New CLSI Report Provides Guidance on MRSA Surveillance

Stephanie:

It's not surprising that attorneys have caught on to the fact that CMS/Medicare has identified certain events including nosocomial infections as events that should never happen in a hospital. That  is, some events should never be caused by the action or negligence of healthcare workers. Such "never events" add considerably to the length of stay, cost of patient care and sometimes may even result in death.

I blogged about these about a year ago.

http://community.advanceweb.com/blogs/mt_2/archive/2009/02/13/ceo-issues-infection-challenge.aspx

Recently a study was published in the Archives of Internal Medicine indicating that healthcare-associated pneumonia affects 250,000 patients annually while 750,000 patients become septic in hospitals annually.This adds an estimated $8.1 billion to the cost of care. Worse than that, 48,000 patients actually die each year from just these 2 classes of infections alone.

http://www.fiercehealthcare.com/story/preventable-hospital-acquired-infections-kill-48-000-annually/2010-02-23

Attorneys realize that If patients/families can prove that an infection like C. diff was nosocomial in origin, that can be converted to dollars!  The American legal system is nothing if not entrepreneurial.

Many hospitals have started defensive documentation: over documenting to show that an infection or other condition discovered during a hospital stay was not caused from the stay and might even have been present before admission. Anything (whether infection, complication or adverse outcome) that happens in a healthcare setting is immediately suspect, scrutinized-and may not be reimbursed.

MRSA is high on the list of such "suspects."

I recently saw a commercial for a law firm that seems to specialize in medical malpractice.  It included a long list in tiny print of "never events" in health care facilities.  My question is whether the Center for Medicare and Medicaid services actually considers Clostridium difficile infection a "never event." (I'm very curious about this since "C-diff" was at the bottom of their miniscule list.)

My infection control nurse wants to do environmental cultures. But she wants to swab surfaces in ED and ICU. I am not sure how wise this is, but even as a non-microbiologist it seems to me that would be overkill. Arent we supposed to be doing best practices and spending money where we get the best return? Any ideas from my micro fellow CLS?