Categories: Healthcare-associated infections
May 3rd, 2013 12:51 pm ET -
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Kerri A. Thom, MD, MS
Guest Author, Dr. Kerri Thom
Assistant Professor of Medicine
Division of Epidemiology and Public Health
University of Maryland School of Medicine
As leaders in infection control and prevention, healthcare epidemiologists and infection preventionists must work to educate other healthcare professionals, from the C-Suite to the frontline, on the need to incorporate comprehensive environmental cleaning and disinfection strategies to reduce HAIs. At the University of Maryland, we look to use data to demonstrate how evidence-based strategies can reduce environmental contamination. For example, using methods like fluorescent dye to capture the rate of high-touch surface disinfection, we are able to provide immediate feedback to frontline staff and to report data back to hospital management highlighting the frequency of cleanliness of these surfaces.
The Society for Healthcare Epidemiology of America’s (SHEA) Spring Meeting puts a spotlight on the impact of the healthcare environment in the spread of bacteria responsible for healthcare-associated infections. Healthcare environment research identifies the role of the healthcare environment to contaminate the hands of healthcare professionals, hospital surfaces and medical equipment. The goal of the meeting is to educate professionals in healthcare epidemiology and infection prevention on evidence-based research and policies in this area.
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Categories: Healthcare-associated infections
March 25th, 2013 7:13 am ET -
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Frieden, MD, MPH
Director, Centers for Disease Control and Prevention
Guest Author, Tom Frieden, MD, MPH
Director, Centers for Disease Control and Prevention
Last Saturday marked the third birthday of the Affordable Care Act. We at CDC are in the prevention business. So, in addition to the Act’s provisions to increase health insurance coverage, improve quality, and address cost, I’m especially excited about the potential for prevention—prevention in communities and prevention in health care settings. It’s wonderful to see the difference it’s making three years later.
- The Affordable Care Act has eliminated out-of-pocket costs–copays and deductibles—for proven preventive services. Despite proven benefits of preventive tests, screenings, and vaccinations, millions of Americans still don’t get these services. The ACA makes it free for millions of Americans with new private health plans to receive these proven services, including mammograms, flu shots, smoking cessation counseling, and more. Last week, HHS released a study showing that approximately 71 million Americans received expanded coverage for preventive services in 2011 and 2012.
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Categories: Healthcare-associated infections, Injection Safety
November 28th, 2012 10:28 am ET -
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The Impacts of Unsafe Medical Injections in the U.S.
Author: Centers for Disease Control and Prevention
Injection safety is part of the minimum expectation for safe care anywhere healthcare is delivered; yet, CDC has had to investigate outbreak after outbreak of life-threatening infections caused by injection errors. How can this completely preventable problem continue to go unchecked? Lack of initial and continued infection control training, denial of the problem, reimbursement pressures, drug shortages, and lack of appreciation for the consequences have all been used as excuses; but in 2012 there is no acceptable excuse for an unsafe injection in the United States.
Eradicating unsafe practices will take a multifaceted approach, and now is the time for action to ensure that no additional patients are harmed through unsafe injections. Today, the CDC and the Safe Injection Practices Coalition released new materials to make it easier for clinicians and others working in healthcare to learn and train others about following safe injection practices.
Two Birds with One Stone: Bloodborne Pathogen Training + Patient Safety – Enhanced PowerPoint
Healthcare providers or training managers who need to keep staff current on bloodborne pathogens training can now use a new presentation: “Safe Injection Practices: Protection Yourself and Your Patients – A Bloodborne Pathogens Training Activity.” This training was created to remind healthcare providers that measures they take to protect themselves from bloodborne pathogens and other exposures also protect patients from healthcare-associated infections. View the training on the One & Only Campaign’s website.
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Categories: Antimicrobial Resistance, Healthcare-associated infections
November 15th, 2012 8:39 am ET -
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Chris Crnich, MD
Author – Chris Crnich, MD
Assistant Professor of Medicine in the Division of Infectious Diseases at the University of Wisconsin School of Medicine and Public Health and is the Hospital Epidemiologist at the William S. Middleton VA Hospital.
A significant proportion of antibiotic use in nursing homes is inappropriate. Inappropriate antibiotic use unnecessarily places residents at risk for adverse drug events and is the major driver of antibiotic resistance in nursing homes.
A traditional approach to the problem of inappropriate antibiotic use in nursing homes centers on educating the provider making prescribing decisions. The thinking goes, that if we can get providers to better understand the adverse consequences of antibiotics and increase their knowledge about antibiotic choice and dosing, the problem of inappropriate antibiotic use in nursing homes will go away. Unfortunately, it is not that simple.
Prescribing in nursing homes is unique in that most decisions to initiate antibiotics are made over the phone without the benefit of a clinical exam performed by the prescribing provider. Coupled with the clinical uncertainty created by the atypical presentation of acute illness in the frail elderly and limited access to diagnostic test results creates a perfect environment for overuse of antibiotics. When viewed through this prism, the likelihood of inappropriate antibiotic use is not simply determined by the provider but by the particulars of the resident’s presentation, accessibility to diagnostic tests, features of the nursing home staff primarily responsible for the clinical exam, as well as the quality of communication between providers and facility staff.
Recognizing that inappropriate antibiotic use is an outcome determined more by the nursing home system rather than an individual provider’s decisions and behaviors is an important step towards addressing this problem. With this in mind, future efforts to improve antibiotic use in nursing homes must begin to focus on strategies that: 1) standardize nursing assessments of the resident with suspected infection; 2) enhance the accessibility of clinical information and diagnostic test results, and 3) improve the quality of communication between providers involved in the antibiotic start process.
Implementing these types of interventions in the nursing home environment will not be without challenge but as Albert Einstein once said, “Insanity is doing the same thing over and over again and expecting different results”. Ignoring the important role of the system on antibiotic use will lead to more of the same. We can and must do better.
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Categories: Antimicrobial Resistance, Healthcare-associated infections
November 13th, 2012 6:46 am ET -
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Ramanan Laxminarayan, PhD
Author – Ramanan Laxminarayan, Ph.D.,
director of Extending the Cure (ETC)
Our ability to conquer microbial diseases with antibiotics goes back only 70 years. Yet, the inevitable and rapid development of resistance to these miracle drugs may soon usher in an era where common infections are once again deadly or very costly to treat.
Since its inception in 2007, Extending the Cure (ETC) has worked to inform stakeholders of the magnitude of this unfolding crisis and to offer broad-based economic solutions based on the idea that antibiotic effectiveness should be managed as a shared societal resource, much like forests or fisheries.
As a capstone to our efforts, ETC and the CDC have brought together representatives from leading research, medical, and trade organizations to express our mutual commitment to extend the useful life of antibiotics. At the start this year’s Get Smart about Antibiotics Week, my colleague and close collaborator, Arjun Srinivasan, and I will unveil a consensus statement on antibiotic resistance from 22 national health organizations at a joint telebriefing on November 13.
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