At the Infectiology- und Hygiene Congress Freiburg (October 24-26) there is a lecture on legal aspects in relation to healthcare associated infections (HAI). We asked Dr. Ernst Tabori, director of the German consulting centre for hygiene (BHZ), about the motivation to integrate this issue in the congress.
Dr. Tabori, what induced you to integrate this issue in the congress?
Physicians need to be informed about the legal requirements in terms of Hospital Acquired Infections (HAI). I repeatedly make the experience that some colleagues don’t know that since 2013 we have a new law in Germany – the law on patient rights.
What does this new law contain?
The burden of proof may be reversed if a lack of hygiene is identified in the healthcare facility. That means that a hygiene deficit is sufficient that the patient is in the right.
What are the reasons for this law?
In the last years there were many processes with long duration, inter alia a spectacular case. A professional football player alleged that he got infected by an injection into his knee. He traced the infection to a hygiene deficit in the doctor’s surgery. 20 years later the doctor was sentenced posthumously because of hygiene deficits in his surgical practice.
Do the patients make use of the possibilities following from the new law?
To what extent the complaints increased I don’t know yet. A specialist who is dealing with this issue is the lawyer Manfred Werthern. In an article, entitled nosocomial infections and increased liability in the course of the new law he is saying: “If in the future only every 10th patient with avoidable infection would sue for compensation, the damage claims would increase by 24.00 cases a year (note: in Germany every year about 5 Percent of the patients acquire a healthcare-associated infection (HAI) during inpatient treatment, that are about 800.000 to 900.000 patients from about 18 Mio people treated in hospital, as the results of the point prevalence survey of the European Centre for Disease Prevention and Control (ECDC)have shown. The authors of the study estimated that 2,609.911 new cases of HAI occur every year in the EU/EEA). This would have enormous consequences for the insurability of treatment risks. It is a double-edged sword. It is not desirable to have a situation like in the U.S. where lobbies are directly confronting patients. Normal medical work should not be shaped by the fear to get sued.
What would be an ideal scenario?
Hygiene resp. hand hygiene is a mandatory act while treating a patient. Hygiene is not an appendage that a healthcare worker likes to do it or not. And the patients should be more self-confident when it comes to ask the doctor or the nurse if they have cleaned their hands.
What does it need that an achieved standard remains high?
It takes a lot of motivation. Hygiene is a permanent process and not a single act.