Canada can learn from Dutch hospital standards: experts
Last Updated: Wednesday, March 23, 2005 | 12:25 PM ET
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INVISIBLE DANGERS Are Canadian hospitals doing enough to fend off infections? |
A CBC News investigation this week suggested a lack of infection control resources and regulations to enforce cleanliness standards has contributed to the spread of "superbugs" that could be killing as many as 8,000 Canadians a year.
Across Canada, about 250,000 people a year come down with a hospital-acquired infection.
- FROM MARCH 21, 2005: 'Superbug' infections spiralling in Canadian hospitals
Methods used in the Netherlands could dramatically cut those numbers, if Canada is willing to pay for them, Dutch medical staff say.
"That would be a disaster for me," said Dr. Rob Diepersloot, the head microbiologist at Deaconess Hospital in Utrecht, of Canada's infection rate. "I can't imagine such a situation."
Annually, he sees only four or five cases of methicillin-resistant Staphylococcus aureus (MRSA), and rates of other life-threatening infections such as Vancomycin-resistant enterococci (VRE) are equally low.
Foreign patients isolated, staff cleanliness monitored
All foreign patients who have been treated at hospitals outside the Netherlands are isolated in private rooms at Dutch hospitals until they can be tested and shown to be free of infections such as MRSA and VRE.
Computer programs carefully track all infected patients and the staff who take care of them.
Peer pressure keeps all nurses and doctors aware of the need to scrub their hands often and discard soiled gloves and gowns, said Diepersloot.
- INDEPTH: Hospital infections
"It only works if everybody is co-operating," he said.
If somebody doesn't co-operate, he has the power to order a room or even a ward closed to patients until a complete sterilization is carried out.
He can even order doctors and other staff to be swabbed and tested for bacteria – and restrict them from working until they are given a clean bill of health.
Antibiotic prescriptions are monitored carefully, and doctors can't use new products until old ones no longer work. That means that antibiotics such as penicillin, which are rarely effective anymore in North America, are still used with good results in Holland.
Low infection rates worth the effort
Some say low infection rates help open up hospital beds for Dutch patients and lower overall costs for the government.
"I think we save a lot, but it is very difficult to convince people that we have saved so much money," said nurse Maria Bron, who works at an Amsterdam hospital near the city's main tourist area. "It is invisible."
The cost of vigilance may seem high, said Diepersloot and Bron, but the Dutch medical system believes the cost of not carrying out such stringent controls could be much steeper.
In Canada, treating antibiotic-resistant infections costs hospitals $100 million a year, Dr. Andrew Simor, who heads the microbiology department at Sunnybrook Hospital in Toronto, has told CBC News.
- FROM MARCH 22, 2005: Restaurants have more germ-fighting rules than hospitals: experts
He made that estimate based on longer hospital stays, extra surgeries needed to track down the specific location of raging infections, and a variety of other factors.
Despite the high cost of failing to prevent such illnesses, many hospitals lack enough isolation rooms and do not have the recommended number of infection control staff of one per every 100 to 120 occupied beds.
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