Category Archives: U.S. Government Announcements

The World Health Assembly and the World Health Organization Adopts Resolution To Improve Sepsis Prevention, Diagnosis, and Management

Congratulations!

On Friday, May 26th, 2017, the World Health Assembly and the World Health Organization made sepsis a global health priority, by adopting a resolution to improve, prevent, diagnose, and manage sepsis. This marks a quantum leap in the global fight against sepsis.

Sepsis, commonly referred to as ‘blood poisoning’, is the life-threatening condition that arises when the body’s response to infection results in organ dysfunction or failure.  Sepsis is often confused with other conditions in its early stages, with delayed recognition of the signs and symptoms quickly leading to multi-system organ failure and ultimately death.

The resolution urges the 194 United Nation Member States to implement appropriate measures to reduce the human and health economic burden of sepsis. In the USA alone, sepsis causes or contributes to half of all deaths in hospitals and has become the leading cause of annual hospitals costs, at over 24 billion USD per year.

The resolution also requests the Director-General of the WHO, Dr. Margaret Chan, to draw attention to the public health impact of sepsis and to 1) publish a report on sepsis and its global consequences by the end of 2018, 2) support the Member States adequately, 3) collaborate with other UN organizations, and 4) report to the 2020 WHA on the implementation of this resolution.

“Community-acquired and health care-acquired sepsis represent a huge global burden that has been estimated to be 31 million cases every year, six million of which result in death,” said Dr. Chan. “One in ten patients world-wide acquires one health care associated infection which often manifests itself with sepsis conditions. I commend the member states for the content of the resolution on sepsis which point to key actions that need to be taken to reverse these shocking statistics.”

The WHO has allocated $4.6 million USD to help implement their sepsis resolution.

The adoption of sepsis as a global priority was initiated by the Global Sepsis Alliance who gathered the consensus and authority of clinicians and families from over 70 countries.

“Worldwide, sepsis is one of the most common deadly diseases, and it is one of the few conditions to strike with equal ferocity in resource-poor areas and in the developed world,” said Dr. Konrad Reinhart, Chairman of the Global Sepsis Alliance.  “In the developed world, sepsis is dramatically increasing by an annual rate of 5-13 per cent over the last decade, and now claims more lives than bowel and breast cancer combined.  When sepsis is quickly recognized and treated, lives are saved but health care providers need better training because they are the critical link to preventing, recognizing, and treating sepsis.”

 

Learn more  by accessing the GSA link:

https://www.global-sepsis-alliance.org/news/2017/5/26/wha-adopts-resolution-on-sepsis

WHO’s World Hand Hygiene Day In Conjunction With Fight Antibiotic Resistance – It’s In Your Hands

SAVE LIVES: Clean Your Hands

WHO’s global annual call to action for health workers


SAVE LIVES: Clean Your Hands 5 May 2017 – Fight antibiotic resistance – it’s in your hands

The WHO’s calls to action are:

  • Health workers: “Clean your hands at the right times and stop the spread of antibiotic resistance.”
  • Hospital Chief Executive Officers and Administrators: “Lead a year-round infection prevention and control programme to protect your patients from resistant infections.”
  • Policy makers: “Stop antibiotic resistance spread by making infection prevention and hand hygiene a national policy priority.”
  • IPC leaders: “Implement WHO’s Core Components for infection prevention, including hand hygiene, to combat antibiotic resistance.”

Every 5 May, WHO urges all health workers and leaders to maintain the profile of hand hygiene action to save patient lives. Being part of the WHO SAVE LIVES: Clean Your Hands campaign means that people can access important information to help in their practice. This year Pr Pittet and three leading surgeons explain why hand hygiene at the right times in surgical care is life saving.

 

 

Le 5 mai de chaque année, l’OMS exhorte tous les travailleurs et responsables de santé à maintenir haut le profil de la promotion des bonnes pratiques d’hygiène des mains afin de sauver la vie de patients. Faire partie de la campagne Pour Sauver des Vies: l’Hygiène des Mains signifie que soignants et collaborateurs de santé peuvent accéder à des informations importantes pour améliorer leurs pratiques. Cette année, le Pr Pittet et trois chirurgiens de renommée internationale expliquent pourquoi l’hygiène des mains au bon moment au cours des soins chirurgicaux sauve des vies.

 

5 Moments for Hand Hygiene

The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.

This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.

This approach recommends health-care workers to clean their hands

  • before touching a patient,
  • before clean/aseptic procedures,
  • after body fluid exposure/risk,
  • after touching a patient, and
  • after touching patient surroundings.

