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New Guidelines for Endoscopy Scope Reprocessing
In response to the recent article from ECRI Institute about the danger of cross contamination from flexible endoscopy tools, the FDA, the Centers for Disease Control and Prevention, and the Department for Veterans Affairs combined to develop new guidelines for the reprocessing of such tools.
Central sterile supply department (CSSD) professionals, take note: ECRI Institute, an independent nonprofit that researches the best approaches to patient care, recently released its 2010 Top Ten Health Technology Hazards, and cross-contamination of flexible endoscopes was ranked the No.1 safety hazard.
The list offers information about how the hazards occur, with recommendations for prevention, and a comprehensive resource list for more in-depth information. The list is updated annually based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis and expertise of the organization’s multidisciplinary staff. ECRI states that the key purpose of the annual list is to answer the question: “Where do you start when trying to minimize the risks from healthcare technology?”
“Because these technology hazards pose significant danger to patient care, we believe that all hospitals and health systems should prioritize and address them in the coming year,” notes James P. Keller, Jr., Vice President, Health Technology and Safety, ECRI Institute. “Ideally, we also recommend that hospitals dedicate a part of their patient safety and quality improvements efforts to addressing healthcare technology issues like these.”
A series of eye-opening articles, reviews and follow-up reports confirm that flexible endoscopes, when not properly cleaned and disinfected, can pose serious safety and health risks. In late 2008 and early 2009, endoscope reprocessing errors at several Veterans Affairs facilities potentially exposed thousands of patients to HIV and hepatitis – but the problem is far more widespread than that. Endoscope processing errors and challenges are a common problem in many other healthcare organizations across the country and beyond. Most mistakes never make headlines and many are never reported – and quite often, CSSD staff and other healthcare workers, as well as patients, aren’t even aware that mistakes have occurred. Even so, the risks are very real.
Diligent adherence to endoscope reprocessing guidelines is critical for reducing the risk of cross-contamination. In fact, it’s been shown that the number of reported infection transmissions drops to zero when cleaning and high-level disinfection of endoscopes are performed in accordance to guidelines.
New Processing Guidelines Released
In an effort to promote proper and consistent endoscope processing, and offer more detailed guidance on the often-challenging process of flexible endoscope handling, cleaning and disinfection, the U.S. FDA, the Centers for Disease Control and Prevention (CDC), and the Department for Veterans Affairs issued a new set of guidelines for all healthcare facilities that perform endoscopic procedures.The Joint Commission reviewed the new guidelines and developed the following recommendations, all of which are based on the new FDA/CDC guidelines:
1 Establish an institutional program for endoscope processing, along with written procedures for monitoring adherence to the program, and a chain of accountability. Ensure that those responsible for endoscope processing understand the importance of this job and that they maintain proficiency in performing it for each type of endoscope they handle.
2 Train employees to set up, clean, disinfect or sterilize, and store endoscopy equipment properly. Periodically retrain and assess competence. Endoscopy is a constantly evolving technology, so it’s essential to stay up-to-date with the specifics of each device your institution uses.
Instruct staff to read and follow the endoscope manufacturer’s instructions for usage. People responsible for reprocessing endoscopes must have the manufacturer’s instructions available for each endoscope and its accessories because various endoscopes and their accessories often must be processed differently (e.g., most flexible endoscopic equipment cannot tolerate steam sterilization).
3 Ensure that staff members understand that the cleaning and disinfecting of endoscopes are two separate processes. Thorough cleaning of the endoscope must be done first to remove gross contamination and debris. Without this step, the endoscope cannot be effectively disinfected or sterilized. Cleaning should begin immediately after use by thoroughly flushing the channels and rinsing/wiping the outside of the endoscope. A very thorough cleaning with brushes, concentrating especially on the channels, must follow this. Only then is the endoscope ready for high-level disinfection, which can be done manually or in an automatic endoscope reprocessor. During disinfection, the high-level disinfectant must contact every contaminated surface/channel for the time recommended by the disinfectant manufacturer.
4 Ensure that the AER or sterilizer is compatible with the endoscope. Before using an AER, confirm that it properly fits the endoscope. Adhere to the AER or sterilizer instructions that specify which endoscope makes and models it can process, and be sure that the instructions for endoscopes, AERs and germicides do not contradict one another. If you become aware that instructions are contradictory, inform the endoscope and AER manufacturers, as well as the FDA.
5 Ensure that endoscopes or accessories that contact sterile tissue are sterilized before each use, and that endoscopes that contact intact mucous membranes (e.g., the respiratory and gastrointestinal tracts) undergo at least high-level disinfection before each use.
