Tag Archives: Healthcare-Associated Infections

Preventing Healthcare-Associated Infections (HAI’s) and the War On Superbugs

Many hospitals have made impressive strides in preventing health care-associated infections; some have seen a 70 percent reduction in the rate of bloodstream infections, thanks to safeguards such as checklists of steps to take before and during medical procedures and stepped-up hand-washing. But the problem continues to worsen. Now the White House has asked Congress for $1.2 billion to fund an effort to cut the rate of dangerous infections in half by 2020. The plan includes steps to prevent and slow the spread of infection, improve surveillance of resistant bugs, develop better diagnostic tests and new antibiotics and curb the misuse of currently available drugs – the main driver of drug resistance.

This is no fleeting crisis. Experts warn that the loss of antibiotics would roll back medical progress by 70 or 80 years. Without them, people could die of everyday dental abscesses and strep throat. Just inserting an IV could have lethal consequences. “Medical practice developed in a way that presumes the ability to treat infection in order to allow other things to be done like major surgery, cancer chemotherapy, transplants and joint replacement,” says James Johnson, senior associate director of the Infectious Disease Fellowship Program at the University of Minnesota in Minneapolis.

In terms of their power and importance, “almost nothing else in medicine comes close,” says Brad Spellberg, chief medical officer and professor of clinical medicine at the Los Angeles County and USC Medical Center. He is also the author of “Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them.”

The trouble is that “any time we use antibiotics, we’re contributing to their future ineffectiveness,” Johnson says. It’s natural for an organism to eventually become resistant to that drug. And too often, bowing to the demands of patients, doctors prescribe antibiotics when they’re not needed; the drugs aren’t effective against viral illnesses.

Another problem: Because it takes time to determine precisely which organism is the culprit, doctors frequently prescribe “broad spectrum” antibiotics that work against a wide range of bacteria when a more targeted drug would do. “The consequence,” Johnson says, is that “we’re using our last-reserve antibiotics with increasing frequency.” The CDC estimates that at least 50 percent of antibiotic use in humans is unnecessary or inappropriate.

At the same time, 80 percent of antibiotics in the U.S. are used in livestock feed to prevent or control infection and promote growth, which fuels outbreaks of drug-resistant organisms such as Salmonella, E. coli and Campylobacter that spread through the environment. The end result: “There are patients in hospitals in the U.S. today suffering and dying from infections for which doctors have no antibiotics to give,” says Arjun Srinivasan, associate director for Healthcare Associated Infection Prevention Programs for the CDC. “They are completely resistant to all therapies.” Experts agree that no single intervention will solve the problem – and are exploring a number of needed solutions:

Under the president’s plan, hospitals would establish antibiotic stewardship programs to focus doctors on “prescribing the right antibiotic at the right time at the right dose for the right duration,” says Ann McIntyre, clinical associate professor in internal medicine at Nova Southeastern University and director of the infectious diseases fellowship program at Palmetto General Hospital in Florida. Only about half of hospitals currently have such programs. But the Centers for Medicare and Medicaid Services is expected to make them a requirement for eligibility for reimbursements by 2017. Typically led by a multidisciplinary team – infectious disease doctors, pharmacists, microbiologists or epidemiologists and nurses – stewardship programs involve keeping careful control over how the drugs are dispensed. They include such strategies as frequently reviewing patients’ status to make sure they still need an antibiotic, and if so, reassessing the drug, dosage and type of delivery (switching from IV to oral antibiotics, for instance, eliminates a potential source of additional infection), and restricting the use of certain broad spectrum antibiotics until an antibiotic expert weighs in. “Physicians are used to practicing for the patient in the moment and not having to think about all patients globally,” says Neil Fishman, an infectious disease specialist and chief patient safety officer at the University of Pennsylvania Health System. That, he says, has to change.

