Julie Louise Gerberding, MD, MPH*
Grant Support: Funding for the Quality Grand Rounds series is supported by the California HealthCare Foundation as part of its Quality Initiative.
Requests for Single Reprints: Julie Louise Gerberding, MD, MPH, 1600 Clifton Road MS A07, Atlanta, GA 30333; e-mail, Jgerberding@cdc.gov.
Hospital-onset infections, particularly those involving the urinary tract, lung, and bloodstream, are common and costly and cause substantial morbidity. This article analyzes the case of a 78-year-old man with lung cancer who died after developing hospital-onset pneumonia and urinary catheter–related infection during hospitalization for elective removal of a cerebellar metastasis.
The field of infection control could benefit by adopting several approaches advocated by patient safety adherents, such as root-cause analysis. For example, hospital-onset infections that are implicated as attributable causes of death should perhaps be reviewed by local infection control teams regardless of the institution's overall infection rates. The patient safety movement can also learn from the traditions of infection control and hospital epidemiology. Specifically, applying infection control–based practices to safety problems may enhance safety. Such practices include establishing clear definitions of adverse events, standardizing methods for detecting and reporting events, creating appropriate rate adjustments for case-mix differences, instituting evidence-based intervention programs, and relying on skilled professionals to promote ongoing improvements in care.
* This paper was prepared by Julie Louise Gerberding, MD, MPH, for the Quality Grand Rounds series. Sanjay Saint, MD, MPH, and Kaveh Shojania, MD, prepared the case for presentation.
Table. Incidence of Infection in the Intensive Care Unit from January 1995 to April 2000, according to the National Nosocomial Infections Surveillance System
Chest radiograph obtained on the sixth day of hospitalization.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Julie Louise Gerberding. Hospital-Onset Infections: A Patient Safety Issue. Ann Intern Med. 2002;137:665–670. doi: 10.7326/0003-4819-137-8-200210150-00011
Download citation file:
Published: Ann Intern Med. 2002;137(8):665-670.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use