Deadly infections

How good is your hospital at preventing them?

Although some hospitals are doing an excellent job of preventing hospital-acquired infections, others are not, according to our recent analysis.

We focused on one of the most dreaded types of the approximately 1.7 million infections that occur each year in U.S. hospitals. They are bloodstream infections introduced through the large intravenous catheters that deliver medication, nutrition, and fluids to patients in intensive care. These so-called central-line infections account for about 15 percent of all hospital infections but are responsible for at least 30 percent of the 99,000 annual hospital-infection-related deaths, according to the best estimates available.

Even for those who survive, a central-line infection means weeks or months of debilitating treatments and side effects.

"I certainly did not expect to go through the torture that happened to me," said Carol Bradley, 61, a registered nurse from Nashville, Tenn., who developed several types of infections, including a bloodstream infection, after surgery for stomach cancer in August 2008. As a result, she spent about three weeks in intensive care hooked up to feeding and breathing tubes and central-line catheters, and more than a year on antibiotics.

For decades, doctors considered central-line infections an unavoidable risk of intensive care. But determined reformers have now shown that hospitals can cut their infection rate to zero or close to it by following a low-tech program that includes a simple checklist. Want proof? See our list of hospitals that report zero central-line infections.

Citizen activists across the country, including those working with Consumer Reports, have helped to enact laws in most, states forcing hospitals to publicly disclose their infection rates as a first step, it's hoped, toward improving them. Many of the states have made that information publicly available.

For our analysis, we compared central-line infection data for intensive-care units at over 1,000 hospitals across the country. (Among the nation's roughly 5,000 acute-care hospitals, about 3,300 provide intensive care, but in many, there were too few patients to yield statistically meaningful data, and many are still not reporting publicly.) Our information comes from the state reports and from the Leapfrog Group, a nonprofit organization based in Washington, D.C., that since 2000 has worked with large employers nationwide to collect and disseminate quality information on individual hospitals. The Leapfrog information, which the hospitals submit voluntarily, includes rates of central-line infections in ICUs. Our analysis adjusts for the fact that Leapfrog and the states have data from varying mixtures of ICUs—such as cardiac and surgical—requiring comparisons to different average infection rates.