 

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

http://health.usnews.com/health-news/patient-advice/articles/2015/10/14/the-new-war-on-superbugs

 

“It Takes A Village” Re: Clostridium difficile (C.diff.) and Healthcare-Associated Infections, By Dr. Rosie D. Lyles, MD,MHA,MSc

“It Takes a Village”
By: Rosie D. Lyles, MD, MHA, MSc, Head of Clinical Affairs for Clorox Healthcare
September 21, 2015

With increasing rates of Clostridium difficile infections (CDI), C. difficile now rivals methicillin-resistance Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections (HAIs) in the United States. (1) The prevalence of C. difficile infections has more than doubled in U.S. hospitals from 2000 to 2009 (2) and CDI is regarded as one of the serious, expensive, and potentially avoidable consequences of hospitalization. The cost of treating CDI in the hospital is $3427-$9960 (in 2012), and the cost of treating patients with recurrent CDI is $11,631, for a total cost of more than $1.2 billion annually in the United States. (3-4)

In June 2015, the White House spearheaded an executive call to action focused on implementing and improving antibiotic stewardship programs (ASPs) across the continuum of care (acute care facilities, outpatient clinics, doctors’ offices and long-term care facilities). The urgency around this issue stems from the increasing number of antibiotics prescribed, which subsequently breeds multi-drug resistant organisms (MDROs) like C. difficile. Unnecessary or excessive antibiotic use combined with poor infection control practices may increase the spread of C. difficile within a facility and across facilities when infected patients transfer, such as from a hospital to a nursing home. Increasing evidence suggests that contaminated surfaces in healthcare facilities play an important role in the transmission of several key pathogens including C. difficile, vancomycin – resistant enterococci (VRE), MRSA, Acinetobacter baumannii, and norovirus.

In order to reduce HAIs, all hands on deck are required to support a successful infection prevention strategy. In other words, “it takes a village.” Growing up, I remember hearing the phrase, “it takes a village to raise a child,” meaning there is a partnership within a community with several individuals playing a role in the maturation of a youth. Within a hospital, it’s a collaborative team across several departments that implements evidence-based protocols, continues to educate staff and patients, and maintains compliance of infection control strategies/approaches to reduce the risk of a broad range of infections, including CDI. From the C-suite (administrators and senior management) to direct healthcare providers (such as physicians, nurses, aides, and therapists) and environmental staff (EVS); everyone with direct or indirect contact with a patient’s care plays an essential role.

As a healthcare professional, it’s very important for hospitals to focus on the bigger picture when it comes to infection prevention strategy and control. Prioritizing infection control measures for just one or two pathogens of concern is insufficient. At the end of the day, one pathogen doesn’t trump another because patients don’t want an HAI from ANY pathogen! The horizontal approaches aim to reduce the risk of infections due to a broad array of pathogens through implementation of standardized practices that do not depend on patient-specific conditions:

• Proper hand hygiene
Hand hygiene practices in compliance with the Centers for Disease Control and Prevention (CDC) or World Health Organization (WHO) guidelines are a key component in preventing and controlling C. difficile, in addition to many other HAI-causing pathogens.
• Universal use of gloves or gloves and gowns
Donning the correct protective equipment minimizes contact with pathogens. It is also important to follow protocols for properly discarding this equipment.
• Universal decolonization (daily optimal bathing with chlorhexidine gluconate (CHG))
CHG bathing has been shown to decrease the bioburden of microorganisms on the patient, the environment, and the hands of healthcare personnel.
• Antimicrobial stewardship program
Ensuring every patient receives an antibiotic only when needed: the right agent, at the right dose, for the right duration.
• Evidence-based environmental cleaning and disinfection products
At a minimum, effective environmental cleaning involves using cleaners & disinfectants that are registered by the Environmental Protection Agency (EPA). Supplementing manual cleaning with new technology like ultraviolet (UV) light provides an extra layer of protection and the most comprehensive approach. UV has the highest-energy form that can inactivate dangerous and persistent pathogens by eradicating microorganism deoxyribonucleic acid (DNA) that may be left on surfaces, which can be missed with traditional cleaning. Finally, because C. difficile has been found in non-CDI patient rooms, using an EPA-registered sporicidal surface disinfectant to clean all patient rooms (daily and terminal) is great strategy to prevent the spread of the bacteria.

I had the pleasure of attending the CDC’s Environmental Hygiene for Ebola and Other Emerging Pathogens meeting on September 14, 2015, with attendees from academia, private industry, federal employees and health organizations, participated in a roundtable discussion on the research framework needed to determine the public health significance of non-critical environmental surface contamination and provide guidance to healthcare facilities about the methods to reduce the contamination of non-critical environmental surfaces reliably in order to improve patient safety. Every participant present at the meeting agreed that, due to the challenges/barriers that hospitals face with preventing HAIs (both from emerging pathogens and more common pathogens like C. difficile), it takes a village to successfully implement evidence-based protocols, continue to educate and maintain compliance with infection prevention protocols.

