Published in the August 2008 issue of Today’s Hospitalist
TAKING AIM AT DISRUPTIVE BEHAVIOR in hospitals, The Joint Commission is setting a new bar for hospitals and nursing homes starting in January 2009. That’s when a new standard takes effect requiring hospitals to put in place a code of conduct that spells out what is unacceptable behavior, as well as a clear-cut process for dealing with behavior issues.
All hospital personnel are covered by the new standard. Recent industry surveys indicate that disruptive behavior affects the quality of inpatient care, as well as nursing satisfaction and hospital liability. In one field review, 57% of those responding reported witnessing intimidating behavior.
The Joint Commission is encouraging hospitals to take a zero-tolerance stance to bad behavior; foster strong physician leadership and support for the standard; apologize to patients and families who witness disruptive behavior; and develop a system that can be used to report behavior that is unprofessional.
More information is online at www.jointcommission.org.
Pneumonia is leading disease among causes of hospitalization
MORE THAN 1.2 MILLION AMERICANS were hospitalized for pneumonia in 2006, making the lung infection the most common reason to be admitted to the hospital other than childbirth.
However, the costs of treating pneumonia hospitalization in 2006 “$10 billion “paled next to other common inpatient conditions. The leader in terms of cost was atherosclerosis, which cost $17 billion and led to only slightly fewer hospital admissions.
Here’s a look at other estimated admission and cost figures by condition:
New alarm sounded on post-surgery prophylaxis
CANADIAN RESEARCHERS HAVE FOUND that patients are more likely to contract a virulent strain of C. difficile if they are given prophylactic antibiotics to prevent post-surgical infections.
Study authors found that 1.5% of patients given antibiotics prophylactically in a tertiary care hospital in Quebec developed a C. diff. infection during 2003-05. That rate was more than 20 times greater than the inpatient rate for C. diff. infections 10 years ago. Patients studied had undergone hip arthroplasty, abdominal hysterectomy, craniotomy, or colon, cardiac, or vascular surgery.
The antibiotic cefoxitin “rather than cefazolin “was an independent risk factor for C. diff. infection, as was older age. The study was published in the June 15 issue of Clinical Infectious Diseases.
Authors urged physicians to carefully evaluate the need for prophylactic antibiotics and to consider forgoing prophylaxis if the infection being prevented would be infrequent or relatively benign. Patients who do need prophylaxis should receive antibiotics for the shortest time possible to minimize the risk of C. diff. infection.
New DVD enlists patients in better hand hygiene
A new patient safety video designed to be shown to patients on admission stresses the importance of hand hygiene in hospitals to cut the incidence of hospital-acquired infections.
Fashioned after the in-flight safety videos shown on airlines, the hand hygiene feature is part of the “Hand Hygiene Saves Lives” campaign developed by the Association for Professionals in Infection Control & Epidemiology and the CDC.
The video, which runs just over five minutes, tells patients about the importance of practicing hand hygiene themselves while they’re in the hospital. It also instructs them to remind all health care providers to wash or sanitize their hands as well.
The video has been released in both English and Spanish, with accompanying posters and brochures. Hard copies are available from the CDC. The DVD can be downloaded from www.cdc.gov/handhygiene.