Tag Archives: Healthcare associated infection

Edmond A. Hooker, MD, DrPH and Nancy Foster, VP, Quality and Patient Safety Policy, American Hospital Association Discuss the CMS 2019 Inpatient Prospective Payment System (IPPS) on ‘C.diff. Spores and More’ Radio on July 3rd

Listen in on Tuesday, July 3rd at 1:00 p.m. ET

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Our guests Edmond A. Hooker, MD, DrPH and Nancy Foster, Vice President, Quality and Patient Safety Policy, American Hospital Association will be discussing the Centers for Medicare and Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services,  CMS 2019 Inpatient Prospective Payment System (IPPS) proposed rule – which includes proposals to de-duplicate measures across the five hospital quality reporting programs.

This special live broadcast discussion will be about the CMS’ recent proposals for Healthcare-associated infection (HAI) measures and to provide facts that will bring forth a better understanding of the proposed rule.

Guest Information:

Eddie Hooker, MD, DrPH,  is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.

Dr. Hooker received his BS degree from Hampden-Sydney College in Virginia. He earned his MD degree from Eastern Virginia Medical School. He then completed his residency training in Emergency Medicine at the University of Louisville. As a full-time faculty member at the University of Louisville from 1991 until 1996, Dr. Hooker served as an Associate Professor and Director of Resident Research. He was very active in brain trauma and stroke research. Dr. Hooker most recently practiced emergency medicine at a private hospital in Cincinnati, Ohio, where he was active cardiac research.   Since 2005, Dr. Hooker has been teaching in the Department of Health Services Administration at Xavier University. In the spring of 2007, Dr. Hooker earned his Doctorate in Public Health from the University of Kentucky.

Dr. Hooker continues to be active in emergency medicine and public-health research. He has authored more than 20 publications in leading emergency-medicine journals, published many book chapters, and continues to have an active research agenda. Dr. Hooker serves as an editor for Emedicine, an online clinical knowledge base. He is the medical advisor for Indian Hill Schools.

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Nancy Foster is the Vice President for Quality and Patient Safety Policy at the American Hospital Association. In this role, she provides advice to public policymakers on legislation and regulations intended to improve patient safety and quality in America’s hospitals. Foster is the AHA’s point person at the National Quality Forum, the Hospital Workgroup of the Measures Application Partnership, and is the liaison to the Joint Commission’s Board, and represents hospital perspectives at many national meetings.

Prior to joining the AHA, Foster was the Coordinator for Quality Activities at the Agency for Healthcare Research and Quality (AHRQ). In this role, she was the principal staff person for the Quality Interagency Coordination Task Force, which brought Federal agencies with health care responsibilities together to coordinate their work and engage in projects to improve quality and safety. She also led the development of patient safety research agenda for AHRQ and managed a portfolio of quality and safety research grants in excess of $10 million.

She is a graduate of Princeton University and has completed graduate work at Chapman University and Johns Hopkins University. In 2000, she was chosen as an Excellence in Government Leadership Fellow.

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California Hemet Valley Medical Center Adds UV Technology to Enhance Patient Safety

Hemet Valley Medical Center has implemented innovative ultraviolet technology with the addition of the Clorox Healthcare® Optimum-UV® System. The system helps remove harmful bacteria and pathogens that can jeopardize health, providing patients, visitors and staff with an additional layer of safety and protection.

U.S. Food and Drug Administration Released Notice For Hospital Mattress Safety

Health care facilities everywhere have been ramping up their disinfection practices in order to prevent the spread of infectious diseases. However, when it comes to hospital mattresses, one of the biggest vectors for spreading deadly bugs, efforts are still falling short.

With health care workers using chemicals that are intended for dry surfaces, the mattresses are harboring pathogens such as Clostridium difficile (C. diff), and, as Edmond A. Hooker, MD, DrPH, professor in the Department of Health Administration at Xavier University, pointed out at the 5th Annual International C. diff Awareness & Health Expo, regulatory agencies seem to have “turned a blind eye” to the issue.

Until now.

The US Food and Drug Administration (FDA) recently released a notice on how to keep hospital mattress covers safe.

In this notice, the FDA notes safety concerns regarding hospital mattress covers, particularly that over time they can “wear out and allow blood and body fluids to penetrate and get trapped inside mattresses.” They added, “If blood or body fluids from one patient penetrate and get absorbed in a mattress, the fluids can leak out the next time the mattress is used.” If that happens, the next patient runs the risk of coming into contact with these fluids, and thus, becoming infected with pathogens from the bed’s previous occupants.

The FDA reports that this is not the first time they acknowledged these concerns; they released a safety communication in 2013 to make health care workers aware of the issue. However, the problem of contaminated hospital mattresses persists.

“There is no question there has been report after report after report of, ‘We had this outbreak. We killed all these people.’ There was just a report that came out on 18 people who were sick in a French hospital; they were on beds manufactured here in America, and 4 people were killed before they finally realized that it was the mattresses. They took all of the mattresses out of service and stopped the outbreak,” Dr. Hooker told Contagion ® in an exclusive interview.

“There’s a reason that it’s an under reported problem; hospitals don’t want to say, ‘Hey, we just killed a bunch of people. We kill 29,000 people a year with C. difficile infections. Do you hear that? I mean, that’s like crashing a plane every day and we do nothing about it. We just act like it didn’t happen.”

In an effort to address the issue, the FDA has released recommendations based on Centers for Disease Control and Prevention (CDC) guidelines for environmental infection control in health care facilities; they include:

  1. Develop an inspection plan for all hospital mattresses and mattress covers in the facility. Learn the time of life for all mattresses/mattress covers by checking the manufacturer’s guidelines; follow any other recommendations that the manufacturers list. If you have any additional questions, contact the mattress manufacturer.
  2. Inspect each hospital mattress for visible signs of damage, which can include: cuts, tears, cracks, pinholes, snags, or stains. On a routine basis, remove mattress covers and check the inside. With the cover removed, check the mattress for wet spots, staining, or other signs of damage. Be sure to check all sides of the mattress as well as underneath. You will not be able to effectively inspect the mattress with the cover on.
  3. Remove any mattresses that are damaged, appear worn, or are visibly stained and immediately replace any mattress covers that are damaged.
  4. Maintain your mattresses and mattress covers by cleaning and disinfecting them “according to the manufacturer’s guidelines.” DO NOT stick needles into the hospital mattress through the cover, the FDA stresses.

“The FDA notice about mattress failures is an important first step. However, much more needs to be done. Most failures are not being reported to FDA, and the 700 reports that they have represents an industry-wide problem. Up to one-third of hospital mattresses currently in service in hospitals have failed. Also, the ones that have not failed are not being cleaned,”

Dr. Hooker stressed to Contagion ® in a follow-up interview. “These mattresses quickly get fissures and microscopic cracks that allow bacteria to remain on the surface during terminal cleaning. The next patient is then exposed to those bacteria and gets a hospital-acquired infection. The CDC needs to mandate better cleaning practices nationwide, which they can do.

The CDC needs to also mandate inspection of every mattress after every patient. Damaged mattresses should be removed from service immediately.”

 

To review the article in its entirety, please click on the link below to be re-directed:

http://www.contagionlive.com/news/fda-acknowledges-hospital-mattresses-as-hotbed-for-germs-releases-recommendations

The Society for Healthcare Epidemiology of America (SHEA) Releases New Guidance for Infectious Disease Outbreak Preparedness in Hospitals

 

 

New Document Guides Hospitals in Responding to Infectious Disease Outbreaks

Healthcare epidemiologists play key role in emergency preparedness and response

New expert guidance document for hospitals to use in preparing for and containing outbreaks was published today by the Society for Healthcare Epidemiology of America, with the support of the Centers for Disease Control and Prevention. The guide was published in Infection Control and Hospital Epidemiology.