###################################################

About Rosie D. Lyles, MD, MHA, MSc, Head of Clinical Affairs for Clorox Healthcare

Rosie D. Lyles, MD, MHA, MSc is the Head of Clinical Affairs for the Clorox Professional Products Company where she serves as a research fellow and primary medical science liaison for the healthcare business, supporting all scientific research as well as clinical and product intervention design and development.
Dr. Lyles previously served as a physician researcher and study director for multiple epidemiologic research initiatives in the Division of Infectious Diseases at the Cook County Health and Hospitals System, investigating healthcare-associated infections with a particular focus on the epidemiology and prevention of multidrug-resistant organisms and infections in intensive care units and in long-term acute care hospitals. She has directed numerous clinical studies and interventions for the Centers for Disease Control and Prevention (CDC) and the Chicago Antimicrobial Resistance and Infection Prevention Epicenter.
During her nine years as a study director and physician researcher at Hektoen Institute for Medical Research, Dr. Lyles’ work included CDC Epicenters Prevention program studies on bloodstream infections, Clostridium difficile infections and case-control studies of community-acquired Methicillin-resistant Staphylococcus aureus (MRSA). She also performed surveillance studies of Klebsiella pneumoniae carbapenemase (KPC) positive patients, examining universal contact isolation and patient skin antisepsis protocols to identify ways to optimize standard infection control measures.
Dr. Lyles received her medical degree from St. Matthew’s University School of Medicine and holds a Master of Health Service Administration from St. Joseph College. She also recently completed a Master of Science in Clinical Research and Translational Sciences through the University of Illinois at Chicago. She is an active member of the Association of Professionals in Infection Control and Epidemiology, the Infectious Disease Society of America, the Society for Healthcare Epidemiology of America and has served as a peer reviewer for the National Institutes of Health, New England Journal of Medicine, and American Journal of Infection Control.
References:
1. Dubberke, ER, et al. Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update. Infect Control Hosp Epidemiol. 2014, V35:S48-S65
2. Tabak et al., Predicting the Risk for Hospital-onset Clostridium difficile Infection (HO-CDI) at the Time if Inpatient Admission: HO-CDI Risk Score. Infect Control Hosp Epidemiol. 2015, 36: 6; 695-701
3. Magill, SS. et al. “Multistate Point-Prevalence Survey of Health Care-Associated Infections.” The New England Journal of Medicine 370.13 (2014): 1198–1208.
4. Dubberke, ER, and Olsen, MA. “Burden of Clostridium Difficile on the Healthcare System.” Clinical infectious diseases 55 Suppl. 2 (2012): S88–92.
5. Septimus, E., et al. “Approaches for preventing Healthcare-associated Infections: Go Long or Go Wide?” Infect Control Hosp Epidemiol. 2014. 35: 7; 797-801

Trinity Guardion Bed Protection System Proven To Reduce C. diff., A Healthcare-Associated Infection, By 50%

NewspaperII IN THE NEWS………….

Trinity Guardion was selected by Xavier University’s Center for Innovation to present their Bed Protection System, which is proven to reduce a Hospital Acquired C.diff infection by 50%, at Healthovate! Summit on Thursday, June 11. The 2015

Xavier Center for Innovation (CFI) Healthovate! Summit is co-sponsored by Intel-GE Care Innovations™. “Trinity Guardion is the world’s only manufacturer of launderable bed covers specifically engineered to eliminate bacteria, spores and viruses from a hospital bed mattress. I’m excited to present this patented technology with over 6 years of research behind it to this esteemed group of innovators,” states Bruce Rippe, Trinity Guardion’s Chief Operating Officer.

Healthovate! Summits give healthcare leaders an opportunity to share their expertise and engage in conversations with other leaders from other industries. Trinity Guardion will also be presenting at similar events in Boston (July 31), Chicago (Oct 5), and Nashville (Oct 28). “Our mission at the CFI is to use innovation to solve complex problems. I can’t think of a more important challenge facing our society than how we keep people healthy, while reducing costs and improving overall well-being,” said Shawn Nason, Chief Innovation Officer at Xavier University. “By bringing together a diverse community of people, all committed to health, I am confident we can find meaningful solutions and innovative technologies and systems that will transform the healthcare industry—not to mention better ways to educate and prepare students to work in and lead healthcare in the future.”

