ICCS Infection Prevention & Control Newsletter: March 2022

This issue covers some of the most significant news from March. Topics include updated endoscope processing guidance, CLABSIs, OSHA inspections, antibiotic stewardship, and a decolonization toolkit.

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Infection Risks Associated With ECRI Top Patient Safety Concerns 2022 — ECRI Institute published its "Top 10 Patient Safety Concerns 2022" report, which includes multiple safety challenges associated with infections.

ANSI and AAMI Update Flexible Endoscope Sterilization and Quality Control Processing Guidance — After seven years, American National Standards Institute (ANSI) and Association for the Advancement of Medical Instrumentation (AAMI) updated their guidance for disinfection/sterilizing, storage, and quality control procedures of flexible endoscopes.

Recommendations for Prevention and Control of Infections in Neonatal Intensive Care Unit Patients: Central Line-associated Blood Stream Infections — CDC released new recommendations for the prevention of CLABSIs in neonatal intensive care unit patients.

Between a Rock and Hard Place: Recommendations for Balancing Patient Safety and Pandemic Response — APIC issued a report providing strategies to increase the nation's infection prevention and control workforce, strengthen prevention programs, and build resiliency for future pandemics.

OSHA to Boost Healthcare Inspections to Prepare for COVID Variants — OSHA announced it is increasing inspection of hospitals and nursing facilities that treat COVID-19 patients over the next few months to prepare for the potential emergence of new variants of the virus.

Engagement in Antibiotic Stewardship Programs Results in Drop in Antibiotics — Research showed that long-term care facilities were able to see a reduction in antibiotic starts and days of antibiotic therapy by engaging in an antibiotic stewardship program.

Toolkit for Decolonization of Non-ICU Patients With Devices — AHRQ published a toolkit that includes step-by-step instructions, handouts, and educational videos to show frontline teams how to apply a decolonization protocol for non-ICU patients at greater risk of bloodstream infections.

New Study Finds Aerosolized Hydrogen Peroxide Can Significantly Reduce C. Difficile Infections in Hospital Settings — Research showed that adding aerosolized hydrogen peroxide to hospital infection prevention protocols can effectively reduce C. diff infections.

Aspirin May Reduce Death in Hospitalized COVID-19 Patients — Research showed that hospitalized patients with moderate COVID-19 who were given aspirin early on in their treatment had a lower risk of dying compared to patients who were not given aspirin.

Infection Risks Associated With ECRI Top Patient Safety Concerns 2022

ECRI Institute's "Top 10 Patient Safety Concerns 2022" report includes multiple safety challenges associated with infections.

ECRI states that it creates the annual list of patient safety concerns to help healthcare organizations identify and respond to imminent safety threats. With each of the top 10 patient safety concerns, ECRI provides guidance (i.e., "action recommendations") to help organizations address these areas of concern.

Coming in first on the 2022 list is "staffing shortages," including those associated with registered nurses, technicians and physicians. Staffing shortages increase the likelihood of staff burnout and exhaustion that can lead to care mistakes and associated infections.

In second is "COVID-19 effects on healthcare workers' mental health." This is another area contributing to burnout that can contribute to safety shortcomings and subsequent infections.

In third is "bias and racism in addressing patient safety." As ECRI notes, "Although patients from racial and ethnic minority groups are more likely to experience an adverse event while in the hospital providers are significantly less likely to report harmful events for patients from minority groups than for white patients."

Sixth on the list is "nonventilator healthcare-associated pneumonia" (NVHAP). Pneumonia is the most common healthcare-associated infection (HAI) in the United States. About 1 in every 100 hospitalized patients experiences NVHAP. ECRI reports that NVHAP diagnoses in the United States make up nearly two-thirds of the cases, compared with about one-third associated with ventilators. Among the action recommendations included in the report: incorporating patient-care intervention bundles, conducting infection surveillance, and targeting performance improvement activities focusing on NVHAP risks.

Coming in eighth is "international supply chain disruptions." When organizations are forced to change processes and develop workarounds to account for a lack of equipment and delays in shipping, the likelihood of mistakes that can lead to an infection increase.

To download ECRI’s report, go here.

The top 10 patient safety concerns list of 2021 included improvised use of medical devices, peripheral vascular harm and infection risk from aerosol-generating procedures.

ICCS Infection Prevention & Control Newsletter: February 2022

This issue covers some of the most significant news from February. Topics include a Joint Commission advisory on reusable instruments, infection risk associated with mattress failure, growing threat of antibiotic-resistant pathogens, federal funding for LTC, and printable PPE.

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Quick Safety Issue 64: Ensuring Critical Instruments and Devices Are Appropriate for Reuse — The Joint Commission issued a new Quick Safety advisory on ensuring the safety of critical medical instruments and devices. The advisory highlights reprocessing guidance from FDA and special circumstances for single-use devices.

Hospital Mattress Failure Is a Potential Threat to Patient Safety — A study shows that patients can potentially be at increased risk for infection from damaged hospital mattresses and beds.