As we have mentioned before, the Tempest washer is a perfect solution to the question of how to meet these new guidelines. The Tempest is capable of providing the high level disinfection that these guidelines require, and its repeatable performance ensures that it will satisfy these requirements everytime. This can help limit risk and ease the minds of both healthcare professionals and patients.
Endoscopes Top List of Medical Technology Hazards
The ECRI Institute recently released its list of the top 10 medical technology hazards in the medical field, and coming in at #1 was the risk of cross contamination from flexible endoscopes.
Incidents of pathogen transmission related to flexible endoscopy continue to be reported in the media, and ECRI Institute continues to receive reports of potential endoscopy-related cross-contamination in facilities around the United States. Often in these cases, large numbers of patients must be notifi ed of exposure to potentially contaminated endoscopic equipment.
ECRI goes on to suggest a few solutions to combat these issues.
Staff need to recognize the importance of tailoring the process to the individual endoscope model (including newly acquired models). They also need to be aware that reprocessing just the endoscope is not sufficient to prepare equipment for safe patient use. A variety of accessories such as those used for irrigation, insufflation, suctioning, or providing therapy to the treatment site—may also become contaminated during use and must be properly reprocessed or (if disposable) replaced. (See Health Devices Alerts Accession No. S0193 for an example of this point.) Even some items used in reprocessing, such as manual cleaning brushes, must themselves be reprocessed or disposed of.
The best defense against endoscopy-related cross-contamination continues to be careful development of and strict adherence to comprehensive, model-specific reprocessing protocols.
The most important step, as suggested by ECRI, in the process of eliminating cross contamination from flexible endoscopy tools has to do with ensuring that a model specific protocol exists.
Ensure that a model-specific reprocessing protocol exists for each flexible endoscope model in your facility’s inventory. Refer to the device’s user manual or consult the endoscope manufacturer to identify unique requirements (e.g., cleaning procedures, channel adapters) that need to be addressed within each protocol document. Remember to repeat this review for each newly purchased endoscope model (or related equipment).
Midbrook understands the importance of adequately cleaning and disinfecting these instruments, and we also understand how difficult it can be when they come in such variable shapes and sizes. That is why we developed the Tempest washer. It is designed for use with tools such as these, as well as many others, and we can help customize the process to fir whatever type of tool you are using. With the help of a Tempest washer, healthcare facilities can dramatically reduce the risk from cross contamination by flexible endoscopy tools, and minimize patient’s exposure to the #1 technology related medical danger.
ECRI Article source: http://www.ecri.org/Forms/Pages/2010_Top_10_Technology_Hazards.aspx
Reprocessing Single Use Devices
OSHA has weighed in on the question raised in an article in the March issue of Academic Medicine about the reprocessing of single use devices (SUDs). The main issue is whether or not the risk to a patient’s health is small enough to justify reprocessing SUDs in order to save money and prevent waste.
The term single-use device (SUD) seems pretty self-explanatory, but in an effort to reduce waste and costs, many medical facilities are reprocessing medical devices such as compression sleeves, laparoscopic ports that are labeled for single-use.
A commentary published in the March issue of Academic Medicine, analyzes the risks and rewards for reprocessing medical equipment, and urges healthcare facilities to consider despite common misconceptions.
More than 25% of hospitals use reprocessing procedures to cut down on disposable waste, according to the article, including the authors’ institution, Johns Hopkins Hospital.
“We have found it to be a commonsense strategy that uses detailed quality-control standards to recalibrate, clean, sterilize, and remanufacture medical equipment,” the authors write. “The result has been a significant waste reduction and cost savings.”
Single-use devices were created by manufacturers because of increasing concern regarding the safety of multiple-use devices. But the sophistication and cost of single-use devices forced hospitals to explore reprocessing options. As FDA reprocessing regulations became stricter, hospitals have utilized third-party reprocessors that are regulated by the FDA, and can reprocess more than 100 single-use devices. (You can find FDA enforcement policies here).
The FDA divides reprocessed SUDs into three categories, each with separate premarket submission requirements:
- A critical reprocessed SUD is intended to contact normally sterile tissue or body spaces during use
- A semicritical reprocessed SUD is intended to contact intact mucous membranes and not penetrate normally sterile areas of the body
- A noncritical reprocessed SUD is intended to make topical contact and not penetrate intact skin.
Approximately 65% to 75% of reprocessed SUDs fall into Class II, according to the commentary, including pulse oximeter sensors, ultrasound catheters, drills, compression sleeves, and most laparoscopic equipment.
