Categories: Healthcare-associated infections, Injection Safety, State HAI Prevention
June 1st, 2012 11:02 am ET -
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Peter Graves MD
Guest Author – Peter Graves, MD
Chairman, Department of Emergency Medicine
Academic Faculty, Kent Hospital Emergency Medicine Residency Program
Kent Hospital
Warwick, RI
One of the great “truisms” of Life is that we often don’t know—what we don’t know. In other words, we can’t imagine the scope of a problem if we are under the assumption that it doesn’t even exist.
No provider goes to the hospital or office with the intent of harming patients. So I was shocked to learn that the Centers for Disease Control and Prevention has tracked over 40 outbreaks of infectious disease caused by unsafe injection practices including hepatitis B (HBV), hepatitis C (HCV) and bacterial infections in the past 10 years in the United States. It is fundamentally unacceptable that these outbreaks were because healthcare providers failed to follow Standard Precautions when preparing an injection. Those lapses in basic infection control include reusing needles and syringes from patient to patient or misusing single-dose and multi-dose vials. This boggles the minds of many practitioners who may feel they are following correct procedures—when in fact they might not be doing so at all.
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Categories: Antimicrobial Resistance, State HAI Prevention
November 17th, 2011 8:45 am ET -
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Dr. Trivedi
Author – Dr. Trivedi,
California Antimicrobial Stewardship Program Initiative,
California Department of Public Health.
In February 2010, the California Department of Public Health (CDPH) launched the country’s first statewide initiative to promote optimization of antimicrobials in healthcare facilities. In less than two years, the cutting-edge California Antimicrobial Stewardship Program (ASP) Initiative is helping California healthcare facilities establish programs to improve patient safety and quality.
The Healthcare Associated Infections (HAI) Program of CDPH developed the statewide California Antimicrobial Stewardship Program (ASP) Initiative as the result of a statutory mandate. California Senate Bill 739 required CDPH to ensure that each general acute care hospital assemble a quality improvement committee to oversee the results of a process for evaluating the judicious use of antibiotics. While hospitals were aware of this mandate, they were left to implement programs on their own. The Initiative offers California healthcare facilities a valuable resource for antimicrobial use education, guidance and consultation.
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Categories: Antimicrobial Resistance, Healthcare-associated infections, State HAI Prevention
November 15th, 2011 2:29 pm ET -
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David P. Calfee, MD, MS
Author – David P. Calfee, MD, MS
Associate Professor of Medicine and Public Health at Weill Cornell Medical College,
Chief Hospital Epidemiologist at New York-Presbyterian Hospital/Weill Cornell in New York City
The GNYHA, UHF, and NYSDOH Antimicrobial Stewardship Project
While most discussions of antibiotic resistance and improving antibiotic prescribing practices (“antimicrobial stewardship”) focus on hospitals, antibiotic resistance and inappropriate antibiotic use are also prevalent in long-term care facilities (LTCFs). In fact, antibiotic resistance rates in LTCFs are often higher than in hospitals. Consequently, in 2009 the Greater New York Hospital Association, United Hospital Fund, and New York State Department of Health launched the Antimicrobial Stewardship Project.
The project pursued effective strategies for antimicrobial stewardship programs in LTCFs to demonstrate that beneficial activities could be performed without significant investment in new resources, and to demonstrate the value of hospital-LTCF partnerships in antimicrobial stewardship activities. Another goal was to develop tools and materials to assist project participants and other healthcare facilities to develop and manage their antimicrobial stewardship programs.
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Categories: Hand Hygiene, Healthcare-associated infections, State HAI Prevention
May 6th, 2011 10:56 am ET -
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Dixie Roberts, APRN, C, MPH
Author – Dixie Roberts, APRN, C, MPH
Healthcare Associated Infections Coordinator
South Carolina Department of Health and Environmental Control
“He who doesn’t prevent grime when he can, encourages it”
In 2007, with the knowledge that hand hygiene compliance is directly related to hospital acquired infections (HAIs), the South Carolina Hospital Association (SCHA) launched the first statewide hand hygiene campaign in alignment with the World Health Organization’s (WHO) international hand hygiene campaign. DHEC, AARP, Mothers Against Medical Error and APIC- Palmetto Chapter soon joined the effort.
This campaign had to be engaging in order to be successful. We selected the theme “Grime Scene Investigators: South Carolina” (GSI:SC), a parody on the popular television series CSI. Enthused about our initiative, the South Carolina Chapter of HOSA and the South Carolina Department of Education joined our effort.
In July 2009 a “summons” was sent to hospital infection prevention and marketing departments and public health regions calling them for training in Grime Scene Investigation. Each hospital received a GSI:SC kit with everything needed to set up a “grime scene” to create awareness while educating people on proper hand hygiene and its importance. Every SCHA member facility and public health region demonstrated their support of the campaign by designating a point of contact.
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Categories: Healthcare-associated infections, NHSN, State HAI Prevention
November 9th, 2010 4:00 pm ET -
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Dr. Scott Fridkin
Author – Dr. Scott Fridkin
Deputy Chief of Surveillance Branch
CDC’s Division of Healthcare Quality Promotion
A tenet of public health practice is that public health surveillance systems evolve in response to ever-changing needs of both society in general and the public health community in particular. In the case of healthcare-associated infections (HAIs), the needs of patients, providers, other consumers, and payors of healthcare have become drivers of recent evolution—although sometimes they are driving in different directions. Prior to this shift, objectives of HAI surveillance have been to provide local data for local action combined with the facilitating smart policy based on national HAI trends. Recently, the needs of HAI surveillance have changed to include state-wide tracking; state-wide, regional, or national prevention assessments; and importantly, public reporting of facility-specific HAIs.
It has been challenging to revise the system to meet these newer objectives, but success has occurred as national and state summary statistics have been published for some HAIs. However, as reporting of certain HAIs becomes mandatory for facilities to receive payment as part of CMS’s IPPS, two critical issues arise. First, there is a risk of losing the balance between the burden of data collection and the benefit of having local data for action. Programs with scarce resources risk spending substantial time on surveillance and less time using data to evaluate HAI efforts. Secondly, NHSN methodology includes inherent differences in the way infection prevention teams implement NHSN operations; despite tremendous efforts at standardizing case finding approaches and applying standardized definitions, there remains subjectivity.
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