Healthcare providers fall short in preventing spread of infection, Joint Commission says

The nation's hospitals, nursing homes and outpatient clinics continue to fall short when it comes to performing necessary—and sometimes very basic—steps to prevent the spread of infection that can cause illness or death, new data from the Joint Commission show.

The Joint Commission, which accredits the quality and safety of healthcare operators, released its ranking of standards (PDF) that proved most problematic for healthcare companies in the first six months of 2013. The ranking, organized by type of provider, lists the five standards for which healthcare organizations were most often not in compliance.

Infection prevention and hand washing were cited as standards where ambulatory care, hospital and long-term-care providers struggled. The results are largely unchanged from the previous two years.

Nearly half of hospitals, 47%, did not comply with processes to reduce the risk of infections associated with medical equipment, devices and supplies. Among ambulatory care operators, such as outpatient surgery centers, 37% failed to meet the same standard.

One out of five long-term care providers and one out of four home care providers did not meet guidelines for hand hygiene.

Infections spread by medical devices or healthcare providers have long been identified as a major source of cost, illness and death. A growing body of research has sought to pinpoint the cost and harm from healthcare-associated infections and ways to prevent their spread.

Pat Adamski, a nurse and director of the Joint Commission standards interpretation group, said the accreditation body is seeking to raise awareness of adherence with protocols for safe storage, transportation and sterilization of pharmaceuticals and medical devices. Providers struggle to comply with the diverse and evolving storage and cleaning requirements set by manufacturers as technology changes, she said. “It's a lot to stay on top of,” she said.

Hand washing ranks highly as a way to prevent patients from acquiring infections in healthcare facilities, but compliance remains a stubborn problem among healthcare providers. One reason for the lack of progress, quality experts said, is an unrealistic and inflated appraisal by providers of their own performance. Others can be time pressures or floor plans that tuck sinks in out-of-the-way locations.

Diane Jacobsen, a director with the Institute for Healthcare Improvement, said many organizations now deploy staff to secretly observe adherence and provide feedback to the organization—or problematic individuals.

That type of accountability is necessary to improve performance, said Patricia McGaffigan, a nurse, chief operating officer and senior vice president of the National Patient Safety Foundation. “A true culture of safety will not tolerate these misses in hand hygiene and they will hold people accountable for not practicing their hand hygiene appropriately,”

McGaffigan said she was “not surprised, but I have to say I'm very disappointed,” by the latest Joint Commission data.

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