A 2008 report from the United States Government Accountability Office (GAO) found that FDA oversight on reprocessing SUDs has increased, and data, although limited did not indicate an elevated health risk.
On the other hand, Michael Bennett, president of the Coalition for Patients’ Rights in Maryland argues there is no reason to take chances with SUDs.
“It is unconscionable for a health care worker or an institution to subject an unsuspecting and uninformed patient to unnecessary risk just to save a few dollars,” Bennett told The Baltimore Sun. “While there very well may be manufacture or sales self-interest in the ’single use’ classification of some devices, would anyone be willing to use a possibly safety-compromised parachute? There are plenty of other areas in health care where money can be saved without jeopardizing patient safety, such as better infection control and fewer errors.”
For more than a year, University of Maryland Medical Center has been buying only non-invasive reprocessed instruments like blood-pressure cuffs. Denise Choiniere, the medical center’s sustainability manager and a registered nurse told The Sun, they have saved roughly $400,000.
“Safety is No. 1, and we need to make sure there are quality checks in place and what they’re sending back is the same quality as new devices,” Choiniere told The Sun. “But it’s hard to find someone who doesn’t think this is a good idea.”
The consensus seems to be that reprocessing SUDs is preferable to throwing them away as long as they are effectively sanitized. The question is how can we be sure that this is happening? Midbrook prides itself on the quality of its Tempest cart and instrumentwashing systems. Not only do these washers clean and disinfect equipment the first time, they also offer consistent, repeatable performance so that healthcare facilities don’t have to worry about reusing SUDs that might endanger patients. Operators can be sure that their instruments are safe.
Threat of Antibiotic Resistant Infections is Increasing
The New York Times published an article last week containing sobering news for the infection control world. It seems that the danger from what are known as Gram negative bacteria is rising. These infections are extremely resistant to antibiotics, giving rise to the term “superbug.” Currently, doctors are forced to rely on little used drugs from the 1940s to treat these infections, because they have been abandoned years ago and the bacteria have not had a chance to develop resistance to them. The problem is, they were abandoned due to the serious damage they cause to kidneys and nerves. This forces patients into making difficult decisions about whether to risk this damage or hope they recover naturally from the infection.
A minor-league pitcher in his younger days, Richard Armbruster kept playing baseball recreationally into his 70s, until his right hip started bothering him. Last February he went to a St. Louis hospital for what was to be a routine hip replacement.
By late March, Mr. Armbruster, then 78, was dead. After a series of postsurgical complications, the final blow was a bloodstream infection that sent him into shock and resisted treatment with antibiotics.
“Never in my wildest dreams did I think my dad would walk in for a hip replacement and be dead two months later,” said Amy Fix, one of his daughters.
Not until the day Mr. Armbruster died did a laboratory culture identify the organism that had infected him: Acinetobacter baumannii.
The germ is one of a category of bacteria that by some estimates are already killing tens of thousands of hospital patients each year. While the organisms do not receive as much attention as the one known as MRSA — for methicillin-resistant Staphylococcus aureus — some infectious-disease specialists say they could emerge as a bigger threat.
That is because there are several drugs, including some approved in the last few years, that can treat MRSA. But for a combination of business reasons and scientific challenges, the pharmaceuticals industry is pursuing very few drugs for Acinetobacter and other organisms of its type, known as Gram-negative bacteria. Meanwhile, the germs are evolving and becoming ever more immune to existing antibiotics.
“In many respects it’s far worse than MRSA,” said Dr. Louis B. Rice, an infectious-disease specialist at the Louis Stokes Cleveland V.A. Medical Center and at Case Western Reserve University. “There are strains out there, and they are becoming more and more common, that are resistant to virtually every antibiotic we have.”
The bacteria, classified as Gram-negative because of their reaction to the so-called Gram stain test, can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Their cell structure makes them more difficult to attack with antibiotics than Gram-positive organisms like MRSA.
Acinetobacter, which killed Mr. Armbruster, came to wide attention a few years ago in infections of soldiers wounded in Iraq.
Meanwhile, New York City hospitals, perhaps because of the large numbers of patients they treat, have become the global breeding ground for another drug-resistant Gram-negative germ, Klebsiella pneumoniae.
According to researchers at SUNY Downstate Medical Center, more than 20 percent of the Klebsiella infections in Brooklyn hospitals are now resistant to virtually all modern antibiotics. And those supergerms are now spreading worldwide.
