INFECTION PREVENTION

Part 1

National Patient Safety Goal #7PREVENTION OF HEALTHCARE ASSOCIATED INFECTIONS

Comply with hand hygiene guidelines by eithero Centers for Disease Control and Prevention (CDC) ORo World Health Organization (WHO)

Healthcare facilities must implement evidence based practices for the prevention ofo Multi-drug resistant organisms (MDRO)o Central Line Associated Blood Stream Infections (CLABSI)o Surgical Site Infections (SSI)o Catheter Associated Urinary Tract Infections (CAUTI)

HAIs causing death or permanent loss of function are managed as sentinel events

HAI

Central Line Associated Blood Stream Infection

(CLABSI)

Catheter AssociatedUrinary Tract Infection

(CAUTI)

Ventilator Associated Event (VAE)

Surgical Site Infection (SSI)

Healthcare Associated Infections (HAI)

An infection not present or incubating on admission

Related to a previous hospitalization (within 30 days)

May be associated with a procedure performed at a healthcare facility

THE MOST EFFECTIVE WAY TO PREVENT THE SPREAD OF INFECTION

HAND HYGIENE

Click icon to add picture

6

Most Frequently

Missed

Frequently Missed 

Less Frequently

Missed

Hand Hygiene Practice

Antibacterial soap and water when hands are:

Alcohol gel hand rub on any other occasion Use friction Cover all surfaces of hands

SING HAPPY BIRTHDAY!To ensure you have washed long enough

Visibly soiled Had contact with blood or body

fluid If C. dif. is suspected or confirmed

Before and after contact with a patient or contaminated surfaces:

Don’t forget to keep nails ¼ inch in length to decrease accumulation of bacteria

Skin CareAn important part of hand hygiene.

Hands that are chapped and dry not only present an exposure risk, but healthcare workers are less likely to wash when skin integrity is impaired.

Maintain good skin health with a hospital grade lotion.

Hospital grade lotions are compatible with alcohol gel.

Other lotion will decrease the efficacy of alcohol based gel.

ESBL

ACINETOBACTER

DRUG RESISTANT ORGANISMS

MRSAVRE

KLEBSIELLA

Multi-drug Resistant Organisms (MDRO)

Microorganisms that are resistant toone or more classes of antimicrobialagents .

Antibiotics fight off disease whenpatient’s immune system cannot.

But what happens when a patient(in a weakened state) acquires an infection that is resistant to antibiotics?

07.03.01 EP# 8&9 Laboratory-Based Alert System for

MDRO

Patients with a history of MDROpose a risk to the inpatientpopulation because they mayremain colonized with theinfectious bacteria even aftertreatment.

Identification of these patientson admission allows us toprotect other patients and staff.

Why identify patients who have a history of drug resistance?

Those aren’t flammin’ hot Cheetos!

Place a black square magnet on thePatient Census board (white board)next to the name of any patient who is suspected or confirmed to haveC.difficile

Purpose: identifies any transmission risk to other patients and staff

1. alerts healthcare personnel to wash with soap and water

2. alerts EVS that a 2 step terminal cleaning process is indicated

Clostridium difficile (C.dif) while not technically a drug resistant organism isconsidered epidemiologically important due to: A propensity for transmission within healthcare facilities. Patients may develop as a result of antibiotic use. General association with serious disease and increased morbidity /mortality.

15

Universal Identifier for C.difficile

Wrong DiagnosisFalse positive or negative result

Wrong treatmentAntibiotic prescribed when not

needed will delay or prevent the appropriate

treatment

Poor Outcomes Antibiotic resistance

C.difficile colitisDrug allergies

…..AND public reporting of erroneous rates by the IP

Use Proper Technique During Specimen Collection to Avoid…

That’s no banana smoothie

HAI Report to the Stakeholders

Report of identified acquired infections within the facility

Posted in designated areas for staff to review

Includes a brief analysis with suggested strategies for improvement

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun0.0

1.0

2.0

3.0

0.0 0.0

0.5

0.0

0.6

0.0 0.0

0.5

0.0 0.0 0.0

0.5

Vancomycin Resistant

Enterococcal (VRE)

Analysis: 1 VRE, 5/27DX Sepsis & Sacral Abscessè 5/28 intra-operative Cultures are negative è6/9 wound Cultures test + VRE

Risks Factors: multiple co-morbidities, multiple transfers during visit, bowel prep when patient has sacral wound

Action Plan: Opportunities for improvement are use of rectal tube if indicated, wound care consult, limit transfers.

07.03.01 EP#6 ▬ 07.04.01 EP#5 ▬ 07.05.01 EP#6

Click icon to add picturePROTECTIVE MEASURES

Standard Precautions

Otherwise known as Universal Precautions

Assumes blood and body fluid of any patient is infectious

Type of PPE used is determined by type of clinical interaction with patient

Gloves

Gowns

Masks

Respirators

Aprons

Eye shields

Personal Protective Equipment (PPE)

References

Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007. Jane D. Siegel, MD; Emily Rhinehart, RN MPH CIC; Marguerite Jackson, PhD; Linda Chiarello, RN MS; the Healthcare Infection Control Practices Advisory Committee. http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf

Chiarello L, Jackson M, Rhinehart E, Siegel JD, and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2006). Management of Multidrug-Resistant Organisms In Healthcare Settings.http://www.cdc.gov/hicpac/pdf/MDRO/MDROGuideline2006.pdf

William A. Rutala, Ph.D., M.P.H., David J. Weber, M.D., M.P.H., and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2008) Guideline for Disinfection and Sterilization in Healthcare Facilities, Centers for Disease Control and Prevention. http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Lynne Sehulster, Ph.D., Raymond Y.W. Chinn, M.D., Center for Disease Control andPrevention / Healthcare Infection Control Practices Advisory Committee (HICPAC)(2003), Guidelines for Environmental Infection Control in Health-Care Facilities http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm