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For Healthcare Professionals

The Centers for Disease Control and Prevention (CDC)'s healthcare-associated infection (HAI) prevalence survey provides an updated national estimate of the overall problem of HAIs in U.S. hospitals. Based on a large sample of U.S. acute care hospitals, the survey found that on any given day, about 1 in 25 hospital patients has at least one HAI. There were an estimated 722,000 HAIs in U.S acute care hospitals in 2011. About 75,000 hospital patients with HAIs died during their hospitalizations. More than half of all HAIs occurred outside of the intensive care unit. HAIs result in an estimated $30 billion in excess healthcare costs nationally each year.

What can you do as a Healthcare Professional to Prevent HAIs?

Wash Your Hands

Clean Hands Save Lives

Hand Hygiene in Healthcare Settings provides healthcare workers and patients with a variety of resources including guidelines for providers, patient empowerment materials, the latest technological advances in hand hygiene adherence measurement, frequently asked questions and links to promotional and educational tools published by the World Health Organization (WHO), universities and health departments.

Follow Safe Injection Practices – Injection Safety is Every Provider’s Responsibility

One and Only Campaign

  1. It is a provider’s responsibility to keep patients, providers and the community safe and to minimize the risk of spreading infections when preparing and administering every injection. Remember that needles and syringes are single-use devices. They should not be used for more than one patient or re-used to draw up additional medication. 1 Needle + 1 Syringe + 1 Time = 0 Infections.
  2. Single-dose vials or IV bags should not be administered to multiple patients.
  3. Multi-dose vials’ use should be limited and dedicated to a single patient whenever possible.  

Recently ODH joined the One & Only Campaign, a public safety campaign led by the CDC Foundation and the Safe Injection Practices Coalition (SIPC). The Campaign offers a wide array of evidenced-based information about safe injection practices on its website where you can also watch videos and download safety presentations and printable materials like the Healthcare Provider Toolkit.

Wear Personal Protective Equipment as appropriate

PPE        

Guidance for the Selection and Use of Personal Protective Equipment in Healthcare Settings

CDC has developed this staff development presentation for use by infection control and occupational health personnel to train healthcare workers on how to select and use personal protective equipment (PPE).

Sequence for Donning and Removing Personal Protective Equipment

This poster demonstrates the sequence for donning and removing PPE. The poster provides key instructions to reinforce safe practices that are intended to limit the spread of contamination.

Use Antibiotics Wisely

Get Smart for Healthcare – Know When Antibiotics Work

Studies indicate that 30-50% of antibiotics prescribed in hospitals are unnecessary or inappropriate. There is no doubt that overprescribing and inappropriate prescribing are contributing to the growing challenges posed by Clostridium difficile and antibiotic-resistant bacteria. Studies demonstrate that improving prescribing practices in hospitals can not only help reduce rates of Clostridium difficile infection and antibiotic resistance, but can also improve individual patient outcomes, all while reducing healthcare costs. Get Smart for Healthcare is a CDC campaign focused on improving prescribing practices in inpatient healthcare facilities.

 

Stay Current

Visit the Agency for Health Research and Quality (AHRQ).  This agency provides free continuing education events in the areas of comparative effectiveness, quality and patient safety and prevention/care management as well as through conferences. Select continuing education opportunities are described here:

  • AHRQ PSNet—A national web-based resource featuring the latest news and essential resources on patient safety
  • TeamSTEPPS™—Eligible for Continuing Medical Education (CME) or Continuing Education Units (CEU) if health care professionals attend the 2 1/2-day training session at one of the 5 National Implementation of TeamSTEPPS™ training centers

Educate Your Patients

Patients in Waiting RoomEncourage your patients to become  more involved with their healthcare by asking questions and keeping the conversation open.  Informed patients are safe patients. Patients and families who engage with healthcare providers ask good questions and help reduce the risk of errors and hospital admissions.

 

 

Tools to engage patients:

Brochure: Help protect your loved ones from healthcare-associated infections

Waiting Room Video (Audio/Video item) - This 7-minute Flash® video features patients and clinicians discussing the importance of asking questions at medical visits. To order a free copy of this video on DVD, call 1-800-358-9295 or email AHRQpubs@ahrq.hhs.gov.

Report Outbreaks

Outbreaks of HAIs are reportable per Ohio Administrative Code 3701-3-02.  The Ohio Department of Health (ODH) Bureau of Infectious Diseases’ Outbreak Response and Bioterrorism Investigation Team (ORBIT) assists local health departments (LHDs) in Ohio with the investigation of all infectious disease outbreaks, including healthcare-associated outbreaks. For assistance, please call your LHD.

Information for Healthcare Professionals in Special Settings

Acute Care

SHEA logoThe Compendium of Strategies to Prevent Health Care-Associated Infections in Acute Care Hospitals synthesizes best evidence for the prevention of surgical site infections, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA). It also highlights basic HAI prevention strategies and advanced approaches for outbreak management and other special circumstances. Included are recommendations for performance and accountability measures to apply to individuals and groups working to implement infection prevention practices.