Health authorities do not have good figures on how many infections and deaths in the United States are caused by Gram-negative bacteria. The Centers for Disease Control and Prevention estimates that roughly 1.7 million hospital-associated infections, from all types of bacteria combined, cause or contribute to 99,000 deaths each year.
But in Europe, where hospital surveys have been conducted, Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year caused by some of the most troublesome hospital-acquired infections, according to a report released in September by health authorities there.
To be sure, MRSA remains the single most common source of hospital infections. And it is especially feared because it can also infect people outside the hospital. There have been serious, even deadly, infections of otherwise healthy athletes and school children.
By comparison, the drug-resistant Gram-negative germs for the most part threaten only hospitalized patients whose immune systems are weak. The germs can survive for a long time on surfaces in the hospital and enter the body through wounds, catheters and ventilators.
What is most worrisome about the Gram-negatives is not their frequency but their drug resistance.
“For Gram-positives we need better drugs; for Gram-negatives we need any drugs,” said Dr. Brad Spellberg, an infectious-disease specialist at Harbor-U.C.L.A. Medical Center in Torrance, Calif., and the author of “Rising Plague,” a book about drug-resistant pathogens. Dr. Spellberg is a consultant to some antibiotics companies and has co-founded two companies working on other anti-infective approaches. Dr. Rice of Cleveland has also been a consultant to some pharmaceutical companies.
Doctors treating resistant strains of Gram-negative bacteria are often forced to rely on two similar antibiotics developed in the 1940s — colistin and polymyxin B. These drugs were largely abandoned decades ago because they can cause kidney and nerve damage, but because they have not been used much, bacteria have not had much chance to evolve resistance to them yet.
“You don’t really have much choice,” said Dr. Azza Elemam, an infectious-disease specialist in Louisville, Ky. “If a person has a life-threatening infection, you have to take a risk of causing damage to the kidney.”
Such a tradeoff confronted Kimberly Dozier, a CBS News correspondent who developed an Acinetobacter infection after being injured by a car bomb in 2006 while on assignment in Iraq. After two weeks on colistin, Ms. Dozier’s kidneys began to fail, she recounted in her book, “Breathing the Fire.”
Rejecting one doctor’s advice to go on dialysis and seek a kidney transplant, Ms. Dozier stopped taking the antibiotic to save her kidneys. She eventually recovered from the infection.
Even that dire tradeoff might not be available to some patients. Last year doctors at St. Vincent’s Hospital in Manhattan published a paper describing two cases of “pan-resistant” Klebsiella, untreatable by even the kidney-damaging older antibiotics. One of the patients died and the other eventually recovered on her own, after the antibiotics were stopped.
“It is a rarity for a physician in the developed world to have a patient die of an overwhelming infection for which there are no therapeutic options,” the authors wrote in the journal Clinical Infectious Diseases.
In some cases, antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital.
Sabiha Khan, 66, went to the emergency room of a Chicago hospital on New Year’s Day suffering from a urinary tract and kidney infection caused by E. coli resistant to the usual oral antibiotics. Instead of being sent home to take pills, Ms. Khan had to stay in the hospital 11 days to receive powerful intravenous antibiotics.
This month, the infection returned, sending her back to the hospital for an additional two weeks.
Some patient advocacy groups say hospitals need to take better steps to prevent such infections, like making sure that health care workers frequently wash their hands and that surfaces and instruments are disinfected. And antibiotics should not be overused, they say, because that contributes to the evolution of resistance.
To encourage prevention, an Atlanta couple, Armando and Victoria Nahum, started the Safe Care Campaign after their 27-year-old son, Joshua, died from a hospital-acquired infection in October 2006.
Joshua, a skydiving instructor in Colorado, had fractured his skull and thigh bone on a hard landing. During his treatment, he twice acquired MRSA and then was infected by Enterobacter aerogenes, a Gram-negative bacterium.
“The MRSA they got rid of with antibiotics,” Mr. Nahum said. “But this one they just couldn’t do anything about.”
Source: http://www.nytimes.com/2010/02/27/business/27germ.html
As this article shows, infection control in hospitals is now more important than ever. Because there are very few safe options for treating these Gram negative “superbugs,” the best way to fight them is by attacking them before they get to the patient. For example, the antimicrobial copper used by Midbrook in their custom fabrications has been proven effective against multiple types of bacteria, including Enterobacter aerogenes, the germ that killed Joshua Nahum. By using things like antimicrobial copper and effective instrument washers, hospitals can kill these dangerous types of bacteria before they are able to infect patients.
