Welcome to Insights on Infection Control

I would like to get more information on

1. Patient placement

2. Environmental management practices

inrelation to infection control

as we are in the process of preparing National guidelines on infection control

Thanks

I am a member of the Maine Qualtity Forum,Infection Control Collaborative,  as a healthcare consumer.  This work came about as  result of my legilative proposal for MRSA Active Detection and Isolation in Maine.  This approach to the control of MRSA is what is used in all of our VA hospitals, HCA hospitals, and many others who have chosen to observe and adhere to the steps  in the 2003 SHEA MRSA and VRE prevention recommendations.

I have not yet read a report that this approach fails.  In fact there are 160 studies that prove that it works.

My legislation in Maine passed but in a much abbreviated form.  We do however have to screen all high risk patients when admitted to Maine hospitals.  We are working out the details of this screening and the rest of our ESO prevention program in the MQF meetings.

I wrote this proposal, Maine LD 1038, after my own father died of hospital acquired MRSA pneumonia in January of this year.  MRSA is preventable and it takes a stringent multifaceted approach to do it.  I am convinced that our Maine hospitals will be safer once we enact and begin our screening, Isolation, precautions, disinfection, and education process in Maine.

Great to read your Blog. I will encourage our staff in JAPAC to read it. It is very useful as we introduce our use of disposable products

Moira,  thank you for the inquiry.  There is evidence to suggest that "bugs" are becoming more resistant, in addition, there are differences across states as well so the answer is that times and "bugs" have changed.  A great resource to understand the federal and state level changes is the public policy area on APIC's web site:  http://www.apic.org/AM/Template.cfm?Section=Government_Advocacy.  Here you can look at legislation in progress in the US Congress as well as legislation in progress in Virginia or any other state.  You can also look at issues and initiatives such as mandatory reporting, MRSA and others.  

I am delighted to see the new blog on infection control.  I agree with your suggestions, and your references are excellent.  Let me suggest an addition to your areas of focus...that of preventing transmission of infectious agents to healthcare workers.  There are many safety guidelines promulgated to protect nurses and other workers, with variable compliance within and across institutions.  Nurses are at greatest risk of exposure and transmission.   Frontline users (often nurses) are required by law to be a part of evaluating safety products for use in their institutions.  Please include our website www.healthsystem.virginia.edu/internet/epinet as an additional reference for nurses interested in this area of infection prevention.

Thank you.

This is very helpful in that I find conflicting definitions and opinions when it comes to basic concepts.  CDC and APIC are my first resources.  We are facing a question of "BioHazardous Waste" right now.  In our clinics we dip stick urine.  If there is no evidence of the presence of blood, may we consider that the urine and urine container is not "BioHazardous?"  OSHA has a different opinion.  Thank you.

Debra,  thanks for the response.  There are several helpful sites with respect to evidence based guidelines, one is on the Society of Healthcare Epidemiology of America (SHEA) web site under evidence based guidelines  http://www.shea-online.org/publications/shea_position_papers.cfm, a second is on the Joint Commission's  web site under standards, http://www.jointcommission.org/standards/, and a third is on the Association for Professionals in Infection Control and Epidemiology (APIC) web site under  guidelines and standards, http://www.apic.org/AM/Template.cfm?Section=Practice, also the CDC has infection control guidelines, http://www.cdc.gov/ncidod/dhqp/guidelines.html.  Sue

Audrey,  Thank you for the helpful comments and for sharing your experience.  Hand hygiene guidelines and surveillance are certainly key in infection prevention.  The CDC has some excellent resources including guidelines, a patient admission video, and interactive training on this topic at: http://www.cdc.gov/hand hygiene/  I would love to hear from others on their experiences as well.   Sue

Mary, thanks for the inquiry and for your efforts in the fight to prevent infections.  There are a number of recommendations and guidelines for infection control practices.  The Association for Professionals in Infection Control and Epidemiology (APIC)   www.apic.org. have guidelines for infection control in health care settings.  The guidelines involve seven elements that begin with coordinating efforts with other departments to help ensure surveillance.  It sounds as though you are already involving other departments at your facility.  Second, before placement of personnel, a medical evaluation must be performed to protect both the employee and the patient from unnecessary exposure to infection or transmission of communicable diseases.  Included in this evaluation is determining immunization status.  Third, conduct health and safety education with clearly written policies, guidelines and procedures for all personnel.  Fourth, an immunization program, fifth, management of job-related illnesses and exposures, sixth, health counseling and seventh, maintenance of records, data management and confidentiality.  The entire guideline along with details behind each element is available at the following link: http://www.apic.org/AM/Template.cfm?Section=Practice

Audrey.  Thank you for the input.  It's great to hear you have had some success at your facility. I am a firm believer in standards and positive reinforcement.  Have any other readers had similar success?  Sue

Margaret.  Thank you for the response.  I too find myself frustrated with issues related to compliance.  There are so many factors that contribute to the problem it can be difficult to address.  Keep up the good work!  Sue

Linda,  thank you for the comment and I look forward to continued dialog on this important topic.  Sue

I am so glad to see a section on Infection Control Resource Center, since, at our facility,  it is on alot of our healthcare workers' minds constantly.  On a daily basis, questions are asked and daily discussions are brought up on Infection Prevention issues.  Is there a particular web site for Best Practices on Infection Prevention that is based on evidence and research?  I will be very interested in monitoring this site.  Thank you.

I just moved here from Ma 1yr ago to Va.  I also lived and worked in NY for awhile.  It seems that some hospitals are less restrictive w/their infection control precautions than others.  Is it just that "bugs" or  times have changed?  Why is it so different  state to state?

I work in an ambulatory surgery setting, free standing center and I'm interested in knowing what others do in their infection control prevention program. We send monthly letters to the surgeons requesting information on any SSI's (surgical site infections). Along with the letters we send both a text and diagram of the definition of an SSI per the CDC as well as the cases they did for the month. We also do a monthly surveillance such as handwashing techmiques, traffic in and out of the OR suites, use of PPE's.

Any other suggestions?

Mary, Risk Management Coordinator, PACU, CPAN

    Issues that concern me most in regards to infection control are both staff and patient teaching.

    Patients & visitors need to be informed just as much of the staff. Patients often have many questions about infection control, contact isolation, and hand hygiene. If the standard is communicated to them at the time of admission, then they will have a clear expectation of the staff.

    I am the Co-Chair at my facility's Shared Governance Council for Quality, and we deal with hand hygiene and infection control practices. We have roving reporters that conduct random hand hygiene observations, and take down the name of the employees observed. If an employee is caught missing an opportunity for hand hygiene, they are politely reminded on the spot, to please be compliant. If the same employee has repeated offenses, then their supervisor takes action (verbal & written warnings, etc).

    Communication housewide to all patient care areas of their hand hygiene scores has also influenced scores to improve. And even more importantly, positive reinforcement of good behaviors and high scores keeps up employee morale.

We all need to become more serious about infection control.  To many times I see healthcare personnel neglect to adhere to infection control guidelines when entering a patient's room who is on contact precautions.  When I intervene, the respone is many times very nonchalant...."I was only going in for a minute..."  it drives me crazy!!

Thank you for this very relevant topic.  In today's day, we have to find ways to reduce the infection rate in hospitals for the benefit of our patients as well as ourselves as hospital employees.