 

 

 

 

 

 

For further Information on WHO My 5 Moments for Hand
Hygiene visit:
To download hand hygiene reminder tools for the workplace visit:
To access WHO hand hygiene improvement tools and resources for use
all year round visit:
To see the latest number of hospitals and health care facilities which
have signed up to support the campaign visit:

 

Medicare Penalties Include Antibiotic-Resistant Bacteria In Hospital Patient Injury Reporting

newsspeaker

The federal government has cut payments to 769 hospitals with high rates of patient injuries, for the first time counting the spread of antibiotic-resistant germs in assessing penalties.

The punishments come in the third year of Medicare penalties for hospitals with patients most frequently suffering from potentially avoidable complications, including various types of infections, blood clots, bed sores and falls.

This year – 2016 –  the government also examined the prevalence of two types of bacteria resistant to drugs.

Based on rates of all these complications, the hospitals identified by federal officials this week will lose 1 percent of all Medicare payments for a year — with that time frame beginning this past October. While the government did not release the dollar amount of the penalties, they will exceed a million dollars for many larger hospitals. In total, hospitals will lose about $430 million, 18 percent more than they lost last year, according to an estimate from the Association of American Medical Colleges.

The reductions apply not only to patient stays but also will reduce the amount of money hospitals get to teach medical residents and care for low-income people.

Forty percent of the hospitals penalized this year – 2016 – escaped punishment in the first two years of the program, a Kaiser Health News analysis shows. Those 306 hospitals include the University of Miami Hospital in Florida, Cambridge Health Alliance in Massachusetts, the University of Michigan Health System in Ann Arbor and Mount Sinai Hospital in New York City.

Nationally, hospital-acquired conditions declined by 21 percent between 2010 and 2015, according to the federal Agency for Healthcare Research and Quality, or AHRQ. The biggest reductions were for bad reactions to medicines, catheter infections and post-surgical blood clots.

Still, hospital harm remains a threat. AHRQ estimates there were 3.8 million hospital injuries last year, which translates to 115 injuries during every 1,000 patient hospital stays during that period.

Each year, at least 2 million people become infected with bacteria that are resistant to antibiotics, including nearly a quarter million cases in hospitals. The Centers for Disease Control and Prevention estimates 23,000 people die from them.

Infection experts fear that soon patients may face new strains of germs that are resistant to all existing antibiotics. Between 20 and 50 percent of all antibiotics prescribed in hospitals are either not needed or inappropriate, studies have found. Their proliferation — inside the hospital, in doctor’s prescriptions and in farm animals sold for food — have hastened new strains of bacteria that are resistant to many drugs.

One resistant bacteria that Medicare included into its formula for determining financial penalties for hospitals is methicillin-resistant Staphylococcus aureus, or MRSA, which can cause pneumonia and bloodstream and skin infections. MRSA is prevalent outside of hospitals and sometimes people with it show no signs of disease. But these people can bring the germ into a hospital, where it can be spread by health care providers and be especially dangerous for older or sick patients whose immune system cannot fight the infection.

Hospitals have had some success in reducing MRSA infections, which dropped by 13 percent between 2011 and 2014, according to the CDC. AHRQ estimates there were 6,300 cases in hospitals last year.

The second bacteria measured for the penalties is Clostridium difficile, known as C. diff, It can be spread through contaminated surfaces or hands. ………,

C. diff has challenged infection control efforts. While hospital infections dropped 8 percent from 2008 to 2014, there was a “significant increase” in C. diff that final year, the CDC says. AHRQ estimated there were 100,000 hospital cases last year.

“The reality is we don’t know how to prevent all these infections,” said Dr. Louise Dembry, a professor at the Yale School of Medicine and president of the Society for Healthcare Epidemiology of America.

The Hospital-Acquired Condition Reduction Program also factors in rates of infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. Those infections carry the most weight in determining penalties, but the formula also takes into account the frequency of bed sores, hip fractures, blood clots and four other complications.

Specialized hospitals, such as those that treat psychiatric patients, veterans and children, are exempted from the penalties, as are hospitals with the “critical access” designation for being the only provider in an area. Of the remaining hospitals, the Affordable Care Act requires that Medicare penalize the 25 percent that perform the worst on these measures, even if they have reduced infection rates from previous years.

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To read the article in its entirety click on the following link to be redirected:

http://triblive.com/news/healthnow/11702788-74/hospitals-hospital-penalties

#AntibioticResistance Global Awareness Week — Get Smart About Antibiotics November 14-20th

getsmartlogo

#AntibioticResistance

November 14-20th , 2016

In recognition of Get Smart about Antibiotics Week; November 14th – 20th, 2016 — the C Diff Foundation is teaming up with the Center for Disease Control and Prevention (CDC) to participate in a number of social media events and we encourage everyone to participate.

On November 14th the CDC launched a Thunderclap campaign that resonated around the world with a powerful message to kick off the Get Smart About Antibiotics Week.

