ICCS Infection Prevention & Control Newsletter: April 2022

This issue covers some of the most significant news from April. Topics include CLABSI guidance, FDA endoscope warning, contaminated flexible endoscopes, C. diff, and long COVID.

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New Guidance for Preventing Healthcare-Associated Bloodstream Infections — Five medical societies released recommendations for prevention of central line-associated bloodstream infections (CLABSI) in hospitals. The guidance can be accessed here.

The FDA Issues Urgent Warning About Karl Storz Endoscopes Reprocessing Methods — The FDA issued a letter about the change in reprocessing methods for certain urological endoscopes manufactured by Karl Storz, with the administration warning about the risk of infections associated with cystoscopes, ureteroscopes, cystourethroscopes, and ureterorenoscopes.

CDC Alerts Providers to Hepatitis Cases of Unknown Origin — CDC issued a health alert about a cluster of children identified with hepatitis and adenovirus infection. The agency asked physicians to be on the lookout for symptoms and report suspected cases of hepatitis of unknown origin to their health departments.

Despite Safety Alerts, Contaminated Flexible Endoscopes Continue to Put Patients at Risk — Despite efforts and recent warnings to increase the safety and efficacy of reprocessing endoscopes, a study found that reprocessing practices may not always be sufficient to prevent flexible endoscopes from exposing patients to infectious organisms.

Robust Association Between Antibiotics and C Difficile Infection, Even in Outpatient Settings — A study showed that the risk of a community-acquired C diff infection was substantially higher in outpatients with antibiotic exposure than those without.

In-Use Disinfectant Bucket Identified as Source of Contamination in Hospital — A study found that failure to adhere to recommended disinfection protocols and manufacturer's instructions for use of a hospital-grade disinfectant led to the contamination of high-touch surfaces.

About 30 Percent of COVID Patients Develop 'Long COVID,' Researchers Find — Research found that 3 out of every 10 people treated for COVID-19 developed post-acute sequelae of COVID-19 (i.e., "long COVID").

Toolkit for Preventing CLABSI and CAUTI in ICUs — AHRQ released a toolkit for preventing CLABSI and CAUTI in ICUs that the agency said was based on the experience of hundreds of ICUs nationwide.

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.