The Daily Item, Sunbury, PA

November 30, 2012

Geisinger Medical Center confronts state report on infections

By Rick Dandes
The Daily Item

— DANVILLE — While Geisinger Medical Center struggles with infection rates higher than those at most Pennsylvania hospitals in three categories, a physician said the facility is making “significant” progress and that it appears badly in a new report because of its enhanced documentation of infections.

According to a state Department of Health infections report released Wednesday, Geisinger in Danville was listed as a hospital with a significantly worse-than-predicted number of surgical site infections, in the category of crude infections. Geisinger reported a rate of 4.11 infections per 1,000 patient days for a total of 559 infections. This rate was based on more than 136,000 patient days.

Geisinger’s Wyoming Valley Medical Center reported 285 infections and a crude infection rate of 4.40 infections per 1,000 patient days based on 64,749 patient days.

The state average is 2.22.

“The data upon which this report is based is not current, and in the time since those infections occurred and were documented, we have made great strides in decreasing the incidence of infections,” said Dr. Lisa Esolen, systems director of infection control for Geisinger Health System.

“We now have a completely electronic reporting system and other hospitals simply don’t have the same degree of robust data gathering. We now have an electronic reminder system that can be accessed by nurses, who can now remove catheters. And since last year’s report, we are decreasing the number of infections and it’s getting better all the time.”

Geisinger continues its program to re-educate nurses and physicians on the issue, said Esolen, who has helped redesign team procedures to avoid infections.

“Let me reassure everyone,” she said. “We take this very seriously.”

The re-education program has shown significantly positive results, Esolen said. Incidences of urinary tract infections have decreased by 20 to 25 percent in the past year; bloodstream infections have decreased by 60 percent.

Crude rates are not risk-adjusted and should not be used for hospital-to-hospital comparisons, according to the state Department of Health.

Sunbury and Evangelical community hospitals had low crude infection rates per 1,000 patient days, based on 2011 statistics.

Sunbury had an infection rate of 1.52, based on 7,897 patient days and 12 infections; Evangelical, in Lewisburg, had an infection rate of 2.7 based on 21,474 patient days and 58 infections.

Evangelical was a 2009 winner of a Hospital & Healthsystem Association Achievement Awards for Patient Safety for catheter-related blood stream infections: zero tolerance and counting.

Hospitals in Pennsylvania are required to report health care-associated infections to the Department of Health through the Centers for Disease Control and Prevention’s National Health Care Safety Network.

The report includes information pertaining to health care-associated infections, including infection types and rates of occurrence.

It uses three benchmarks to determine hospital performance: catheter-associated urinary tract infections, central-line blood stream infections and six types of surgical-site infections.

This year’s data showed a 3.1 percent decrease in the overall health care-associated infections rate in Pennsylvania between 2010 and 2011.

Urinary tract infections decreased 9.4 percent in the state between 2010 and 2011.

Hospitals statewide continue to make steady progress in reducing medical complications, the report’s data indicates.

Since the baseline year of 2009, the overall rate of infection has decreased by 3 to 4 percent annually.

This is “a significant achievement with a substantial impact on patient care,” according to the report.