On November 18th the European Centre for Disease Prevention and Control @ECDC_EU  is hosting an ALL-DAY GLOBAL TWITTER CHAT using hashtag #AntibioticResistance

CDC will be hosting part of this live Twitter chat on Friday, November 18th from 11a.m. – 1p.m. EDT @CDCgov and would love your organization to join us in the conversation.

CDC Director, Dr. Tom Frieden @DrFriedenCDC w2ill be Tweeting during the chat, and we hope that you will make plans to take part in this important conversation with antibiotic-resistance partners and experts worldwide.

The Get Smart About Antibiotics Week 2016 observance marks the second annual World Antibiotic Awareness Week, which coincides with European Antibiotic-Awareness Day, Canada Antibiotic Awareness Week, and other similar observances across the world.

There are exceptional opportunities to raise awareness of the threat of antibiotic-resistance and the importance of preserving the power of antibiotics.  With that in mind, please promote your organization’s antibiotic resistance and stewardship materials and resources during the Twitter chat on Friday, November 18th.

Super-bugs Capture Attention As A Worldwide Health Threat

About 2 million Americans catch drug-resistant infections each year, and 23,000 die, according to the CDC.

As superbugs capture attention as a worldwide health threat, Washington University will be part of a national campaign against drug-resistant bacteria with a $2 million federal grant. The Centers for Disease Control and Prevention awarded $14 million to 25 medical schools and other organizations for research into how microorganisms in the body, known as the microbiome, can track and prevent infections by outsider, drug-resistant germs.

“Understanding the role the microbiome plays in antibiotic-resistant infections is necessary to protect the public’s health,” Dr. Tom Frieden, CDC director, said in a statement. “We think it is key to innovative approaches to combat antibiotic resistance, protect patients, and improve antibiotic use.”

The microbiome includes “good” bacteria and other beneficial organisms that live in the skin and in the digestive and respiratory tracts. Antibiotics that are supposed to fight “bad” bacteria can disrupt the natural habitat by unbalancing the good and bad. Then drug-resistant bacteria can take over and create an environment for out-of-control bugs, including methicillin-resistant staphylococcus aureus (MRSA), carbapenem-resistant enterobacteriaceae (CRE) and clostridium difficile (C. diff.).

Overexposure to antibiotics has been blamed for the rise in superbugs, with the CDC estimating that one in three antibiotic prescriptions is unnecessary.

The research project will look at how early exposure to antibiotics affects the development of the microbiome and whether there are better ways to protect the microbiome.

Four teams of researchers at Washington University were named to the local project:

  • Dr. Jeffrey Henderson will lead a team working to identify how diet and metabolism interact with the gut microbiome in a study to combat C. diff. intestinal infections.
  • A team led by Gautam Dantas will study the long-term effects of antibiotic therapy in premature infants and how their digestive microbiomes are affected.
  • Dr. Jennie Kwon will study antibiotics and the microbiome as it relates to pneumonia.
  • Dr. Brian Gage will help look at hemorrhages linked to the use of blood thinners.

The United Nations General Assembly focused on superbugs — in a rare discussion of health issues. The meeting comes after a new superbug resistant to last-resort antibiotics infected a Pennsylvania woman over the summer, and a resistant strain of E. coli was recently found in a 2-year-old Connecticut girl.

The CDC recommends increased testing for the superbug gene among certain types of E. coli bacteria that show resistance to the powerful antibiotic colistin. The gene spreads readily among bacteria, and it could make these multi-drug-resistant strains almost impossible to treat.

A cluster of gonorrhea infections in Hawaii has shown resistance to all treatments. Doctors are increasingly worried that the common sexually transmitted disease is gaining strength as one of the most urgent superbug threats. If untreated, the disease can lead to infertility.

To read article in its entirety click on the following link:

http://www.stltoday.com/lifestyles/health-med-fit/health/antibiotic-resistance-focus-of-washington-university-and-national-research-project/article_b192afec-7dbe-59b8-8e06-5e64b7d8795c.html

Clostridium difficile (C.diff.) Infection (CDI) Rates In the United States and Across the Globe Have Increased In the Last Decade, Along With Associated Morbidity and Mortality

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Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
5600 Fishers Lane
Rockville, MD 20857
March 2016

 

Clostridium difficile is a gram-positive, anaerobic bacterium generally associated through ingestion. Various strains of the bacteria may produce disease generating toxins
and TedA and TedB, as well as the lesser understood binary toxin.

Our use of the term indicates this review’s focus is the presence of clinical disease rather than asymptomatic carriage of C. difficile CDI symptoms can range from mild diarrhea to severe cases including pseudomembranous colitis and toxic megacolon and death.

Estimated U.S. health care associated CDI incidence in 2011 was 95.3 per 100,000, or about
293,000 cases nationally. Incidence is higher among females, whites, and persons 65 years of
age or older. (1)

About one third to one half of health-care onset CDI cases begin in long term care,thus residents in these facilities are at high risk.  Incidence rates may increase by four or five-fold during outbreaks.