Handrails, Equipment Controls Among Most Contaminated High-Touch Surfaces in Long-Term Care Facilities — A study of LTC facilities shows that these surfaces were 4 times more likely to register high levels of contamination.

Dublin VA May Have Exposed 4,000 Veterans to Infection With Improperly Cleaned Equipment — An internal review found there may have been times when "all the steps needed for a complete or safe sterilization weren't followed." We wrote about the importance of strictly adhering to IFUs, which you can read here.

APIC Calls for Increased Investment in Infection Prevention — In response to a NEJM Group perspective, APIC called for healthcare organizations to strengthen infection prevention programs by adding personnel, resources, and training to support prevention and surge capacity for future pandemics.

Report Highlights 'Fragile and Failing' Antibiotic Pipeline — A concerning analysis shows that the breadth and novelty of the clinical antibacterial pipeline is insufficient to meet the growing threat of antibiotic-resistant pathogens.

CMS Unleashes New Tool for Improving Facility Air Quality — Funding is available for LTC providers that want to make air quality upgrades to reduce the spread of COVID-19.

Inhaled COVID-19 Vaccine Protects Against Variants of Concern — Research shows that intranasal COVID-19 vaccines may be more effective at protecting against current and future variants than a shot.

Not Enough PPE? Print Some Out — The more we can learn from our experience over these past two years, the better prepared we will be for the next public health emergency. One key takeaway: 3D printing may prove to be a big help.

ICCS Infection Prevention & Control Newsletter: January 2022

This issue covers some of the most significant news from January. Topics include Supreme Court rulings, health tech hazards, superbugs, LTC surveys, and vaccine mix-ups.

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ICYMI: Check out our Special Edition: 2021 Year in Review newsletter.

Supreme Court Upholds HHS' Vaccine Requirement for Healthcare Workers, Blocks OSHA's Large Employer Mandate — The Supreme Court decided to allow HHS to require COVID-19 vaccination among healthcare facilities employees but blocked the federal government's broader vaccine-or-mask mandate for employers with at least 100 employees.

ECRI's 2022 Health Technology Hazards List Includes Infection Issues — Multiple infection-related issues are highlighted in ECRI's 2022 annual list of top 10 health technology hazards.

Why Humans Are Losing the Race Against Superbugs — Drug-resistant bacteria are on the rise globally and killing more people annually than either HIV/AIDS or malaria.

CMS Clarifies COVID-Related LTC Survey Process — Long-term care providers have more information on how surveyors will interpret infection control and vaccination requirements moving forward after CMS updated guidance to the LTC survey process procedure guide.

New Study Suggests N95 Respirators Can Be Safely Reprocessed to Augment Supply in Future Epidemics — Study findings suggest no significant differences in respirator function or effectiveness after 25 decontamination cycles

Age-Related COVID-19 Vaccine Mix-Ups — The Institute for Safe Medication Practices issued an important alert for those administering adult and pediatric COVID-19 vaccines.

75% of COVID ICU Survivors Have Physical Symptoms 1 Year On — Another study shows the importance of looking at and discussing the impact of COVID in ways going beyond cases and deaths.

Machine Learning Predicts C. Diff Infection — Data show that several commonly used machine learning algorithms can accurately predict which hospitalized patients will become infected with C. diff.

Effectiveness of mRNA Vaccines Against COVID-19 Hospitalization by Age and Chronic Medical Conditions Burden Among Immunocompetent US Adults — A study found that mRNA vaccines reduced the risk of COVID-19 hospitalization by >95% in healthy adults without chronic medical conditions regardless of age, sex, obesity or race/ethnicity.

ECRI's 2022 Health Technology Hazards List Includes Infection Issues

Multiple infection-related issues are highlighted in ECRI's 2022 annual list of top 10 health technology hazards, according to a news release.

Coming in at #8 on the top 10 list is poor duodenoscope reprocessing ergonomics and workflows, which ECRI notes can put patients and healthcare workers at risk. An executive brief for the "Top 10 Health Technology Hazards for 2022" report elaborates, stating, "The failure to adequately reprocess contaminated duodenoscopes between uses is a well-known hazard, one that has led to the spread of deadly pathogens. Perhaps less well known are the risks of injury to the healthcare workers who perform this function, and the ways in which ergonomic and workflow factors can compromise reprocessing effectiveness, putting patients at risk."

At #9 is disposable gowns with insufficient barrier protection, with ECRI noting that its testing of such gowns has raised concerns about manufacturing quality, particularly in gowns from nontraditional suppliers. The executive brief states, "Gown wearers can be put at risk of cross-contamination if the wrong type of gown is purchased and worn for the intended application, or if the gown does not provide the level of protection that is claimed."

The hazards taking the top three spots on the 2022 list are:

1. Cybersecurity attacks can disrupt healthcare delivery, impacting patient safety

2. Supply chain shortfalls pose risks to patient care

3. Damaged infusion pumps can cause medication errors

The 2021 top hazards list included imported N95-style masks, ultraviolet (UV) disinfection, remote operation of medical devices designed for bedside use, and 3D printing quality.