Categories: Healthcare-associated infections
October 19th, 2010 12:38 pm ET -
Neil Fishman, M.D.
Guest Author – Neil Fishman, M.D.
President of the Society for Healthcare Epidemiology of America (SHEA), Director of the Department of Healthcare Epidemiology and Infection Control and the Director of the Antimicrobial Management Program for the University of Pennsylvania Health System
In celebration of International Infection Prevention Week (IIPW), I wanted to draw attention to one of the key drivers of elimination of HAIs: collaboration. As Moving toward Elimination of Healthcare-Associated Infections: A Call to Action describes, a cooperative and team-based approach is the way toward success. We know this means applying consistently and cooperatively the tools and methods proven to work. Defined by the Call to Action, the broad-based pillars that make the goal of elimination possible are: adherence to evidence‐based practices; alignment of incentives; innovation in research; and collection of data to target efforts and measure progress.
This fall marks some serious challenges: the emergence of increasingly dangerous resistant bacteria and the advent of the 2011 influenza season to name a few. It is the case that these issues and other enduring problems for infection prevention must be tackled through collaboration among stakeholders, including professional societies, agencies, policymakers, and administrators. But actions at the macro level are powerless if not underpinned by our full dedication as individual healthcare professionals. Even the simplest of our individual choices propel or hinder the goal of elimination and better patient safety. This call to action is not new, but is well served as a reminder that reaching the maximum reduction of HAIs also requires our individual, day-to-day dedication. This week provides a timely opportunity to reiterate these crucial steps:
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Categories: Healthcare-associated infections
October 15th, 2010 3:05 pm ET -
Cathryn Louise Murphy, RN, PhD, CIC
Guest Author -Cathryn Louise Murphy, RN, PhD, CIC
2010 President – Association for Professionals in Infection Control & Epidemiology
Managing Director – Infection Control Plus
Associate Professor – Faculty of Health Services and Medicine, Bond University
Each year in October, infection preventionists (IPs) and others working toward the common goal of eliminating healthcare-associated infections (HAIs) observe International Infection Prevention Week (IIPW ). With IIPW 2010 upon us, it again seems prudent to consider some milestones in 2010. Given the long history of U.S. leadership in global HAI prevention, much of this posting will focus on U.S.-driven HAI prevention initiatives.
In March 2010, U.S. Consumer Reports published hospital-specific intensive care unit central line-associated bloodstream infection rates from the highest and lowest performing hospitals in 10 states where such data is publicly reported. The impact of providing such data to the public in terms of achieving further reductions is not yet clear. However, as Consumer Reports suggests, patients and their families can and should rightfully assume an increased role in ensuring caregivers provide high quality and safe care designed to reduce their risk of HAI acquisition.
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Categories: CLABSI, Healthcare-associated infections, Hemodialysis, Long Term Care (LTC), Outpatient Care
October 7th, 2010 11:54 am ET -
Dr. Denise Cardo
Author – Dr. Denise Cardo
Director of CDC’s Division of Healthcare Quality Promotion
Recently, partners hosting the 5th Decennial International Conference on healthcare-associated infections (HAIs) – APIC, CDC, IDSA and SHEA – along with public health and other professional organizations (CSTE, ASTHO, PIDS), called for the elimination of healthcare-associated infections (HAIs), by implementing proven public health strategies used to combat other diseases (see statement in ICHE or AJIC). This is a bold step.
Is it possible?
Scientifically, there exists a legitimate opportunity to eliminate specific HAIs, including central line-associated bloodstream infections (CLABSIs). Recent local and regional initiatives have shown 60%-70% overall decreases of CLABSIs in intensive care units (ICUs), with some locations reporting zero CLABSIs for up to four years following implementation.
Is this enough?
More needs to be done to accomplish the HHS Action Plan to Prevent HAIs and extend those successes into all healthcare settings such as outpatient surgery centers, long-term care facilities and dialysis clinics.
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Categories: Healthcare-associated infections, MRSA
October 1st, 2010 9:00 am ET -
John A. Jernigan, MD, MS
Author – John Jernigan, M.D.CDC’s Division of Healthcare Quality Promotion
In recent weeks, we have witnessed some encouraging progress in preventing healthcare associated MRSA infections in the US, mainly through better implementation of existing prevention recommendations. While this is certainly a cause for celebration, there is still a long way to go.
This is where prevention research comes in. We need to increase our arsenal of weapons if we hope to get close to the goal of eliminating HAIs. There could be new and effective strategies out there remaining to be discovered. These will remain hidden to us unless we explore novel approaches to HAI prevention, and translate the findings into evidence-based guidelines.
That’s why CDC engages in and funds HAI prevention research. CDC’s Prevention Epicenter Program supports efforts to develop and test innovative approaches to reducing infections in healthcare settings. One example of how CDC’s investment in HAI prevention research helped develop a promising new strategy is the use of a skin antiseptic in routine bathing of patients to prevent HAIs. CDC-funded investigators at Cook County Hospital and Rush University Medical School hypothesized that bathing patients daily with a skin antiseptic would decrease the burden of the germs on the patient’s skin, and indirectly decrease contamination of the environment of healthcare personnel (HCP) hands, and thus decrease transmission of pathogens.
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Categories: Antibiotic use, Gram negatives, Healthcare-associated infections
September 22nd, 2010 5:52 am ET -
Alexander J. Kallen, MD, MPH
Author – Alexander Kallen, MD, MPH
CDC’s Division of Healthcare Quality Promotion
Last week my colleague Dr. Brandi Limbago addressed the issue of carbapenem-resistant Enterobacteriaceae (CRE) and specifically enzymes called KPCs and NDM-1s that are causing the bacteria to become resistant to last-resort antibiotics. Today, CDC released a report about another enzyme causing CRE. This one is called VIM (Verona integron-encoded metallo-beta-lactamase). VIM has been found previously in a number of countries including Greece where this patient had been transferred from. View recommendations for surveillance and prevention here.
Just as Dr. Limbago mentioned last week, these enzymes are new routes to the same destination: CRE. All types of CRE are significant and emerging public health problems, regardless of their route to resistance or their country of origin. The fact is that we live in a very small world, medically speaking, and it’s not surprising that these organisms are moving from country to country. This situation simply reinforces the need for better antibiotic stewardship, transmission prevention and overall healthcare-associated infection (HAI) prevention in every hospital and practice – today.
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