Prevention Update
Infection preventionists may spend more time collecting data than protecting patients Collecting and reporting hospital infection data to federal health agencies takes more than fi ve hours each day, at the expense of time needed to ensure that frontline healthcare personnel are adhering to basic infection prevention practices such as hand hygiene, according to a recent case study presented at the 42nd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Infection preventionists (IPs) play a critical role in
the effort to eliminate healthcare-associated infections (HAIs), which strike one in 25 U.S. hospital patients. But many IPs, especially those in community hospitals, feel burdened by the time necessary to comply with the Centers for Medicare & Medicaid Services (CMS) report- ing requirements — so much so that one IP decided to fi nd out just how much time it takes. The answer: fi ve hours and eight minutes a day of IP time, based on a fi ve-day work week. That leaves little time to observe practices, go on rounds, lead safety drills, or answer questions about how to keep patients safe. IPs at Robert Wood Johnson University Hospital Somerset tabulated the amount of time necessary to review lab data and complete reports for blood- stream infections, urinary tract infections, surgical site infections, MRSA infections, and Clostridium diffi cile infections to the Centers for Disease Control and Pre- vention’s National Healthcare Safety Network (NHSN). IPs at hospitals across the country are responsible for analyzing lab reports and reporting infection data to the NHSN database, which is used for Medicare pay- ment determination by CMS.
Pilot program in pediatric long- term care facility halves topical antibiotic use A pilot antibiotic stewardship program at a pediatric long-term care facility brought about a 59 percent de- crease in use of a topical antibiotic and an 83 percent decrease in orders for antibiotics without proper docu- mentation in their electronic medical records system during a six-month period, according to a new study. When the infection prevention team at Elizabeth
Seton Pediatric Center in Yonkers, NY noticed that cer- tain antibiotics were being prescribed for a prolonged period of time and for non-infection indications, they launched a trial program to make improvements in antibiotic prescribing and reduce the risk of antibiotic- resistant infections in their vulnerable patient popula- tion. The program aimed to decrease the number of prescriptions without a documented indication, and to decrease the use of mupirocin, a topical antibiotic oint- ment, for non-infectious conditions such as skin rashes and abrasions. Both of these goals were achieved due to a new barrier built into the electronic medical records, providers are required to document the specifi c condition that dictates the need for the antibiotic they want to order. Once this was in place, they noted a sharper decline in prescription numbers.
INFECTION PREVENTION
Wound care product assessment improves cost, quality and patient outcomes
By Susan Cantrell, ELS
dressings will increase from $2.87 billion in 2014 to $3.51 billion by 2021, driven primar- ily by rising risk factor rates and the need for cost-effi cient treatments . . . The U.S. will remain the largest market, with its value ap- proaching $1.73 billion by 2021.”1 A related report from GlobalData noted,
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“The advanced dressings market will be strongly driven by increasing prevalence of chronic wounds worldwide because rates of risk factors, such as diabetes, obesity and cardiovascular disease, continue to rise. Unmet needs will future innovation in the development of smart dressings and wound diagnostics. Key Opinion Leaders emphasize the rise of chronic wounds and associated risk factors as an incentive for the development of better wound care.”2 Chronic wounds can often begin on the surgical table — as surgical incisions that become infected and do not heal. Pressure ulcers can also begin to develop on the sur- gical table during prolonged operations. Subscribing to the school of an ounce-of-prevention-is-worth-a- pound-of-cure, Margaret Falconio- West, Senior Vice President of Clinical Services, Medline Industries, addressed the impor- tance of assessing the patient’s risk factors prior to the operation. “Today, more focus is being placed on conducting a preoperative assessment and consider- ing a patient’s medical past, activity level, and any history of smoking or alcohol use. This approach can help create an effective postoperative care plan,” said Falconio- West. “Patients with comorbidities, such as diabetes and obesity, are at greater risk for postoperative complications. In particular, individuals with diabetes are generally faced with complications of hyperglycemia, which can ultimately have an impact on wound healing. Obesity is another factor that can have an impact on postsurgical wound care. The trend toward early discharge also has
a bearing on wound care. Beth Hawkins- Bradley, RN, MN, CWON, Director of
18 August 2015 • HEALTHCARE PURCHASING NEWS •
www.hpnonline.com
recent report from the consulting fi rm GlobalData stated, “The global market value for advanced wound
Clinical Operations, Cardinal Health, explained, “More patients are being dis- charged soon after surgery, leading to in- creased recovery time at home. Given that a major concern of postsurgical wounds is prevention of surgical-site infection (SSI), pa- tients need access to advanced wound-care products that provide the same quality as what is available in the hospital. Postsurgical wound infections also are considered ‘never events’ by Centers for Medicare and Medicaid Services. One event can lead to burdensome fi nancial implications. Advanced wound-care products that are easily applied, have long wear time, and can be obtained postdischarge play an important role in recovery and reduction of costs and patient ‘bounce backs’ after discharge.”
Addressing the wounds Some wound-care products actively help to prevent or fi ght infection. Sandra A. Bentley- Williams, RN, CWOCN, 3M, explained how their product works toward that end. “The 3M Steri-Strip Antimicrobial Skin Closures are adhesive skin closures that are placed across the cleansed wound. This product con- tains iodophor in the adhesive, which has broad- spectrum activity against the most common patho-
3M Steri-Strip Adhesive Skin Closures
gens causing SSIs. 3M’s full line of Steri-Strip Adhesive Skin Closures have been clinically proven in numerous studies to help stop SSIs before they start, ultimately saving thou- sands in added healthcare costs, reducing lengths of stay, and aiding in better patient outcomes. The products also offer strong and long-lasting adhesion. Studies have also shown that 3M Steri-Strip Adhesive Skin Closures are associated with a lower infec- tion rate than from wounds closed with in- vasive suture or staples.” Bentley-Williams added that the 3M Steri-Strip Skin Adhesive Skin Closures are simple to apply, come in a variety of sizes, and provide better cosmetic outcome than sutures or staples.
See INFECTION PREVENTION on page 20
INFECTION PREVENTION
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