,” Dr. Rosemurgy said.
That vital fact has lead Dr. Rosemurgy and his partner, Dr. Sharona Ross, to launch new strategies to reduce infections at Florida Hospital Tampa.
“We changed the air handling system, we changed the way we bring people into the hospital, we changed the pre-operative process-- like the way patients prep themselves,” Dr. Rosemurgy said.
Instead of testing patients to see if they have MRSA (a serious antibiotic resistant infection) when they arrive at the hospital, this new protocol essentially assumes every patient will have it and has them follow a preventive protocol.
Night Before Surgery
Before surgery, every patient gets a prep kit with a protocol to follow the night before surgery. First, they have to swab their nose with iodine. Then, they must rinse their mouth with an anti-microbial agent, and finally, wash down their bodies with that same antimicrobial agent, three times before the operation.
“I was so comforted, because I’ve seen hospitals have serious problems with germs,” said patient Genny Pavlovic, who is being treated for pancreatic cancer. “Germs are relentless and this just made me feel so reassured.”
Pavlovic has had an infection, in the past, at another hospital and says it made everything more difficult. She was happy follow this protocol the night before surgery to help prevent that from happening again.
“It’s totally, totally, important,” she said, “and totally easy.”
Keeping Patients Warm
Another new protocol being implemented involves keeping patients warm before and during surgery.
“We have them warm in the pre-op holding area. They wear full length jackets. The intent is to get their body temperatures up before going into the OR,” Dr. Rosemurgy explained.
Once in the often chilly operating room, special blankets are used to keep a patient’s body temperature at normal or a little above.
“White blood cells and the cells involved in fighting infection don’t work if they’re cold,” Dr. Rosemurgy said. “It’s like when you get an infection when you get sick. Your body temperature goes way up. You get a fever, right? The reason your body does that is to kill the bacteria, before it kills you.”
The results of implementing the new infection control procedures for Dr. Rosemurgy’s and Dr. Ross’s patients have been impressive, particularly for complex pancreatic cancer.
“We were able to reduce the infection rate by more than 50-percent for patients with bad problems, like pancreatico-duodinectomies,” Dr. Rosemurgy said, adding, “It was already half of the national standard, but we brought it down by another half.”
For some less complex cases, the results were even better: no infections for an entire year.
That led to a hospital-wide program called Chasing Zero.
“We want to have no infections anywhere, for anybody,” Dr. Rosemurgy said.
Besides improving patient outcomes, the Chasing Zero program also revealed an added benefit: getting patients more involved in their own care increased their satisfaction.
“I think it’s really wonderful. It’s completely reassuring,” Pavlovic said.
Immune Enhancing Drinks
Dr. Rosemurgy’s team is also implementing another new protocol they hope will help to lower infection rates and improve outcomes even more. Patients are being asked to drink immune enhancing drinks five days before they come to the hospital. Once they arrive at the hospital, they’re also given drinks high in carbohydrates to help their glucose metabolism while they’re under anesthesia.
Cost of Hospital Infections
The Centers for Disease Control and Prevention estimates that about 1.7 million patients get a hospital acquired infection (HAI), each year.
Dr. Rosemurgy says the Chasing Zero infection control procedures cost the hospital about a hundred dollars a patient, but end up saving a lot more. Most importantly, of course, it helps to save lives, but financially, it also saves the cost of treating patients who acquire infections, which can be quite high. On average, the cost of treating a patient with a hospital acquired infection runs about $25,000.
In addition, hospitals nationwide now face financial penalties if their infection rates are too high. As part of a national effort to reduce hospital acquired infections, the CDC is collecting data from hospitals on several common infections-- including bloodstream and urinary tract infections. Hospitals that fall short of benchmarks must pay fines. Click here to see recently released results.
And click here for CDC data and statistics on Hospital Associated Infections (HAI’s):