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Study: Proper Hand Hygiene Practices Significantly Reduce Infections in Nursing Homes

The results of a new study indicate that infection prevention practices focused on hand hygiene protocols can help save lives in nursing homes and likely other healthcare facilities as well.

The study, "Impact of a multicomponent hand hygiene–related intervention on the infectious risk in nursing homes: A cluster randomized trial," was published in the February issue of the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

For the study, researchers reviewed the impact of implementing a multicomponent hand hygiene program that prompt staff, residents and visitors to wash hands. Interventions included availability of alcohol-based handrub, hand hygiene promotional campaign with posters and events, staff education and local work groups.

From April 2014 through April 2015, the study assessed 26 French nursing homes, with half assigned randomly to an intervention group, half to a control group. Researchers concluded that following proper protocols can help reduce mortality and antibiotic prescription rates.

The study is among the first to assess hand hygiene practices outside of the acute-care hospital setting through a randomized controlled trial, according to an APIC news release.

"Hand hygiene protocols have traditionally focused on acute care settings," said Laura Temime, the study’s lead author and a professor at the Conservatoire National des Arts et Métiers, in the news release. "Our study is changing this narrative, underscoring that we can take a proven intervention practice and make it work outside of the hospital space, by specifically adapting it to long-term settings."

As the Centers for Disease Control and Prevention note, while data about infections in long-term care facilities like nursing homes and skilled nursing facilities are limited, it has been estimated in medical literature that:
  • 1 to 3 million serious infections occur every year in these facilities;
  • infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others; and
  • infections are a major cause of hospitalization and death; as many as 380,000 people die of the infections in long-term care facilities annually.
For assistance with implementing proper nursing home infection prevention practices, contact Infection Control Consulting Services.


New Brochure Helps Educate Patients About Healthcare-Associated Infections

Healthcare providers can download a new brochure designed to help them inform patients about healthcare-associated infection (HAI) and prevention.

The brochure, titled "For Our Patients and Their Visitors: Help Prevent Infections," covers a number of issues, including the following:
  • Common indications of HAIs
  • Common HAIs — Clostridium difficile (C. diff), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), methicillin-resistant staphylococcus aureus (MRSA), catheter-associated urinary tract infection (CAUTI) and surgical-site infection (SSI)
  • HAI treatment
  • Infection prevention best practices in the hospital and home
The brochure was developed from the Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals, a resource published by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) that also includes recommendations by the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC) and the Joint Commission.

Download the HAI prevention brochure.



New Technology Detects Wound Infections

A new device can determine whether bacteria are present in a wound, according to a Bioengineering Today report, which cited a study published in the Journal of Wound Care.

The MolecuLight i:X uses fluorescence to illuminate bacteria. When the device is placed over a wound, the image on its screen will light up in red to reveal the bacteria.

Researchers used the device to examine 60 lower limb chronic wounds. They detected nine common pathogens found in chronic wounds, including Staphylococcus aureus.

In the study's abstract, the researchers note the following: "Fluorescence imaging of wounds offers clinicians real-time information on a wound's bacterial burden, insight which can influence treatment decisions at the point-of care."

View the study here (subscription or purchase required to access full text).


Flu Continues Deadly Spread Across U.S.

Federal health officials have declared this year's influenza season to be more severe than any since 2009 (swine flu pandemic) and getting worse, with hospitalization rates likely to equal or surpass that of the 2014-2015 flu season, according to the Centers for Disease Control and Prevention (CDC) and media reports.

Here are some of the key facts and figures from CDC's latest "FluView Activity Update:"

  • All U.S. states but Hawaii continue to report widespread flu activity. 
  • The number of states experiencing "high" influenza activity increased from 32 states plus New York City and Puerto Rico to 39 states plus New York City and Puerto Rico.
  • The number of flu-related pediatric deaths reported this season is 37. 
  • Since Oct. 1, 2017, nearly 12,000 laboratory-confirmed influenza-associated hospitalizations have been reported through the Influenza Hospitalization Network. This translates to a cumulative overall rate of nearly 42 hospitalizations per 100,000 people in the United States.
  • The highest hospitalization rate is among people 65 years and older followed by adults aged 50-64 years and then younger children aged 0-4 years. 