Over 40 area start-up hospitals, universities, national organizations, healthcare professionals, and Xavier alumni will learn how this innovative mattress cover acts as a barrier to prevent bacteria and fluids, which can be harbored in a hospital mattress as a result of ineffective cleaning, from coming in contact with a patient. Due to its abilities in preventing viruses such as Ebola and other bacteria from penetrating through the cover, hospitals have begun to implement the covers in their infection control wards. Last year, the innovative technology of the Trinity Bed Protection System was recognized when the honorable mention for the 2014 NALTH Goldberg Innovation Award was awarded to St. Vincent Seton Specialty Hospital, Indianapolis for their use of the mattress cover in their facility.

Tested in two Midwestern hospitals, the Trinity Bed Protection System does not impede bed operation or any clinical aspects of the underlying mattress. In fact, it helps reduce terminal clean time, while improving asset life of the bed.

The Trinity Bed Protection System from Trinity Guardion makes bed surfaces cleaner for every person every time.

About Trinity Guardion: Trinity Guardion is the result of an international collaboration of scientists, doctors and academic professionals in the healthcare industry, united in the concern that hospital beds are not clean. This concern was corroborated by peer reviewed research that is available upon request. The product line includes mattress covers for most brands of hospital beds, therapy tables and pillow cases.

C. diff. Infection Prevention Study: Phase 2 Study SER-109 by Seres Therapeutics; First Patient Dosed for the Prevention of Recurrent C. diff. Infection in Adults

* In The News *

Seres Therapeutics, Inc., a leading microbiome therapeutics platform company, announced on May 28th, 2015 the enrollment and dosing of the first patient in its Phase 2 clinical study of SER-109, an investigational oral microbiome therapeutic for the prevention of recurrent Clostridium difficile infection (CDI) in adults.

The objective of the Phase 2 study is to further assess the efficacy and safety of SER-109, Seres’ leading development candidate.

“Recurrent CDI is a rapidly growing problem in the U.S., and antibiotics are currently the only FDA-approved treatment option,” said Roger Pomerantz, Chairman, President and CEO of Seres. “For many patients, antibiotics may exacerbate the problem by inducing or prolonging an imbalance of the microbiome and creating the conditions that support disease recurrence. We are excited about evaluating the potential of SER-109 to correct the microbiome and address this critical patient need.

“The start of our Phase 2 study is an important milestone for patients, and for Seres.

Our earlier studies suggest that SER-109 is a potentially transformative therapeutic for tens of thousands of patients each year, validating our conviction that treating dysbiosis of the microbiome enables us to address the underlying cause of disease and bring about rapid improvements in health.”

Results from the Phase 1b/2 study of SER-109 in recurrent CDI patients showed that 87 percent of patients met the primary study endpoint and 97 percent of patients achieved a clinical cure, which was defined as the absence of CDI requiring antibiotic treatment during the eight-week period after SER-109 dosing.

The Phase 2 study is a multicenter, randomized, placebo-controlled study that will evaluate the efficacy and safety of SER-109. The primary outcome measure is the absence of clinically-significant CDI through eight weeks following administration of SER-109 compared to placebo. SER-109 will be administered orally as a single dose, following the standard of care antibiotics for CDI. The study is actively enrolling and will be conducted at approximately 35 centers across the U.S. The read-out from the Phase 2 study is currently expected in the middle of 2016.

About SER-109

SER-109 is the lead Seres Ecobiotic® microbiome therapeutic in clinical testing for the treatment of recurrent Clostridium difficile infection (CDI). SER-109 was developed utilizing the Seres Microbiome Therapeutics™ platform that provides deep insight into the ecologies of disease and then identifies microbial compositions that can catalyze a shift to health. CDI is a rapidly growing problem associated with antibiotic use. Approximately 85,000 to 110,000 CDI patients in the U.S. are expected to have more than one recurrence.

About Seres Therapeutics, Inc.

Seres Therapeutics, Inc. is a leading microbiome therapeutics platform company developing a novel class of biological drugs that are designed to treat disease by restoring the function of a dysbiotic microbiome.

