Patient Safety
CHAPTER ONE INTRODUCTION “There is a huge missed opportunity for health care professionals to contribute to hand hygiene as they miss 1 in 2 of all hand cleaning opportunities.” --WHO, 2006
“What kills women with childbed fever is you doctors who carry deadly microbes from sick women to healthy ones!”—Louis Pasteur, 1870
1 . 1. Background of the Study 1.1.1. Nosocomial infection burden Nosocomial infections or healthcare acquired infections can truly be a grave toll for hospital management as much as it is for end-beneficiaries, customers, and stakeholders. Mortality reaches 80,000 annually ; 3 patients die per minute ; 10-20% % incidence globally, and figures are expectedly higher in Third World settings. This is not to mention the corollary problem of emerging microorganisms resistant to overuse of prophylactic and anticipatory shotgun antibiotic therapy as empirical solution. The damage wrought is paramount, reaching a cost of one billion pounds per year in Europe alone, resulting from these.1 excluding priceless, needless mortalities and morbidities
1
1.1.2. Role of Hand Hygiene Institute of Medicine has identified nosocomial Infection to be the most common complication for hospital patients and hands are the most common mode of transmission. In 1991, Harvard Practice Study on adverse events in health care indicated that surgical site infections were the second most frequent type of adverse event for inpatients, constituting 13%. One study
established an excess mortality caused by NI to as high as 44% in ICU patients.2 In a local study at Makati Medical Center by Tupasi & Littaua, mortality rate was reported to be all NI cases documented 4.6 % of
in the intensive care unit , and authors conclude that risk factors
included invasive and manipulative procedures. “Majority of deaths from NI were associated with the use of respiratory equipment and Foley catheters which were potentially
“What kills women with childbed fever is you doctors who carry deadly microbes from sick women to healthy ones!”—Louis Pasteur, 1870
1 . 1. Background of the Study 1.1.1. Nosocomial infection burden Nosocomial infections or healthcare acquired infections can truly be a grave toll for hospital management as much as it is for end-beneficiaries, customers, and stakeholders. Mortality reaches 80,000 annually ; 3 patients die per minute ; 10-20% % incidence globally, and figures are expectedly higher in Third World settings. This is not to mention the corollary problem of emerging microorganisms resistant to overuse of prophylactic and anticipatory shotgun antibiotic therapy as empirical solution. The damage wrought is paramount, reaching a cost of one billion pounds per year in Europe alone, resulting from these.1 excluding priceless, needless mortalities and morbidities
1
1.1.2. Role of Hand Hygiene Institute of Medicine has identified nosocomial Infection to be the most common complication for hospital patients and hands are the most common mode of transmission. In 1991, Harvard Practice Study on adverse events in health care indicated that surgical site infections were the second most frequent type of adverse event for inpatients, constituting 13%. One study
established an excess mortality caused by NI to as high as 44% in ICU patients.2 In a local study at Makati Medical Center by Tupasi & Littaua, mortality rate was reported to be all NI cases documented 4.6 % of
in the intensive care unit , and authors conclude that risk factors
included invasive and manipulative procedures. “Majority of deaths from NI were associated with the use of respiratory equipment and Foley catheters which were potentially
Cited: at www.shea- marked online.org/Assets/files/08a_Hand_hygiene.pdf. Accessed 9 April 2009. 11Second International Consultation on WHO Guidelines on Hand Hygiene in Health Care: Implementation Strategies : Final Report. Geneva , April 2005, 186. 12D Pittet, et al “ Evidence-based model for hand transmission during patient care and the role of improved practices: Lancet Infect Dis 2006; 6:641-52. 20