My ENT and I were having this very discussion during my last trach change. Hopefully hopsitals will utilize better technology to prevent infection. When I was still a nurse, I observed alot of carelessness from staff not washing hands as they should, improper cleaning of the rooms, not placing lines that should be sterile properly etc...There were alot of infections that could have been prevented..but I do think that there are some instances that are hard to avoid that might result in a nosicomial infection.
For instance, during a code when someone was either in dire need of being put on a vent or having a cardiac emergency, placing lines aseptically quickly to gain IV access sometimes was difficult to do while as many as 10 people worked on this one individual, bumping into each other contaminating each other's fields.
If the person survived the code, he or she was watched very closely for infection for the reasons above and more. The more lines placed, the more of a chance for infection. I had the duty of changing the dressings on each of these lines aseptically every 72 hours. IV's...same thing..they had to be changed out. I saw alot of pneumonias, sometimes line sepsis as a result of these codes. I guess doctors probably thought that death was far worse than a resulting infection...at least an infection could be treated.
My ENT had issues with this, should every nosocomial infection not be reimbursed? Should there be some exceptions to the rule...he has a point. I actually can relate to this. I was trached and vented 3 years ago due to respiratory failure (I am still trached and vented). Because of the trach and vent, I developed pneumonia. At the time, my nutritional status was quite poor...I had very little proteins stores and my immune system was suppressed due to chronic steroids. My doctors gave me IV's, antibiotics, tube feeds to strengthen my body. Having a foreign plastic object where germs love to cling onto made me a very high risk for infection, not to mention being vented and having very thick mucous (this was all before dx with CF). With each suction, I watched the staff. They used aseptic technique. I made everyone wash their hands right in front of me, the right way. They wiped down the surfaces in my room with special antimicrobial wipes. Yet I still got pneumonia. I felt that the staff did what they could to try and prevent infection.... Should Medicare re imburse a situation that reads like this?
I think it will be interesting to see what happens as a result of this...hopefully it will be positive.
Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">