UPMC employees risk steep penalties for violating guidelines
Administrators at UPMC Presbyterian are threatening to fine doctors $1,000 and send workers home if they don't wash their hands or follow other infection control guidelines after an outbreak of hard-to-treat bacteria in the Oakland hospital.
"We want people to know that we will hold you responsible if you choose to be reckless or to follow risky behaviors," said Tami Minnier, chief quality officer at UPMC. "This is important. These are patients' lives that we're responsible for."
During routine surveillance in mid-January, infection control workers noticed a spike in the number of patients harboring an antibiotic-resistant bacteria called acinetobacter. The hospital typically counts two or fewer acinetobacter infections a month, but workers identified five infected patients, said Dr. Carlene Muto, chief of infection control at UPMC.
"Once we felt a pulse that something is not right, we jumped on it immediately," Muto said. "We decided we would implement some extra measures just to be sure that we're doing everything possible not to transmit to other patients."
Keeping hands clean is the best way to prevent the spread of germs and reduce hospital-acquired infections, experts said. Although it is a relatively simple action, compliance has been a problem among health care workers for years, said Marcia Patrick, a registered nurse and board member of the Association for Professionals in Infection Control and Epidemiology, a leading infection prevention group.
"Wow, talk about getting your attention," Patrick said about the measures UPMC imposed.
Patrick said she had not heard of such drastic disciplinary measures, but UPMC officials said some hospitals throughout the country are taking similar steps.
Acinetobacter is a hardy bug that typically infects the sickest patients, such as those in intensive care or trauma units, said Dr. Alex Kallen, a medical officer at the Centers for Disease Control and Prevention. It can live on the skin and survive on bed rails and table surfaces for days, he said.
"It's one of those bugs that because it affects generally people who are very ill, mortality rates tend to be high," Kallen said, noting the bacteria is associated with infections in wounded soldiers fighting in Iraq and Afghanistan.
UPMC administrators, who encountered an acinetobacter outbreak in 2006, placed workers in selected areas at Presby to monitor nurses and doctors as they go in and out of patient rooms. If they see someone who doesn't use a hand sanitizer or doesn't clean equipment according to standards, the monitor will intervene and show them how to follow hygiene guidelines. If they refuse, penalties kick in.
Workers could be sent home on the spot, without pay. On their next scheduled shift, they will be asked if they understand the precautions, and their infraction will be noted on their permanent employee record. The fine on physicians is not as steep for residents and fellows, who would pay $250. No one has been disciplined since the rules took effect Jan. 20, said Holly Lorenz, UPMC's chief nursing officer.
"We've had 100 percent complete cooperation," Minnier said. "No one wants to do the wrong thing. That's one of the things about health care that makes me the proudest: Very, very rarely when you point something out to somebody, they say, 'I don't care what you think.'
"They all want to do the right thing. The staff have responded tremendously well. I think they've done an amazing job."
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Penguins president: General manager, coach won’t be fired
- Rossi: Crosby, Malkin didn’t sign on for this
- Views of Heinz Field entice National Guard recruits
- Three names added to Tuskegee Airmen Memorial in Sewickley
- Penguins’ Malkin: ‘We’re not a championship team’
- Hempfield man dies in single-vehicle accident
- Soap Summary: John attempts to make amends with Paul
- Toni Morrison sets her new novel, “God Help the Child,” in an alien world: Today
- Review: ‘I Refuse,’ by Per Petterson is emotionally powerful
- Defense dominates West Virginia’s spring game
- Fleury valiant in defeat