Dentist Infection Control

Infection Control Consulting Services Blog

9/21/18

Study: Jet Air Dryers Raise Infection Risk


A new study shows that the type of hand drying method available in washrooms affects the amount of bacterial contamination in the room.

More specifically, the presence of antibiotic-resistant bacteria (e.g., MRSA, MSSA, ESBL-resistant enterococci) were detected more frequently in those washrooms with jet air dryers than in washrooms with paper hand towels.

The 2017 study was led by Professor Mark Wilcox of the University of Leeds and Leeds Teaching Hospitals and conducted independently by research scientists at hospitals in France, Italy and the United Kingdom.

"The findings will have important implications for hand drying guidance in healthcare settings and they should be of particular interest to infection prevention and control doctors and nurses, procurement managers and all responsible for minimizing the spread of cross-infection," said Wilcox.   

The study, "Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study," was published in the Journal of Hospital Infection.
 

9/18/18

Study: Surgical Site Infections Significantly Increase Costs of Hip, Knee Replacements


A study published in Infection Control & Hospital Epidemiology examines how much the cost of hip and knee replacements increase when patients develop surgical site infections (SSIs).

The conclusion: a lot.

Researchers noted that there are nearly 800,000 primary hip and knee arthroplasty procedures performed annually in North America, with approximately 1 percent complicated by a complex SSI. They focused their study on all patients in Alberta, Canada, who underwent the procedures over a three-year period from 2012–2015 and identified those patients who developed a postoperative complex SSI. They then determined the total costs over one year and two years, analyzing the data comparing hip and knee replacement patients with and without SSIs.

What they found was that total costs more than quadrupled over a 12-month period for patients who developed a complex SSI, increasing from about $14,000 to about $68,000 in U.S. dollars.

The researchers also found that the most commonly identified causative pathogen was Staphylococcus aureus.

While preventing patient harm should be reason enough to increase efforts to reduce SSIs, the financial implications lend further support for their need and importance.
 

9/13/18

Study Reinforces Importance of Disinfecting High-Touch Surfaces


The results of a new study published in the American Journal of Infection Control further support the need for outpatient clinics — and all other healthcare organizations — to ensure effective disinfection processes for high-touch surfaces.

The study specifically focused on microbial transmission in these outpatient settings, examining how microbes moved through the facility and the effect of disinfectant spray on high-touch surfaces.

Results showed that exam room door handles and nurses' station chairs were the surfaces with the highest level of contamination and that virus concentrations were decreased significantly when disinfectant spray was used.

A Centers for Disease Control and Prevention (CDC) report shared a checklist of high-touch hospital surfaces, noting that the objects were "chosen on the basis of information regarding the contamination of these surfaces with healthcare-associated pathogens as well as a consideration of the likelihood they would be touched during routine care by healthcare personnel without changing gloves or performing hand hygiene prior to using these items."

These objects were as follows:

Patient room
  • Bed rails/controls
  • Tray table
  • IV pole (grab area)
  • Call box/button
  • Telephone
  • Bedside table handle
  • Chair
  • Room sink
  • Room light switch
  • Room inner door knob
  • Bathroom inner door knob / plate
  • Bathroom light switch
  • Bathroom handrails by toilet
  • Bathroom sink
  • Toilet seat
  • Toilet flush handle
  • Toilet bedpan cleaner
Where applicable
  • IV pump control
  • Multi-module monitor controls
  • Multi-module monitor touch screen
  • Multi-module monitor cables
  • Ventilator control panel
Research published several years after this checklist noted that the list omitted surfaces in the operating room (OR) and determined that the following were primary high-touch areas in the OR:
  • Anesthesia computer mouse 
  • OR bed 
  • Nurse computer mouse 
  • OR door 
  • Anesthesia medical cart
Does your organization need assistance with identifying risk factors that can create a threat for healthcare-associated infections (HAIs)? Contact Infection Control Consulting Services (ICCS) and schedule an infection risk assessment today! A written risk assessment specific to a facility is required by the Centers for Medicare & Medicaid Services and most accreditation agencies.
 

9/7/18

Parents Sue Hospital Following Infant Death Linked to Infection Prevention Practices


Parents of an infant that died while under the care of the Children's Hospital of Philadelphia (CHOP) are suing the hospital, accusing its staff of failing to follow proper infection prevention protocols, according a National Law Review article.

The article references a 2017 American Journal of Infection Control report describing 23 infants at CHOP who, after receiving eye examinations, contracted eye infections, specifically an adenovirus infection. All patients suffered respiratory symptoms, with five developing pneumonia and 11 experiencing ocular symptoms. Six hospital employees and three parents of the infants also contracted viral infections.

The outbreak occurred in 2016. CHOP attributed the cause to a "lack of standard cleaning practices of bedside ophthalmologic equipment and limited glove use."

The lawsuit alleges the premature baby died because of her contracted infection at CHOP. The hospital has denied that the infection was what specially caused her death.

According to a report from The Inquirer, CHOP issued the following statement concerning the outbreak and the hospital's response:

"Upon identification of the outbreak, the hospital led a swift and proactive response, informing all at risk and quickly determining the unusual source of the outbreak. Strict infection control procedures, coupled with numerous safety enhancements, were immediately put into place, and no additional cases have since been identified. While we are unable to share details of active litigation, the health and safety of our patients and their families remains our foremost priority. The safety measures instituted as the result of this outbreak are currently being widely shared with physicians around the country as a best practice to prevent future outbreaks of adenovirus, ensuring that all children receive the best and safest care possible."