With flu activity likely to continue for several more weeks, CDC is continuing to recommend influenza vaccination for all persons 6 months of age and older.


Joint Commission Issues New Maternal Infectious Disease Requirements

The Joint Commission is implementing three new elements of performance (EPs) pertaining to maternal infectious disease identification and prevention, according to an R3 Report.

The EPs, which take effect July 1, 2018, are applicable to all Joint Commission-accredited hospitals and critical access hospitals that provide obstetric services, specifically labor and delivery. The Joint Commission stated that the EPs are "…designed to improve the identification of mothers upon admission to labor and delivery who are at risk for transmitting certain infectious diseases to their newborns so that the mother and/or the newborn can be treated promptly to prevent harm."

The EPs are part of standard PC.01.02.01 in the Provision of Care (PC) chapter of the hospital accreditation manual. They are as follows:

EP 14: For [critical access] hospitals that provide obstetric services: Upon admission to labor and delivery, the mother's status of the following diseases (during the current pregnancy) is documented in the mother's medical record:
  • Human immunodeficiency virus (HIV)
  • Hepatitis B
  • Group B streptococcus (GBS)
  • Syphilis
EP 15: For [critical access] hospitals that provide obstetric services: If the mother had no prenatal care or the disease status is unknown, testing for the following diseases are performed and the results documented in the mother's medical record:
  • HIV
  • Hepatitis B
  • GBS
  • Syphilis
Note: Because GBS test results may not be available for 24-48 hours, organizations may elect not to perform this test but instead administer prophylactic antibiotics to the mother.

EP 16: For [critical access] hospitals that provide obstetric services: If the mother tests positive for HIV, hepatitis B, GBS or syphilis when tested in labor and delivery, that information is also documented in the newborn's medical record after delivery.

"The requirements will help improve maternal and neonatal health in Joint Commission accredited hospitals and critical access hospitals across the country," said Kathy Clark, MSN, RN, associate project director specialist, Division of Health Care Quality Evaluation, The Joint Commission, in a news release. "If left undiagnosed or untreated, infectious diseases can be extremely dangerous and even life-threatening, so it is critical that testing and treatment for both the woman and baby is completed according to clinical practice guidelines."


SHEA Issues Hospital Guidance on Contact Precautions for Drug-Resistant Infections

The Society for Healthcare Epidemiology of America has issued new guidance for hospitals concerning when they can safely discontinue contact precautions for patients with multi-drug resistant bacteria.

The guidance, titled "Duration of Contact Precautions for Acute-Care Settings" and published in SHEA's Infection Control and Hospital Epidemiology journal, provides a framework for how long staff should use the safety protocols to reduce the spread of infection.

"The duration of contact precautions can have a significant impact on the health of the patient, the hospital and the community," said Gonzolo Bearman, MD, MPH, an author of the study and chairman of the Division of Infectious Diseases at Virginia Commonwealth University, according to a SHEA news release.

The recommendations for duration of contact precautions (e.g., gowns, gloves, masks), assembled by the SHEA Guidelines Committee, are specific to multi-drug resistant organisms (MDROs) that include Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE), Carbapenem-resistant Enterobacteriaceae (CRE) and Clostridium difficile.

The authors note that prior to adopting a new policy on the duration of contact precautions, "…hospitals should carefully assess their institutional risks, priorities, and resources. Infection prevention and control leadership should revisit and revise policies if the epidemiology of specific organisms of concern change, particularly in an outbreak or hyperendemic situation."


Joint Commission Now Citing Any Hand Hygiene Failure

The Joint Commission recently announced that as of January 1, 2018, surveyors witnessing any failure of healthcare personnel to perform hand hygiene while providing direct patient care will be cited as a deficiency.

The new requirement applies to all accreditation programs. The citation will result in a requirement for improvement under the Joint Commission's infection prevention and control chapter, specifically Standard IC.02.01.01, element of performance 2, which states, "The [organization] uses standard precautions, including the use of personal protective equipment, to reduce the risk of infection."

The Joint Commission noted that, except for home care and ambulatory care accreditation programs, observations of individual failure to perform hand hygiene were not previously cited as deficiencies as long there was a progressive program of increased compliance.

For assistance with accreditation survey preparation, including surveys performed by The Joint Commission, contact ICCS today.