December 2018 Issue of Infection Prevention & Control Newsletter Published

The December 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 November. Included in this issue are stories on changes to AORN surgical attire guidelines, importance of facial protection, hand hygiene risks linked to gloves, high-risk surfaces, troubling developments out of New Jersey and Michigan, and antibiotic resistance.

Access the issue by clicking here.

Receive the free ICCS Newsletter by signing up here.

Study: Facial Protection Helps Reduce Risk of Infection for Endoscopists

The results of a new study indicate that endoscopists and assisting staff who do not wear facial protection during procedures are at an elevated risk for exposure to blood and body fluids which could lead to infections.

The research, published in Gastrointestinal Endoscopy, was conducted over a six-month period and involved four gastroenterologists who performed 1,100 procedures in 239 endoscopy sessions. The physicians wore face shields during the sessions, with the shields swabbed before and at the end of the session to determine the number of colony-forming units (CFU). Controls included swabs of face shields placed on the endoscopy suite wall, remote patient intake bay wall and following intentional contamination with a colonoscope immediately after a colonoscopy. 

Researchers found that the CFU rate in the pre-endoscopy groups was significantly lower than the post-endoscopist face shield and endoscopy suite wall groups. They noted that "… exposure may result in transmission of infectious diseases. As such, we recommend the use of universal facial protection during GI endoscopy."

One of the researchers, Asif Khalid, MD, told Healio Gastroenterology and Liver Disease, "While endoscopy staff discard used gloves and gowns, and wash hands after performing endoscopy, we doubt colleagues that do not use face shields wash their faces in between cases. Inadvertently touching our face and then patients may serve to spread pathogenic bacteria between patients."

Access the research here.

October 2018 Issue of Infection Prevention & Control Newsletter Published

The October 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 October. Stories included in this issue include Joint Commission scoring changes, progress report on healthcare-associated infection improvement efforts, outpatient antibiotic overprescribing, total hip and knee infections, a deadly adenovirus outbreak and a new flu medication.

Access the issue by clicking here.

Receive the free ICCS Newsletter by signing up here.

AORN Previews Changes to Surgical Attire Guideline

The Association of periOperative Registered Nurses (AORN) has published a preview of four likely changes to its guideline on surgical attire.

In this Periop Today article, Lisa Spruce, AORN director of evidence-based practice and lead author of the forthcoming guideline update, highlights the following proposed updates:

• Covering of arms. AORN is likely to recommend that arms only be covered when performing patient skin antisepsis.

• Wearing clothing under scrubs. AORN is considering allowing facilities to dictate the types of clothing perioperative staff may wear under scrubs and how such clothing should be laundered.

• Choice of head and facial hear cover. AORN expects to add a recommendation allowing facilities to determine the type of head coverings healthcare professionals can use to cover their head and facial hair during perioperative care.

• Practices for covering ears. AORN will likely recommend interdisciplinary teams establish their own practices for ear covering and safe earring wear in the perioperative setting.

The article notes that AORN is also considering changes in several other areas, including scrub attire, changing attire, wearing dresses or leggings and storing scrubs in lockers.

The current guideline was published in 2015. The updated guideline goes up for public comment in January 2019.

Learn about the series of events that led to AORN revising its surgical attire guideline and the possible implications of these changes in this special report from Infection Control Consulting Services (ICCS).

Small Progress Made in Reducing Hospital Infections

A survey funded by the Centers for Disease Control and Prevention (CDC) reveals that hospitals have made some progress in reducing their number of healthcare-associated infections (HAIs).

The 2015 survey of more than 12,000 patients in 199 hospitals showed that 3.2% of patients experienced a HAI. That's down from a 2011 survey of about 11,300 patients in 183 hospitals which revealed a 4% HAI rate — a reduction of 16%.

While that is a noteworthy improvement, it still means hundreds of thousands of hospitalized patients experience a HAI every year, which could lead to sepsis or death.

The 2015 survey results indicated that the improvement achieved between 2011 and 2015 was largely attributable to reductions in the prevalence of surgical-site infections (SSIs) and urinary tract infections (UTIs), with pneumonia, gastrointestinal infections and SSIs as the most common HAIs reported.

Surveyors advocate for increased prevention strategies against Clostridium difficile infections and pneumonia. Hospitals must also remain diligent in their efforts to consistently follow evidence-based protocols that can help reduce HAIs, such as those associated with hand hygiene, standard precautions and other precautions, and medical device disinfection and sterilization.

In addition, hospitals should ensure that they implement formal antimicrobial stewardship programs. The Centers for Medicare & Medicaid Services (CMS) require, as part of its Conditions of Participation (CoP), implementation of such programs in all hospitals and critical access hospitals participating in Medicare and Medicaid programs. These programs are critical to reducing antibiotic-resistant threats that can contribute to HAIs.