10 Stories on Tackling Healthcare-Associated Infections

Here are 10 recent stories on prevention of healthcare-associated infections.

1. A study of three hand antiseptics showed while all three products had similar antibacterial efficacy, one with chlorhexidine gluconate 1 percent solution and ethyl alcohol 61 percent w/w concentration demonstrated longer persistence compared to the other two products. The three products were applied 12 times over five days with 83 male and female healthy volunteers. Samples were collected immediately after drying and six hours later on the first and fifth days. The antiseptic with chlorhexidine gluconate and ethyl alcohol showed better persistence after six hours of glove wear, compared to the other two hand products.

2. Recent research showed infection control lapses may have contributed to three patients who were infected with MRSA after receiving epidural shots at a West Virginia outpatient pain clinic in 2009. Researchers retrospectively studied patients who received injections during a three-week period and compliance to infection control protocols. They found inadequate use of face masks and skin preparation on patients. In addition, epidural infection syringes were reused. The researchers suggested these infection control lapses most likely contributed to the infections.

3. AtlantiCare Regional Medical Center in Atlantic, N.J., found a six-part bundle helped decrease the incidence of bloodstream infections at its outpatient dialysis center. In September 2009, the hospital joined a federal collaborative that aimed to implement six interventions designed to decrease the risk of bloodstream infections. They included use of chlorhexidine for skin antisepsis and hand hygiene auditing. Only one bloodstream infection was identified in the final 12 months of AtlantiCare Regional's intervention period, which included more than 1,200 patient-months.

4. Researchers suggested healthcare providers may require more robust efforts to decrease the risk of ventilator-associated pneumonia. Recent study results not only revealed infections were significantly more frequent than other types of adverse events; ventilator-associated pneumonia was responsible for 62.5 percent of adverse event-related deaths.

5. A statewide collaboration of 20 Illinois hospitals helped decrease the incidence of C. difficile infections by more than 15 percent. The collaborative kicked off March 2010 with 11 acute-care hospitals from the Chicago area, with a second cohort of 9 acute-care hospitals from central and southern Illinois added in October 2010. Participating hospitals established multidisciplinary teams (staff from infection prevention, quality management, environmental services and housekeeping, nursing, microbiology and others) with a designated project lead and returned participation agreement forms signed by the hospital executive.

6. UW Hospital in Madison, Wis., is conducting a study to determine whether required protective gear for all caregivers and visitors in an intensive care unit may decrease the risk of infections among patients. The UW effort is part of a larger CDC-sponsored study called Benefits of Universal Glove and Gowning. UW Hospital and nine other hospitals will study the impact of gloving and gowns for all ICU caregivers and visitors.

7. The Infectious Diseases Society of America released new guidelines to help physicians distinguish between viral and bacterial sinus infections. The guidelines also provide treatment recommendations for physicians in case a sinus infection is bacterial. Although sinus infections are the fifth leading reason for antibiotic prescriptions, 90-98 percent of cases are caused by viruses, which are not affected by antibiotics. Improper antibiotic administration could foster the development of drug-resistant superbugs.

8. A five-part prevention bundle helped a statewide collaborative in New York reduce C. difficile rates by 20 percent over a 22-month period. The bundle included placement of patients on contact precautions at symptom onset, hand hygiene monitoring and thermometers for C. difficile patients. A separate checklist was developed to assess compliance with environmental protocols. After 22 months, the collaborative reported 1,084 fewer C. difficile infection cases.

9. A total of 27 acute- and post-acute care hospitals participated in the 20-month collaborative that successfully led to a 25 percent decrease in C. difficile infections among participating hospitals. The hospitals relied on multidisciplinary teams comprised of representatives from infection prevention, nursing, quality improvement and others, with a strong emphasis on frontline engagement. Hospitals also supported a common set of practices for surveillance, testing, isolation policies, hand hygiene, contact precautions, and environmental cleaning and disinfection, with additional support for antibiotic stewardship.

10. Central Michigan University researchers are calling for federal mandates to regularly test tap water to protect patients from infections caused by waterborne pathogens. The researchers surveyed 900 hospitals to determine frequency of water testing and found 27.5 percent conducted water testing monthly and 15.8 percent conducted tests yearly. The researchers suggest weekly water testing, as well as risk management and training, to prevent the spread of waterborne pathogens.

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