As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.
Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.
I urge you to use this guidance document, and the accompanying Infection Prevention Checklist for Outpatient Settings to assess the practices in your facility to assure that patients are receiving the safe care that they expect and deserve.
Serious infections are becoming more prevalent and more virulent both in our hospitals and in our communities. The numbers are staggering: 1.7 million people will suffer from a hospital-acquired infections each year and almost 100,000 will die as a result.
When our late daughter, Kate, was diagnosed with an aggressive eye cancer in 1989 at five months of age, our life became consumed by doctor visits, MRI scans, radiation treatments, chemotherapy — and fear. My husband and I assumed that our fight was against the ravages of cancer, but almost eight years later we faced another life-threatening challenge we never counted on — a hospital-acquired infection. In 1997, Kate was infected with methicillin-resistant staphylococcus aureus (MRSA) in the operating room during a “routine” 30-minute biopsy procedure to confirm the reoccurrence of her cancer.
Kate’s hospital-acquired infection led to seven weeks in the pediatric intensive care unit on life support, the amputation of her right leg, kidney damage, and the loss of 70 percent of her lung capacity. While most infections are not this serious, the ones that are often lead to permanent loss of function and lifelong disabilities. In the years since Kate’s infection, resistant strains of the bacteria have emerged and now pose even more of a threat since they can be impossible to treat with our existing arsenal of antibiotics.
Patients afflicted with MRSA will often have to contend with the threat of recurrent infections for the rest of their lives. These patients live in constant fear of re-infection and often struggle with feelings of vulnerability and helplessness. Family members, friends, and co-workers may not fully understand the facts and have nowhere to turn for education about risks and prevention. Loved ones may worry unnecessarily for their own safety, which can cause them to distance themselves from someone who desperately needs their presence and support.
We have the knowledge and the ability to prevent a great number of these frightening infections, but the busy and fragmented system in which healthcare is delivered doesn’t encourage adequate infection control measures, and patients continue to be at risk. A significant part of the problem is that the public doesn’t receive timely and accurate information about the detection and prevention of MRSA and other dangerous organisms, and they aren’t engaged as “safety partners” in the quest to eliminate infections. Read more »
Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.
In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,
fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.
Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »
*This blog post was originally published at KevinMD.com*
The Centers for Disease Control and Prevention (CDC) has produced a patient safety video about the importance of handwashing for hospital patients and their healthcare providers. The instructional piece entitled “Hand Hygiene Saves Lives” is available for hospitals to offer their newly-admitted patients. I think everyone should watch and learn:
I was hesitant to post this photo because it is an image of my girlfriend’s bathtub in New York City. I’m sure she wouldn’t want me to post this, but I figure it’s ok because I didn’t reveal her identity and also, she doesn’t read my blog.
My girlfriend is a physician. She is friendly and smart and well-groomed. Her bathroom, on the other hand, is pretty scary. It’s not unlike other bathrooms I’ve seen in New York – which means this could be partially a cultural phenomenon. She knows it needs cleaning – I guess.
She invited me to stay at her place during a recent visit – instead of a hotel – and I gladly accepted. We planned to have a nice dinner and drinks out on the town. She showed me to my room and casually mentioned that she needed to get some Draino for the bathroom. I wondered what exactly that might mean, and was surprised by her use of understatement in this case. Read more »
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