As the Centers for Disease Control and Prevention (CDC) notes, adenoviruses are common viruses that cause a range of illness, including cold-like symptoms, sore throat, bronchitis, pneumonia, diarrhea and conjunctivitis. People can contract an adenovirus infection at any age. People with weakened immune systems or existing respiratory or cardiac disease are more likely than others to become very ill from an adenovirus infection.
 

8/29/18

Study: Antibiotics are the Leading Cause of Adverse Drug Event ED Visits in Children


A new study authored by the Centers for Disease Control and Prevention (CDC) reveals that in children, antibiotics are the leading cause for emergency department (ED) visits related to adverse drug events (ADEs).

The study was published in the Journal of the Pediatric Infectious Diseases Society. It used ADE data from the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance project and retail pharmacy dispensing data from QuintilesIMS.

Based on more than 6,500 surveillance cases, CDC estimated that nearly 70,000 children 19 years or younger visited the ED for antibiotic-related adverse drug events each year from 2011–2015. Many of these ED visits — 41% — were made by children 2 years or younger. Most visits — 86% — involved allergic reactions, such as rash, itching and severe swelling beneath the skin.

As the study authors conclude, "Minimizing antibiotic overprescribing (i.e., antimicrobial stewardship) is important for reducing acute and clinically significant harms to individual patients and for reducing the societal risk of antibiotic resistance. Quantifying the risks of antibiotic ADEs can provide additional information to help clinicians and parents/caregivers weigh the risks and benefits of antibiotic treatment. Prevention efforts could target pediatric patients with the highest frequencies and rates of ED visits for antibiotic ADEs."
 

8/23/18

FDA: Use Fluoroquinolone to Treat Infections With Caution


The U.S. Food and Drug Administration has strengthened its black box warning regarding fluoroquinolone use to help better protect patients.

The updated warning notes the association between fluoroquinolones and disabling and potentially permanent side effects, such as decreases in blood sugar (which can lead to coma) and some mental health issues. FDA is advising healthcare providers to limit fluoroquinolone use in patients with less serious bacterial infections.

A recent Clinical Infectious Diseases study shows that fluoroquinolones are commonly prescribed for conditions when antibiotics are not needed or when fluoroquinolones are not the recommended first-line therapy.

Fluoroquinolone antibiotics are approved to treat certain serious bacterial infections. Used for more than 30 years, they work kill or stop the growth of bacteria that can cause illness.

FDA-approved fluoroquinolones include levofloxacin (Levaquin), ciprofloxacin (Cipro), ciprofloxacin extended-release tablets, moxifloxacin (Avelox), ofloxacin, gemifloxacin (Factive) and delafloxacin (Baxdela). There are more than 60 generic versions. The safety labeling changes were based on a comprehensive review of the FDA's adverse event reports and case reports published in medical literature, according to an FDA news release.

"The use of fluoroquinolones has a place in the treatment of serious bacterial infections — such as certain types of bacterial pneumonia — where the benefits of these drugs outweigh the risks, and they should remain available as a therapeutic option," said Edward Cox, MD, director of the Office of Antimicrobial Products in the FDA's Center for Drug Evaluation and Research, in the release. "The FDA remains committed to keeping the risk information about these products current and comprehensive to ensure that healthcare providers and patients consider the risks and benefits of fluoroquinolones and make an informed decision about their use."

Improving antibiotic prescribing and antibiotic stewardship, an area of focus for infection prevention consulting firm ICCS, is important to prevent serious adverse events and potentially deadly infections.
 

8/22/18

Survey: Healthcare Professionals Often Hesitate to Express Hand Hygiene Concerns


The results of a new study published in the American Journal of Infection Control point to a need for stronger efforts toward encouraging healthcare professionals (HCPs) to speak up when observing questionable hand hygiene practices.

More than 1,200 HCPs, specifically nurses and physicians, across five Swiss hospitals participated in a self-administered survey. It covered past speaking-up behaviors, their evaluations of the speaking-up climate in the workplace and their likelihood to speak up about poor hand hygiene practice described in a scenario.

Here are some of the key takeaways:

  • While nearly 86% of respondents reported at least one episode of speaking up due to a safety concern over the previous four weeks, about 61 of respondents also reported at least one episode of withholding their voice during that period despite having safety concerns.
  • 56% of respondents stated they would speak up to a colleague if they witnessed the poor hand hygiene practice described in the scenario, with 43% indicating they would feel uncomfortable with speaking up. 
  • Nurses expressed more discomfort with speaking up and reported a slightly lower likelihood of speaking up than physicians. 
  • Hierarchy was strongly associated with speaking-up behavior. 
  • Higher risk of patient harm and higher frequencies of past speaking-up behaviors were associated positively with likelihood to speak up. Higher frequencies of past withholding voice and higher levels of resignation were associated with a lower likelihood to speak up.
As the study notes, "Infection control interventions should empower HCPs to speak up about non-adherence with prevention practices by addressing authority gradients and risk perceptions and by focusing on resignation."

For more information on hand hygiene and proper practices, access these past Infection Control Consulting Services (ICCS) blogs:

If your organization requires assistance with improving hand hygiene or any other infection prevention and control practice, contact infection control consultant Phenelle Segal, RN, CIC, FAPIC, and her ICCS team of experts.