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    How We Beat Hospital Infections

    April 21st, 2008

    by Nick Jacobs

    For a decade now, we have been bragging about Windber Medical Center’s low infection rates. The cynics simply declare that it is due to a lack of patients, but this year 153,000 patients would probably differ with you. For those who know that this rate of infection is accurate and real, our amazing housekeeping staff is given the credit. That fact is not arguable for me. They are remarkable, but I know there is more to the story.

    Recently, we once again produced annual infection rates that are well below the average national rate of nine percent. In fact, they are eight percent below that figure. Although I believe that our outstanding success is due to our total and complete commitment to patient centered care, for those of you who are in need of more quantitative substantiation that is less subjective, we decided to provide that for you as well. So, we went directly to the source, our infection control specialist, Carol, and asked her to elaborate on some of the steps that she takes on a daily basis. Here is her response.

    "This is a listing of just a few things that we do to assure that we keep our infection rates low. Education is the most important factor. Keeping employees informed of up to date information on infections is the primary basis of our success. Yearly education includes hand hygiene, infection control, all transmission based precautions, Methicillin Resistant Staph Aureus (MRSA), and other related updates as needed.

    If a nosocomial infection is noted, each floor that might be impacted by that patient’s presence is notified so they can focus enhanced attention on the necessary appropriate care each patient receives.

    With special attention on rooms utilized by the patients who have an infection, education is also made available to all environmental services department employees on terminal cleaning of rooms.

    Brochures have been created for all staff during the orientation process for Hand Hygiene. During the orientation process they are given information on Infection Control. They are also taught to report concerns relating to infections to the Infection Control Practitioner to evaluate and provide recommendations.

    Alcohol based hand foams are available in all patient and ancillary rooms on the floors. Every bathroom is equipped with approved antibacterial soaps. Hand hygiene observation rounds are completed twice weekly, and when non-compliance is observed, the employee is immediately informed of the deficiency.

    Each day we review all of the cultures that have been processed though our lab. These cultures are investigated for outpatient, inpatient, and nursing homes within our area. The investigation determines if Nosocomial or Community acquired infections are present. When suspected as nosocomial, prompt chart reviews are completed both for appropriateness of antibiotic therapy and to ensure that transmission based precautions have been instituted.

    Brochures have been created to be placed strategically throughout the facility for our visitors regarding infection control issues and how washing their hands and taking other infection control practices can help significantly.

    When necessary, special notices are included in paycheck receipt notification envelopes containing updates on issues that reach levels of concern.

    If the surveillance indicates a specific area of concern, to assure that we can observe that area of concern, outbreak investigations are handled promptly and thoroughly. When an employee is found to have an infection, they are not permitted to return to work until they are treated with the appropriate antibiotics and their culture examination exhibits no growth.

    Counseling is provided to patients and their families on outbreaks of MRSA or other infections that occur within the home. They are given instructions, and information, and they are also free to call me with any concerns or questions. Also available are the recent documents that have been published by the Pennsylvania Hospital Health Care Cost Containment. "

    In closing, if you’re initial response to this list is “we do all of that, and still have a major infection problem,” then bring in the therapy dogs, open your facility to 24 hour visits, add fresh flowers, decorative fountains, guest accommodations for care partners, fresh bread baking machines, therapeutic music and humor, massage, reiki, aroma therapy and acupuncture. It’s a Planetree thing.

    Comments:

    Comment from: AZReam [Visitor] · http://www.azream.us
    Dispensers are important- they are an essential part of hospitals, clinics, doctor and dentist offices, or anywhere health-care workers and patients need protection. Dispensers keep supplies organized, add convenience, and provide accessibility to (PPA) personal protection apparel.

    There have also been major breakthroughs in one-step surface care and the containment of bacteria and virus which are otherwise spread by hand-to-surface and surface-to-hand contact. Since you really can’t prevent soiling, shielding surfaces for easier next-time cleaning and the cross-contamination of surface-contact germs is the best way to protect public facilities.

    Additionally, consider a Stethoscope Diaphragm Conversion Program
    with an easy-to-use dispenser box containing four different color diaphragms to facilitate hospital-wide compliance. Such soft stethoscope diaphragms do exist - incorporating an antimicrobial compound to suppress the growth of bacteria and mold. It is impregnated throughout the material, not just on the surface of the diaphragm. Standard precautions should be followed, including cleaning of the diaphragm between use.
    Permalink 04/21/08 @ 11:57
    Comment from: Luke [Visitor] · http://www.sciencetrader.com
    One of the biggest culprits to these types of infections are the doctors themselves, who carelessly carry germs from one location to another. According to hospital regulations, any work clothing such as lab coats, stethoscopes etc, must not leave the treatment area. Very often I see many doctors walking around outside in these lab coats because it makes them feel important. Since I have my PhD, a degree that requires logical reasoning, cause and effect type skills, not just memorization which today's medical schools emphasize, I realize that anything or anyone coming in contact with sick patients has the potential of infecting them. Even though everyone at the hospital attends annual training about personal protective equipment and how it must not leave the lab or clinic, these doctors and med students don't give a damn. It isn't unusual to see them in the cafeteria, a nearby restaurant, or walking to the nearest parking garage wearing the coats. Then they wonder why their patients get infections from bacteria normally present outside? Really, are medical professionals that stupid? Being an immunologist and performing surgeries and some procedures not in an OR type setting, I have yet to encounter any type of infections. Furthermore nurses are also to blame. How many times do I see them adjusting someones tubes, wounds etc with rubber gloves that came from somewhere else? Larger strides should be made and fines should be levied on any Hospital staff that leave ANY area wearing PPE, including lab coats. I think by taking some money away from the status seekers, common sense and good hygiene practices can once again be seen at Hospitals. Oh, by the way, this is one of the largest hospitals in Chicago.
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    Comment from: Meredith Juengel [Visitor] · http://blog.amistaff.com
    Luke - From someone who does not come from the medical background, your insights are very appreciated.

    It does seem like practical sense that doctors and med students would not parade around in lab coats. However, human egos,and as you put it the strive to "feel important," can hamper practical reasoning.

    Great ideas on measurable ways to minimize spread of infection!
    Permalink 01/21/10 @ 13:56
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    Interesting that you spotlighted that education is the most important factor. I suppose that it is obvious that keeping employees informed of up to date information on infections is going to be very effective but I wonder how many clinical establishments practice this to beat the infection problems that they experience.
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    Safety Tip

    Hospital facilities built today do not include asbestos, but many older buildings still have asbestos components in them. Steam pipes, boilers and furnace ducts were often insulated with an asbestos blanket or asbestos paper tape because of their fireproof and insulating properties. Resilient floor tiles were made from vinyl asbestos. Asbestos cement was employed in roofing, shingles and siding materials. The hazard of this carcinogen increases when the fibers become airborne, and untrained contractors can inadvertently increase risks by cutting, tearing, sawing, scraping, or sanding asbestos materials. Elevated asbestos levels can occur in hospitals where old materials are damaged or disturbed. It is best to leave undamaged asbestos material alone if it is not likely to be disturbed. Inhaling asbestos fibers is known to cause mesothelioma and other diseases. Be sure to use an experienced asbestos removal contractor when you need to get rid of old materials that might contain asbestos.