 

For article in its entirety:

http://finance.yahoo.com/news/seres-therapeutics-inc-announces-first-113000601.html

 

 

*Please note – The C Diff Foundation does not endorse this product or any product and this posting is strictly for informational purposes only.

Loyola Int’l C. diff. Research, Dr. Dale Gerding, MD Makes Important Breakthrough Towards the Prevention of Recurring C.diff. Infection

laboratorybeakers3

In what is a major step towards the prevention of recurring bouts of Clostridium difficile (C.diff.) infection, an international team led by Dr. Dale Gerding, MD, Hines Veterans Administration (VA) research physician and professor of Medicine at Loyola University Chicago Stritch School of Medicine, has shown that giving spores of non-toxic C.diff. by mouth is effective in stopping repeated bouts of C.diff. infection which occurs in 25-30 percent of patients who suffer an initial episode of diarrhea or colitis.

 

The study is published in the May 5 issue of the Journal of American Medical Association (JAMA) and is the focus of a JAMA-produced video.

“The results of this study are very gratifying because the preclinical laboratory and patient studies were all done through our VA research program supported by the Department of Veterans Affairs Research Service,” says Gerding. “Results of this study confirm findings of earlier studies that showed that if we can establish non-toxic C.diff. as a resident of the gut of the patient, that we can protect the patient from infection by the toxic strains of C.diff..” Viropharma and Shire pharmaceutical companies supported the clinical trials.

These results warrant additional study to confirm that treatment with non-toxic C.diff. spores can reduce recurrent C.diff. infection and prevent a first episode of C.diff. infection in those who are taking any antibiotics and are at high risk of infection, he added.

Gerding and an international team of infectious disease researchers, including those at Loyola University Medical Center (LUMC), randomly assigned 168 adult patients with C.diff. infection who had been treated for their infection with antibiotics to receive doses of 10 thousand or 10 million spores per day of non-toxic C.diff. in liquid form for 7 or 14 days, or to receive an identical placebo. Of those assigned any dose of non-toxic C.diff. , 11 percent experienced a repeat of infection within 42 days compared with 30 percent of those given a placebo, a statistically significant reduction. For the most favorable dose tested, 10 million spores a day for 7 days, the recurrence of C.diff. infection was reduced to 5 percent.

Healthcare-acquired infections (HAI) including a leading HAI, C.diff. causes severe diarrhea and inflammation of the lower bowel or colon, continues to escalate in frequency and severity in the U.S.

According to the Centers for Disease Control and Prevention (CDC) report published in
February 2015, almost 500,000 C.diff. infections occurred in the U.S. in 2011, with 83,000 recurrences and 29,000 deaths within 30 days of diagnosis.  Older adults taking antibiotics and who receive care at medical institutions have a higher risk at acquiring this infection.

Cheryl O’Riordan, who has had repeated bouts of C.diff. infection, said having C.diff. made her visit the bathroom on an average of 10 times per day. “Before receiving effective treatment, I was unable to leave the house,” says the active cyclist, skier and hiker. O’Riordan went into remission after being treated successfully at LUMC. “I am back cycling more than 3 miles every day and have several major adventure trips planned.”

Gerding, who has published more than 135 studies on C.diff. is considered one of the leading international experts on C.diff..

Stuart Johnson, MD, infectious disease specialist at LUMC, is also the director of research at Hines VA hospital. Together Gerding and Johnson have partnered on C.diff. research for almost three decades, involving many LUMC patients.

“The study offers real hope for those debilitated by recurring bouts of C.diff.,” says Johnson “This study represents a novel and potentially highly effective bacteriotherapy approach to restoring colonization resistance against toxic strains of C.diff. in these patients,” he adds.

Loyola University Health System is recognized internationally as a leader in infection control and prevention.

LUMC is one of a few select hospitals who invest in universal screening of all inpatients for MRSA. Loyola was one of the first institutions to require all staff to have mandatory flu shots as a condition of employment. Loyola was one of several academic hospitals that participated in this recent benchmark international study.

 

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

http://www.eurekalert.org/pub_releases/2015-05/luhs-lso050115.php

WHO Healthcare-Associated Infection Pledge 2015

worldaround
C Diff Foundation Pledges Continued Support to Reduce Healthcare-Associated Infections
The C Diff Foundation continues to recognize the serious disease burden and significant economic impact that healthcare-associated infections places on patients and the health care systems throughout the world.

