September Puts Sepsis and Infection Prevention in the Spotlight

September is Sepsis Awareness Month, which provides us an opportunity to shine a light on this life-threatening condition. Sepsis occurs when an infection triggers a chain reaction in patients' bodies, quickly leading to tissue damage, organ failure and even death. The Centers for Disease Control and Prevention (CDC) report that more than 1.7 million people get sepsis every year, with about 270,000 Americans dying from it. In fact, one in three patients who die in a hospital reportedly have sepsis.

The most frequently identified pathogens that cause infections turning into sepsis include Staphylococcus aureus, Escherichia coli and some types of Streptococcus. The four types of infections most often linked with sepsis are infections of the lungs; urinary track, skin and gut.

To help patients avoid sepsis, healthcare professionals should follow infection prevention best practices, including good hand hygiene and proper catheter removal. By preventing infections, healthcare professionals can prevent sepsis.

But healthcare professionals must also learn what signs to watch for that may indicate an infection has developed into sepsis. These include:

• Confusion or disorientation

• Shortness of breath

• High heart rate

• Fever, shivering and/or feeling very cold

• Extreme pain or discomfort

• Clammy or sweaty skin

Healthcare professionals must also know their facilities guidelines for diagnosing and managing sepsis as any delays in recognition and treatment can cause significant harm.

Nursing Home Infection Risk

One facility type where sepsis rates are high is nursing homes, which is not surprising considering sepsis is most common in elderly individuals. It's also not a surprise when you consider that, as a Kaiser Health News (KHN) report notes, "Poor infection control ranks among the most common citations in nursing homes. Since 2015, inspectors have cited 72 percent of homes nationally for not having or following an infection control program."

To help patients and their families choose a nursing home, KHN conducted an analysis of Nursing Home Compare data available from the Centers for Medicare & Medicaid Services (CMS). Using this data, KHN developed tool that tracks infection-related deficiencies and staffing levels for nursing homes contracted with Medicare and/or Medicaid. Users of the tool can narrow their search down by state and then do a keyword search for a nursing home by name or city. Access the nursing home search tool.

Improve Sepsis Prevention

One approach healthcare organizations can take to jumpstart their sepsis prevention efforts is to review the clinical practice guides for the management of sepsis ("Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016​"), which were developed by the Surviving Sepsis Campaign and most recently updated in 2016.

But what will ultimately make a bigger difference is an unwavering commitment to preventing infections. As noted earlier, you can't have sepsis without an existing infection. Infection Control Consulting Services (ICCS) is a national provider of infection prevention and control services for nursing homes, hospitals and many other facility types. Contact ICCS today to learn more about how its team of expert infection prevention consulting service providers can assist your organization.

August 2018 Issue of Infection Prevention & Control Newsletter Published

The August 2018 issue of the ICCS Infection Prevention & Control Newsletter has published.

The issue identifies some of the most pertinent infection prevention and control news from August. Topics covered in this issue include scope cleaning, handwashing and hand hygiene challenges, antibiotic stewardship, C. diff, MRSA and fluoroquinolones.

Access the issue by clicking here.

Receive the free ICCS Newsletter by signing up here.

July 2018 Issue of Infection Prevention & Control Newsletter Published

The July 2018 issue of the ICCS Infection Prevention & Control Newsletter has published.

The issue identifies some of the most pertinent infection prevention and control news from July. Topics covered in this issue include dental unit waterline guidelines, hospital occupancy and infection risks, urinary catheter dangers, antibiotic resistance, infection prevention staffing and HIV guidelines.

Access the issue by clicking here.

Receive the free ICCS Newsletter by joining the mailing list here.

June 2018 Issue of Infection Prevention & Control Newsletter Published

The June 2018 issue of the ICCS Infection Prevention & Control Newsletter has published.

The issue identifies some of the most pertinent infection prevention and control news from June. Topics covered in this issue include surgery center colonoscopy infection rates, infection prevention gaps at critical access hospitals, a proposed federal rule on hospital infection reporting, influenza vaccine requirements and outpatient antibiotic use.

Access the issue by clicking here.

Receive the free ICCS Newsletter by joining the mailing list here.

Improperly Cleaned Surgical Instruments Puts CA Hospital Into 'Immediate Jeopardy'

A California hospital was assigned "immediate jeopardy" after state health officials discovered improper surgical instrument cleaning processes, according to a 10News report.

In its State Operations Manual, the Centers for Medicare & Medicaid Services (CMS) defines immediate jeopardy as: "A situation in which the provider's noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident."

The problem was found at UC San Diego Health, Hillcrest campus in March during a routine compliance check conducted by the California Department of Public Health (CDPH). Officials stated that "surgical instruments were not cleaned and processed according to nationally recognized infection control standards," according to the report.

Deficiencies discovered reportedly included the following:

• trays with surgical equipment that had brown staining;
• sterilizing machines with large amounts of dark rust color and exteriors covered with dirt; and
• instruments in a post-operative room with red stains.

In a statement provided to 10News, the hospital said, "Opportunities for improvement were identified within an early phase of instrument cleaning that occurs before the actual sterilization. Immediate actions were taken. … UC San Diego Health conducted a review of surgical data before, during and after the survey. This review found no infections related to cleaning and sterilization processes. There has been no evidence of patient impact or harm."

After reprocessing all surgical instruments, an approach approved by CDPH, immediate jeopardy was lifted.

10News reported its research has determined that the hospital was placed into immediate jeopardy at least seven other times in recent years, with at least one case resulting in a fine.

Reprocessing Remains Significant Infection Prevention Challenge Nationwide

Despite the ongoing efforts of infection prevention professionals to promote "best practices," suboptimal practices within the reprocessing of medical devices and instruments continue to plague facilities — inpatient and ambulatory surgery centers (ASCs) — across the nation. Phenelle Segal, President of Infection Control Consulting Services and her team of infection prevention experts, spend a significant amount of time consulting in the perioperative environment. The ICCS team places a major emphasis on sterile processing, including onsite observations in hospitals and ASCs as well as development of policies and procedures to ensure that facilities comply with federal, state and accreditation organization requirements.

"We focus on the inpatient and outpatient surgery environment and have expanded our services to include onboarding infection prevention designees as we continue to find gaps in knowledge, understanding of practices, available resources, monitoring and accountability," says Phenelle. "Our team has identified that these factors and others contributed greatly to the pitfalls as described in this immediate jeopardy situation."

Phenelle and her team of experts observe a variety of facility practices, with varying levels of compliance, and believe that ongoing failure is a multifactorial issue. Tight surgery schedules, quick turnover of cases, staff turnover and lack of monitoring and conducting competencies contribute to noncompliance.

She notes that reprocessing of medical devices is a practice that cannot be compromised for any reason. It is up to a team of key players, such as OR and central processing and infection prevention personnel, to oversee processes and conduct compliance monitoring with competencies. Administrators of outpatient centers and the C-suite in hospitals should provide the appropriate support and resources at all times.  

Learn more about how ICCS assists facilities nationwide with central processing department compliance.