 Ambulatory/Outpatient

Guide to Infection Prevention in Outpatient SettingsThe Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care is a summary guide of infection prevention recommendations for outpatient (ambulatory care) settings. The recommendations included in this document are not new but rather reflect existing evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). This summary guide is based primarily upon elements of Standard Precautions and represents the minimum infection prevention expectations for safe care in ambulatory care settings.

The Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care distills existing infection prevention guidance from the CDC and HICPAC. 

Dialysis

Dialysis

Patients who undergo dialysis treatment have an increased risk for getting a healthcare-associated infection (HAI). Hemodialysis patients are at a high risk for infection because the process of hemodialysis requires frequent use of catheters or insertion of needles to access the bloodstream. Also, hemodialysis patients have weakened immune systems, which increase their risk for infection, and they require frequent hospitalizations and surgery where they might acquire an infection. 

On May 13, 2013, the Centers for Disease Control and Prevention (CDC) released results of its Dialysis Bloodstream Infection Prevention Collaborative showing a 32 percent decrease in overall bloodstream infections and a 54 percent decrease in vascular access-related bloodstream infections after CDC prevention guidelines were used. Dialysis facilities can implement many of CDC’s recommendations by using a series of checklist  s and performing observations using audit tools  that are currently available on CDC’s website. Additionally, CDC has released a free infection prevention course for dialysis nurses and technicians that reviews CDC recommended practices in a convenient, 1-hour self-guided internet training course that also offers continuing education credits.

Long Term Care

Prevention of Norovirus: In a long term care (LTC) facility, patients with suspected norovirus may be placed in private rooms or share rooms with other patients with the same infection. Additional prevention measures in LTC facilities can decrease the chance of coming in contact with noroviruses:

  • Follow hand-hygiene guidelines, and wash hands with soap and water after contact with patients with norovirus infection
  • Use gowns and gloves when in contact with patients who are symptomatic with norovirus
  • Routinely clean and disinfect high touch patient surfaces and equipment with an Environmental Protection Agency-approved product with a label claim for norovirus
  • Remove and wash contaminated clothing or linens
  • Exclude from work healthcare workers who have symptoms consistent with norovirus

For more information please see the Norovirus Toolkit .

Improving Patient Safety in Long Term Care Facilities: CE for RNs, Case Managers, and Staff Educators—This series of 4 webinars provides guidance on implementing AHRQ's Patient Safety training in LTC facilities.

Dentistry

Child At DentistAlthough the principles of infection control remain unchanged, new technologies, materials, equipment and data require continuous evaluation of current infection control practices. The unique nature of many dental procedures, instruments and patient care settings also require specific strategies directed to preventing pathogen transmission among dental healthcare personnel and their patients. For more information see:

Infection Control in Dental Settings

ADA Statement on Infection Control in Dentistry

Rehabilitation and Corrections

Rehab and CorrectionOften health, mental health and substance abuse problems are more apparent in jails and prisons than in the community. Incarcerated men and women may be diagnosed with health, mental health and substance abuse problems after receiving care from a correctional healthcare provider. The CDC has created correctional health resources.

The Federal Bureau of Prisons’ (BOP) Clinical Practice Guidelines (CPGs) are available to the public. Infectious disease topics include: hepatitis A, B and C, human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), MRSA, lice, scabies and tuberculosis (TB). Proper medical practice necessitates that all cases be evaluated on an individual basis and that treatment decisions be patient-specific.

The Ohio Department of Rehabilitation and Correction also has infection control guidelines .

A 2012 article published by ODH staff suggests that improved screening and treatment of latent TB infection (LTBI) in correctional facilities may improve TB control.

Specific types of HAIs

Ventilator Associated Pneumonia

Ventilator associated pneumonia (VAP) is the leading cause of death among HAIs. Reducing mortality due to VAP requires an organized process that guarantees early recognition of pneumonia and consistent application of the best evidence-based practices.

References:

Strategies to prevent VAP in acute care hospitals

Institute for Healthcare Improvement Ventilator Bundle - series of interventions to prevent VAP

Intravascular Catheter-Related Infections

In the United States, about 15 million central vascular catheter (CVC) days occur in intensive care units (ICUs) each year.iv

CDC guidelines for the prevention of intravascular catheter related infections

IHI Central Line Bundle - a series of interventions to prevent infections related to CVCs

Urinary Catheter-Related Infections

Urinary tract infections (UTIs) account for about 40 percent of all HAIs. More than 80 of those infections are associated with catheters. Nursing staff can be instrumental in preventing urinary catheter-related infections.

References:

CDC overview video on catheter associated UTIs

Prevention and management guidelines for catheter associated UTIs 

Preventing Other HAIs

HAIs lead to 99,000 deaths annually. There are more than 75,000 bloodstream infections a year among hospital patients, and as many as 25 percent of infected patients die. Nurses are on the frontline of preventing these infections, and by implementing certain evidence-based recommendations these infections can be dramatically reduced.

CDC recommendations to prevent infections

CDC guide to infection prevention for outpatient settings

Various CDC toolkits for preventing healthcare associated infections

FROM: http://www.ahrq.gov/professionals/systems/monahrq/myqi/nursing.html

Last updated:  2/12/16