 

Considering that the majority of these infections are treatable and preventable, appreciating the momentum that the Global Patient Safety Challenge program of the WHO World Alliance for Patient Safety is bringing to reduce healthcare-associated infection at the global level.
Emphasizing that a unique opportunity exists to reverse the incidence of healthcare-associated infections, members of the C Diff Foundation shares and pledges……..
To work together to witness a reduction in healthcare–associated infections through the following actions:
• Acknowledging the importance of healthcare-associated infections;
• Developing or expanding ongoing campaigns at national or sub-national levels to promote and improve hand-washing (aka hand hygiene) methods among health care providers;
• Making reliable and validated information available on healthcare-associated infections at community and district levels to foster appropriate actions;
• Sharing experiences and, where appropriate, available surveillance data, with the WHO World Alliance for Patient Safety;
• Consider the use of WHO strategies and guidelines to tackle healthcare-associated infection, in particular in the areas of hand-washing (aka hand hygiene), raise awareness of antibiotic stewardship, and environmental procedure safety.

We will work with health professionals and associations worldwide:
-To promote the highest standards of practice and behavior to reduce the risks of healthcare-associated infection;
-To foster and sustain collaboration with research institutions, training schools, educational centers, universities, healthcare settings, and agencies of other WHO Member States to ensure full utilization of knowledge and experience in the field of healthcare-associated infection.
-To encourage senior management support and role-modeling from key staff to promote the implementation of interventions to reduce healthcare-associated infections.
C Diff Foundation
May 5, 2015

 

For more information about Clean Care is Safer Care, please contact the team at savelives@who.int

 

What you need to know about C. diff. and High Touch Surfaces discussed on C. diff. Spores and More on April 28th with Bradley Whitchurch CEO Seal Shield, Dr. Rosie Lyles, MD Clorox Healthcare, and Shelby Lassiter, BSN,RN,CPHO,CIC Infection Preventionist

cdiffRadioLogoMarch2015What you need to know about C. diff. and high touch surfaces

Join us on Tuesday, April 28th at 11:00 a.m. Pacific
time – 2 p.m. Eastern Time with our three guests…………

 

 

 

http://www.voiceamerica.com/show/2441/c-diff-spores-and-more

 

Bradley Whitchurch, Founder and Chairman of the Board at Seal Shield, LLC,
Dr. Rosie D. Lyles, MD, Clinical Affairs Head, Research and Department, Clorox Healthcare and Shelby Lassiter, BSN, RN, CPHO, CIC, Infection Preventionist at a University Hospital in North Carolina,.

Listen in as these three professionals come together to discuss C. diff. infections,
healthcare-associated infections, and you will want to learn why hand hygiene alone is not enough.  Plus discussions about infection prevention measures being utilized in healthcare and home settings to keep everyone safe.

Guest Bio’s:

Bradley Whitchurch
Brad is the Founder, CEO and Chairman of the Board at Seal Shield LLC. Seal Shield is an infection control solutions manufacturer headquartered in Jacksonville, FL. The Company produces waterproof, antimicrobial input devices for healthcare and other global markets. Seal Shield’s primary products include washable, antimicrobial keyboards, mice and TV remote controls. Mr. Whitchurch has been a pioneer in the computer products industry for 25 years.

Dr Rosie Lyles MD
Dr. Lyles is Currently the Clinical Affairs Head, Research and Department, Clorox Healthcare and serves as the primary liaison for Client’s Healthcare division as a department head to relevant professional, research and academic institutions, public health agencies, and forums. The role will provide strategic guidance and assist with the development and implementation of a plan for clinical/scientific support of marketing initiatives. This includes overall responsibility for public health message development, publication planning, key opinion leader development and provides relevant input into the clinical and product intervention design and development.

Shelby Lassiter, BSN,RN,CPHQ,CIC
Shelby holds an Associate Degree in Nursing from Wake Technical College and a Bachelor’s Degree in Nursing from East Carolina University. She is certified in Infection Control (CIC) and is a Certified Professional in Healthcare Quality (CPHQ) through the National Association of Healthcare Quality (NAHQ). She has over thirty-five years of experience in healthcare: medical/surgical nursing, critical care, healthcare quality and infection prevention. Shelby has held a variety of positions in Infection Prevention and is currently an Infection Preventionist at a University Hospital located in North Carolina.