Meanwhile hand-hygiene compliance went from 45% to 92% over the past few years.
Edmond says the VCU administrator "asks me every year, 'Why don't we test for colonized patients?' And I say, 'Why?'
"Instead of trying to figure out who's got it, we should assume everybody may have it and do the right thing every time."
He adds that many state laws, urged on by advocacy groups of patients whose loved ones were harmed or died because of MRSA, mandate MRSA screening.
"But there are many more organisms out there that do bad things to people, too. And if you think about it, for MRSA, we have multiple effective antibiotics?but for others, for example Acetobacter strains, we have no antibiotics that work. I can't make sense of that."
Of course, hand washing isn't the only thing that makes VCU's nosocomial prevention program work, Edmond says. It also involves basic, commonsense cleanliness, "separating uninfected from infected, clean things from dirty things."
Also critical is the need to constantly remind hospital staff how they're doing on hand washing with weekly results of graduate students' surveys. "You can't let up. A lot of the impact you have will extinguish if you do," Edmond says.
Jernigan advises hospitals to know not only their own transmission rates for HAIs, but also rates in the region, at other hospitals and long-term care facilities.
"When other patients from these facilities go back to any other hospital in the region, they can help spread these bugs from facility to facility. So it's pretty convincing that regional awareness, and a regional approach is likely to have the greatest impact."
This article appears in the August 2011 issue of HealthLeaders magazine.