Yesterday I attended a presentation by Dr Gregory Martin, Chief Medical Officer of Emerson Hospital in Concord MA. Dr Martin highlighted, with justifiable pride, a recent program by Emerson to reduce their already-low rate of hospital infection. Anyone familiar with current elder care issues at hospitals knows the concern that the facilities can be a petri dish of infection, and with frail elders and compromised immune systems, the risk of becoming sicker in a place designed for healing is one of the frustrating ironies in today's health care world.
As a home care agency owner, I was particularly interested in his remarks about reducing infection for clients with catheters, since so many of our clients have them.
The primary method for their dramatic reduction was simple: avoid as many catheter days as possible. Catheters are sometimes medically necessary but can remain inserted longer than necessary because of the convenience they offer nurses, patients, and caregivers. But that convenience comes with a risk: the catheter offers a pathway into the body and the bloodstream, and every day it is in use increases the opportunity for infectious bacteria.
I had hoped that Dr Martin would identify procedural steps which, combined with standard precautions around infection control, home care workers could follow to support the reduction in infection rates. But as it turns out, the largest role our staff will play is helping with care for clients who cannot manage toileting tasks independently and who, because of the reduction in catheter days, have more days when they will need help.
Families with elders who use catheters, especially following a hospitalization, might do well to check with the physician to determine the earliest point when the catheter can be safely removed. It does increase the care burden for families or professional caregivers, but if the trade-off is reduced chance of a hospital readmission, the additional work is more than worth it from every viewpoint: financial, patient health, quality of life, and simple disruptions in the lives of all who family who care for a hospitalized elder.