Community associated CDI, where CDI occurs outside the institutional setting,
is also on the rise, though still generally lower than institution associated rates and may be in part due to increased surveillance. Estimated community associated CDI was 51.9 per 100,000, or   159,700 cases in 2011.  (1)

Community-associated CDI complicates measuring the effectiveness of  prevention within an institutional setting. 3  Additionally, the pathogenesis of CDI is complex and not
completely understood, and onset may occur as late as several months after hospitalization or antibiotic use

The estimated mortality rate for health -care associated CDI ranged from 2.4 to 8.9 deaths per

100,000 population in 2011.(1) For individuals ≥65 years of age, the mortality rate
was 55.1 deaths per 100,000; (1)

CDI was the 17th leading cause of death in this age group (4)
Hypervirulent C. difficile  strains have emerged since 2000 . These affect a wider population

that includes children, pregnant women, and other healthy
adults, many of whom lack standard risk profiles such as previous hospitalization or antibiotic use.(5)

The hypervirulent strains  account for 51 percent of CDI, compared to only 17 percent
of historical isolates. (6)

Time from symptom development to septic shock may be reduced in the hypervirulent strains, making quick diagnosis and proactive treatment regimens critical for positive outcomes.

To read more on  TREATMENT, PREVENTION, KEY QUESTIONS ——

https://www.effectivehealthcare.ahrq.gov/ehc/products/604/2208/c-difficile-update-report-160329.pdf

Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
5600 Fishers Lane
Rockville, MD 20857
March 2016

 

Sources:

1Appendix J. References for Appendixes
1.Alcala L, Reigadas E, Marin M, et al.
Comparison of GenomEra C. difficile and Xpert
C. difficile as confirmatory tests in a multistep
algorithm for diagnosis of Clostridium difficile
infection.
J Clin Microbiol 2015 Jan;53(1):332
5. PMID: 25392360.
2.Barkin JA, Nandi N, Miller N, et al.
Super iority
of the DNA amplification assay for the
diagnosis of C. difficile infection: a clinical
comparison of fecal tests.
Dig Dis Sci 2012Oct;57(10):2592-
9. PMID: 22576711.
3.Bruins MJ, Verbeek E, Wallinga JA, et al.
Evaluation of three enzyme immunoassay
s and a loo mediated isothermal amplification test
for the laboratory diagnosis of Clostridium
difficile infection. Eur J Clin Microbiol Infect
Dis 2012 Nov;31(11):3035 9. PMID:
22706512.
4.Buchan BW, Mackey TL, Daly JA, et al.
Multicenter clinical evalu
ation of the portrait
toxigenic C. difficile assay for detection of
toxigenic Clostridium difficile strains in clinical
stool specimens. J Clin Microbiol 2012
Dec;50(12):3932-
6. PMID: 23015667.
5.Calderaro A, Buttrini M, Martinelli M, et al.
Comparative analysis of different methods to
detect Clostridium difficile infection. New
Microbiol 2013 Jan;36(1):57-
63. PMID:
23435816.
6.Carroll KC, Buchan BW, Tan S, et al.
Multicenter evaluation of the Verigene
Clostridium difficile nucleic acid assay.
J ClinMicrobiol 2013 Dec;51(12):4120-
5. PMID:24088862

Patient Safety In Hospitals Nationwide Continued To Improve From 2010 to 2014 With A Decline In Hospital-Acquired Conditions By 17% According To the 2015 QDR Report

P A T I E N T    S A F E T Y     N E W S

This Patient Safety chartbook is part of a family of documents and tools that support the National Healthcare Quality and Disparities Report (QDR).

Patient safety in hospitals nationwide continued to improve from 2010 to 2014, as the overall rate of hospital-acquired conditions (HACs) declined by 17 percent, according to the 2015 National Healthcare Quality and Disparities Report’s         Chartbook on Patient Safety

Examples of HACs include surgical site infections, adverse drug events, pressure ulcers and catheter-associated urinary tract and vascular infections.

The overall HAC rate declined from 145 per 1,000 hospital stays in 2010 to 121 per 1,000 stays in 2013 and remained at that lower rate in 2014. Approximately 2 million harmful events were avoided from 2010 to 2014, saving an estimated 87,000 lives and $20 billion in health care costs.

Researchers found that more than 60 percent of patient safety measures showed improvement from 2001-2002 through 2013.

http://www.ahrq.gov/research/findings/nhqrdr/chartbooks/patientsafety/index.html?utm_source=GOVDEL&utm_medium=PSLS&utm_term=&utm_content=20&utm_campaign=AHRQ_PSCB_2016

 

Get more information on AHRQ’s patient safety resources.