Monday Medical: Infections rare at YVMC
December 6, 2010
It is difficult to correct a myth, but that is the goal of this column. We're taking direct aim at the persistent rumor alleging that Yampa Valley Medical Center has "a high rate of infections."
The very opposite is true. Recognizing the significant impact that an infection can have on a person's life, YVMC continues to focus on reducing its already low surgical infection rate. Anyone can look at our numbers by visiting our website, http://www.yvmc.org/infections.
Yet Steamboat physicians continue to hear doubts expressed by patients who have heard that YVMC has a lot of infections. The doctors are quick to respond.
"Our infection rate is actually quite low and we're proud of it," said internal medicine physician Mark McCaulley, YVMC's medical director for infection prevention. "We take a very proactive stance to keep as low as possible the risk of getting an infection here."
"We know we are doing well, especially in total joint surgery," orthopaedic surgeon Eric Verploeg said. "We have a rigorous review system, we look extensively at our infection rates and compare them to national and state averages, and we compare very favorably."
"Specific to our spine surgery program, going back to my start here in August 2004, we have an infection rate of well under one-half of 1 percent," orthopaedic spine surgeon Henry Fabian said. "The Journal of Spine recently published data about postoperative spinal infection and reported infection rates ranging from 1 percent to 10.9 percent. Obviously, we're doing very well."
"We don't have a high infection rate," orthopaedic surgeon Bryan Bomberg said. "That's some sort of myth. The hospital and surgeons do all the critical things necessary to reduce the risk of infection, including a strong emphasis on surgical-site preparation and handwashing."
"The misperception obviously comes from only a few people," said Andreas Sauerbrey, a hand and upper extremity orthopaedic surgeon. "We take this very seriously and actively do many things to prevent infections.
"We screen for MRSA (antibiotic-resistant bacteria). We identify patient factors that contribute to infection risk, such as immuno-compromised systems and diabetes. And we make sure we have a nurse — Steve Hilley — in an infection prevention role."
Hilley also is puzzled by the persistent but incorrect rumor about YVMC's infection rate.
"I'm starting to hear the rumor that we have a high MRSA infection rate," he said. "In reality, MRSA infections that occur as a result of a patient's hospitalization at YVMC are extremely rare. The last health care-associated MRSA infection we saw here was in the spring of 2007.
"We have treated cases of MRSA and other infections here at YVMC. However, those infections may have originated elsewhere — either in the community or at another health care facility," Hilley said. "If a patient comes to us with an existing infection, we have very specific protocols in place to prevent transmission to others.
"I encourage people to call me at 970-871-2430 so that I can share the facts," Hilley said. "I don't like to hear that people have gone to a different hospital because they assumed that they won't get an infection if they go somewhere else."
Physicians interviewed for this article agree with Hilley that all hospitals have some infections. That's why YVMC and its doctors spend time educating and encouraging patients to join the infection-prevention effort.
"There will always be a risk of surgical-site infection, but our goal is to minimize that risk on an individual basis," general surgeon Mark Hermacinski said. "I cover all significant risks of surgery, including infection, with my patients before surgery."
Infection-prevention factors that physicians feel they and the hospital have control over include:
■ Washing hands, using hand disinfectant and wearing gloves
■ Ensuring every patient has the appropriate preventive antibiotics
■ Proper preparation of the incision site, using clippers and antiseptic skin scrub to reduce the chance that a patient's own bacteria will cause infection
■ Performing minimally invasive surgery whenever possible
■ Maintaining a sterile environment in the operating room
■ Providing clear instructions to patients about what they must do at home to keep the surgical site clean.
"It is really important that a patient be compliant in following post-op instructions and wound care," Verploeg said.
"People who are most at risk for a surgical infection are those who do not follow the recommendations provided by YVMC and their surgeon," Hilley said.
"We have seen infections that resulted when people sat in hot tubs, allowed their dog to lick their surgical wound or shoveled manure a few days after surgery. Or their wound has broken open and they've waited two weeks to call their doctor.
"We do not consider these kinds of infections 'health care-associated' since they did not originate from care in the hospital," Hilley said.
Some individuals automatically have a higher risk for contracting an infection, Fabian noted.
"In the case of our few spine infections, virtually all could be associated with a combination of risk factors, these being obesity, diabetes and steroid dependency," Fabian said. "Smoking and poor nutrition also affect the risk of an infection.
"Therefore, all patients are informed of these risks and counseled about making changes to reduce the risks. This involves a team approach by getting the primary care physicians involved and everyone — including the patient — working together to lessen the risks of a postoperative infection."
McCaulley said YVMC will continue to follow best practices to reduce the risk of infection.
"We are not going to be complacent, and we will keep trying to reach zero percent," he said. "Any time there is an infection postoperatively, a lot of people hear about it in a small town. I hope there is also the community perception that the quality of care here at YVMC is very good, because that is true.
"Our concept of an excellent hospital is expert physicians and skilled and caring staff working as a team to prevent infections."
Christine McKelvie is public relations director of Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.