Collaborative efforts around infection lead to improved patient safety

21 Mar 2016

By: Julie Koch, infection prevention manager

 

Recently Consumer Reports and the U.S. Centers for Disease Control and Prevention released safety reports which could generate patient and media interest. The following summary and links are provided to keep you informed.

Consumer Reports
Consumer Reports expanded its hospital ratings to include methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C. diff). The report, “How Your Hospital Can Make You Sick,” gives an overview of the new ratings. This is the second piece in Consumer Reports’ three-part investigative series focused on “America’s antibiotic crisis.”

Consumer Reports analyzed information hospitals reported to the CDC from October 2013 through September 2014. The MRSA and C. diff ratings join central line-associated bloodstream infections (CLABSI), surgical-site infections and catheter-associated urinary tract infections (CAUTI) in the annual Consumer Reports’ hospital ratings. These five scores make up a larger composite infection score for individual hospitals.

In this report, Salem Health’s Salem hospital tied with Providence Portland Medical Center for the top place. As in previous reports, the high scores are only in the mid-60s, showing that Consumer Reports feels there is plenty of room for improvement. The report showed Salem Health’s Salem hospital with average ratings on avoiding C.difficile infections and avoiding MRSA infections. Salem Health West Valley was not rated.

CDC
The U.S. Centers for Disease Control and Prevention released a new Vital Signs report outlining ways in which the health care field and communities can fight heath care-associated infections through effective antibiotic stewardship.

The CDC also released a progress report on national and state health care-associated infections. This report is a roll-up of state reports. Last fall we shared Salem Health’s results from the state report with you. The key takeaway at that time was that infection rates at Salem Health’s hospitals in Salem and Dallas were lower than national rates and below what was predicted for the two hospitals.

What’s happening at Salem Health
By the time state and national reports are published the data is old. Even though our results are good, our goal is to get to zero infections. Our medical staff and employees continue to collaborate, review literature and take steps to reach zero infections.

Some recent examples:

• Central-line-associated bloodstream infections (CLABSI) were a target for us last year. We have reduced the CLABSI rate by 50 percent and we’re on target to improve even more. A multi-disciplinary group reviewed literature, including research on the ways to best clean equipment, maintain and flush lines, change dressings, and more. It resulted in new standard work. Nursing staff who care for patients with CLABSI completed training on the standard work. Then they were observed carrying out the new tasks to verify their skill.
• C. difficile infections are another area of focus. Literature shows that ultraviolet light penetrates proteins on surfaces. Since C. diff spores can live on surfaces for up to six months, it’s important to kill them right away. Environmental Services now uses a UV light machine in rooms that had been occupied by patients with C. diff. EVS cleans the room normally, then treats the room with UV light for about 13 minutes as the final step.

Over-use or inappropriate use of antibiotics is tied to C. diff. We know that about 85 percent of patients with C. diff used an antibiotic within four weeks prior to getting C. diff. Antibiotics clear the gut of good bacteria as well as the bad, setting up a hospitable home for C. diff. Treating it requires even more powerful antibiotics and putting the patient in isolation. Killing the bacteria, using the right antibiotic, and not overusing antibiotics are important measures to prevent further infections.

Our goal is to have zero infections. If you have an opportunity to participate in work to accomplish that goal, please do so. Also, be sure to practice excellent hand hygiene techniques in your work. Each person’s efforts matter.