“This guidance details the role of the healthcare epidemiologist as an expert and leader supporting hospitals in preparing for, stopping, and recovering from infectious diseases crises,” said David Banach, MD, co-chair of the writing panel and Assistant Professor of Medicine at the University of Connecticut and Hospital Epidemiologist at UConn Health. “Armed with the resources to develop and support key activities, healthcare epidemiologists can utilize their skills and expertise in investigation and response to infectious disease outbreaks within a hospital’s incident command system.”

SHEA and CDC collaborated in 2016 to form the Outbreak Response Training Program to guide healthcare epidemiologists in how to maximize their facilities’ preparedness and response efforts to combat outbreaks such as Ebola, Zika, pandemic influenza, and other infectious diseases. The new document, Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals, leads epidemiologists through how to apply, use, and interact with emergency response structures, groups, and frameworks from the institutional to the federal levels, and provides an overview of essential resources. The principles in the guidance are intended for acute care hospitals, but may apply to other types of healthcare facilities, such as free-standing emergency departments and long-term care facilities.

According to the guidance document, during a crisis the epidemiologist provides medical and technical expertise and leads infection prevention and control efforts, coordinates with institutional stakeholders, and provides input into internal and external communications.

“We will always be faced with new and re-emerging pathogens,” said Lynn Johnston, MD, co-chair of the writing panel and professor of medicine and infectious diseases at Dalhousie University, Halifax, Canada. “This guidance is part of an ongoing effort to develop tools and strategies to prevent and manage contagious diseases to ensure patient and public safety.”

The document is part of a partnership between SHEA and CDC to prepare for emerging and re-emerging infections by providing training, educational resources, and expert guidance for dealing with outbreaks in healthcare facilities. The program is designed to train U.S. healthcare epidemiologists, who oversee infection control programs, to have the skills, abilities, and tools available to implement infection control practices and provide a leadership voice in responding to infectious threats.

To operationalize the guidance, SHEA will conduct an outbreak response workshop in January, develop and post toolkits based on the recommendations, and provide online training modules and webinars.

 

 

To view article in its entirety please click on the following link:

http://www.shea-online.org/index.php/journal-news/press-room/press-release-archives/555-w-document-guides-hospitals-in-responding-to-infectious-disease-outbreaks

 

Recent Emergence of C.difficile Infection in Romanian Hospitals – Abstract

Recent Emergence of Clostridium Difficile Infection in Romanian Hospitals is Associated With a High Prevalence of Polymerase Chain Reaction Ribotype 027.

Abstract

AIMS:

To evaluate the epidemiology of Clostridium difficile infection in several Romanian hospitals.

METHODS:

A survey was conducted from November 2013 to February 2014 in 9 hospitals selected from different Romanian regions.

RESULT:

The survey identified 393 patients with C. difficile infection. The median age was 67 years (range: 2-94 years) with 56% of patients older than 65 years. The mean C. difficile infection prevalence was 5.2 per 10.000 patient-days, with the highest prevalence, 24.9 and 20 per 10.000 patients-days, reported in a gastroenterology and an infectious diseases hospital, respectively. The origin of C. difficile infection was health care-associated for 70.5% of the patients, community-acquired for 10.2% of patients and indeterminate for other 19.3%. Severe C. difficile infection was registred in 12.3% cases and in hospital all-cause mortality was 8.8%. Polymerase chain reaction-ribotype 027 was the most prevalent in all participating hospitals, and represented 82.6% of the total ribotyped isolates. Moxifloxacin minimal inhibitory concentrations were higher than 4 μg/mL for 59 of 80 tested isolates (73.8%). Fifty-four of these 59 isolates were highly resistant to moxifloxacin, (minimal inhibitory concentration ≥32 μg/mL) and belonged more frequently to polymerase chain reaction-ribotype 027 (p<0.0001).

CONCLUSION:

The present study is the first multicentre study performed in Romania and shows that the ribotype 027 is largely predominant in C. difficile infection cases in Romania. The prevalence of C. difficile infection in some specialized hospitals is higher than the European mean prevalence and demonstrates the need of strict adherence to infection control programmes.

 

https://www.ncbi.nlm.nih.gov/pubmed/29188783?dopt=Abstract&utm_source=dlvr.it&utm_medium=twitter