Collaboration in Civic Spheres

Washington State Hospital Infection Rates

by Matt Rosenberg June 21st, 2010

BACKGROUND: “Central line” tubing, ventilators and surgery all provide an opportunity for hospital patients to become infected. The Washington State Department of Health tracks annual infection rates at hospitals in the first two categories and publishes them online. Infection rates for certain types of surgical procedures will be reported starting no later than 2013. Central lines are long tubes inserted in the neck, chest, leg or arm to deliver fluids or drugs or take samples of blood or monitor pressure of inside heart arteries. They can become infected if enough germs move through them. Ventilators can give rise to pneumonia infections if enough germs enter the air stream or leak around the tubing. Surgery also presents an opportunity for infection if germs enter a wound during or immediately after the procedure. The state classifies different types of hospitals differently, according to types of patients and associated infection risk factors – and sets infection rate standards accordingly.

KEY LINKS AND FINDINGS

Washington State Department of Health, Hospital-Associated Infection (HAI) Performance Data information hub.

Central Line Infection Rate Map, Washington Hospitals 2009. This map marks in red those hospitals with high central line infection rates for 2009, and those with average rates in green. Click on any portion of the map to go to that quadrant of the state, then view rate of infection per 1,000 line days by positioning your mouse over any hospital. At bottom, each quadrant map also includes explanations and corrective steps for any hospitals with high rates. Of the four hospitals in Washington state with high rates of central line infections in 2009, three were in the Northwest quadrant: Skagit Valley Hospital in Mount Vernon, Adult Medical Surgical Intensive Care Unit (ICU), 2.01 infections per 1,000 line days; Harrison Medical Center in Bremerton, Adult Medical Surgical ICU, 2.8 per 1,000; and Swedish Medical Center Cherry Hill in Seattle, Adult Medical Surgical ICU, 1.97 per 1,000. Explanations for all three here. The fourth was Yakima Valley Memorial Hospital, Neonatal ICU, 8.55 per 1,000. Explanation here.

Central line infection rates for 2009 are also listed by table, for each hospital and type of ICU. The state’s HAI program provides information on best practices to avoid central line infections. These include use of gowns, masks and drapes; sanitary handling of the lines; and careful cleaning around the insertion site.

Ventilator Associated Pneumonia Infection Rate Map, Washington Hospitals 2009. This map marks in red the eight Washington hospitals with high ventilator associated pneumonia infection rates for 2009, and those with average rates in green. Click on any portion of the map to go to that quadrant of the state, then view rate of infection per 1,000 ventilator days by positioning your mouse over any hospital. At bottom, each quadrant map also includes explanations and corrective steps for any hospitals with high rates. In the state’s Northwest quadrant, high 2009 rates for ventilator associated pneumonia infection were reported for Harrison Medical Center in Bremerton, 2.22 infections per 1,000 ventilator days; and for Overlake Medical Center in Bellevue, 0.72 infections per 1,000 ventilator days. Explanations and corrective actions discussed here. In the Southwest quadrant, high rates were reported at Mary Bridge Children’s Hospital in Tacoma, 5.97 per 1,000 ventilator days (until June of 2009); Saint Clare Hospital in Lakewood, 1.33 per 1,000; Peace Health St. John Medical Center in Longview, 7.31; and Legacy Salmon Creek Hospital in Vancouver, 2.58. Explanations here. In the Northeast quadrant, high rates were reported at Holy Family Hospital In Spokane, 2.46 per 1,000 ventilator days; and Valley Medical Center in Spokane Valley, 1.34 per 1,000. Explanations here.

Statewide ventilator associated infection rates for hospitals are also listed in table form. HAI best practices on preventing ventilator associated infections are discussed here. They include disinfection and sterilization of instruments between patients; wearing of gloves and hand washing between patients; and checking daily to see if ventilator is no longer needed.

Surgical infections rates will be publicly reported in Washington State not later than 2013 for certain procedures only, under state law – cardiac surgery, total hip and knee replacements, and hysterectomies. More details here.

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