Improving Efficiency with Case Carts
Georgia Tech has publishedthe results of a program at Piedmont Newnan Hospital in Georgia that shows how important organization can be to a hospital. By designing new case carts and developing a system for preparing them for surgery, the hospital staff was able to improve case cart accuracy from 50% to 98%.
Pam Murphy, a registered nurse and director of surgical services at Piedmont Newnan Hospital, has seen it all in her 23 years of employment at the hospital.
In 2007, when the Newnan, Georgia-based hospital was chosen as a pilot site for a lean implementation for the Piedmont Healthcare System, she knew that participation from the hospital’s staff would be critical. She also knew there would be a concern that lean—a methodology that aims to eliminate waste—would mean doing more with less.
“A lot of staff members first thought that we were just trying to get efficient so we could eliminate positions. We had to assure them that this was not the case; we just wanted to be as efficient as we could be so we could build the business,” she recalls. “The hard part for an organization is committing the resources, something especially difficult in health care. Once you do that, however, you can attack the issue in one week and come up with solutions.”
The focus of Piedmont Newnan’s process improvement project was the six operating rooms on its main campus. Jennifer Trapp-Lingenfelter and Kelley Hundt of Georgia Tech’s Enterprise Innovation Institute helped train Piedmont staff in lean principles, an operational strategy that focuses on eliminating waste while increasing value-added work. Lean techniques improve profitability, customer satisfaction, throughput time, and employee morale.
“We knew that the turnaround time on the operating rooms was our biggest issue, but when we did the value-stream map that outlined the entire process, we decided to tackle something we knew could make a big difference,” says Murphy. “We decided to focus on the case carts, which are used for pulling together everything that we need for a surgical procedure.”
The case cart project began in December 2007 with an introduction to lean principles.
According to Trapp-Lingenfelter, at least 90 percent of the operating room (OR) staff had received basic lean training by the end of the project, a critical component of the success. A cross-functional team composed of nurses, surgical technologists, and central service personnel went to the OR and the central sterilization department to observe the case cart process and note which steps were value added and which ones involved waste.
Prior to the lean implementation, the case cart accuracy at Piedmont Newnan was approximately 50 percent. The team observed that there was no formal scheduling process for the central sterilization department, no designated person to pull together case carts, no standard process to pull the case carts and a lack of labeling and organization. These issues led to a significant amount of rework.
After the team analyzed the process, it identified solutions that could be implemented that same week, such as 5S, a method for organizing the workplace. The team developed a new standard case cart design, labeled cabinets and carts, established parking spots for case carts, defined the path for picking items that go in the carts, alphabetized instruments, designated a return bin for unused supplies, centralized the case cart picking tools and set a minimum inventory level for all instruments. Now all case carts are pulled the day of a procedure, with the exception of 7:30 a.m. surgeries pulled the afternoon before. In addition, missing items are highlighted in yellow, the standard picking procedure is posted, and one person is assigned the responsibility of picking the case carts.
“Before the lean process, whenever we had down time we would tell staff to pull case carts for the next day. They would begin to look down the list and see items that were currently in use or needed to be in use that afternoon, so we would end up with case carts that were missing instruments,” Murphy notes. “As a result of this project, we realized that our computer system would allow us to see where equipment was, so we built a location into everything. Now, if I gave you a card with a list of items that needed to be pulled for a surgery tomorrow, you could go pull everything even if you had never been in my OR before.”
As a result of the lean implementation, case carts can now be pulled in five minutes vs. 20 minutes before, and the overall case cart accuracy has risen from 50 percent to 98 percent. Supply items that need to be available on case carts but that may not be used with all procedures are only opened if needed, reducing waste. The bins have yielded a projected savings of $118,000 annually.
“The success of the case cart project was a win-win, so when we decided to tackle turnaround times, we had buy-in from the staff and they had already been educated on the process,” says Murphy.
In this project, the team developed a process that defined roles, responsibilities, and visual controls to reduce the time required to clean and prepare an operating room for a new procedure. Prior to the implementation, the average turnaround time for patient out to patient in was 19 minutes; it now averages 14 minutes. Physician turnaround time went from 51 minutes to 40 minutes. Piedmont Newnan has also been able to increase its percentage of on-time procedure starts and decrease after-hours cases and resulting overtime pay. Moving forward, the team will set goals specific to each specialty.
The projects at Piedmont Newnan were so successful that they were recognized by VHA Georgia, part of the national health care alliance, VHA Inc. Last year, 10 Georgia hospitals were recognized for improving their supply chain performance, clinical care, operational efficiency, and community benefit performance. Piedmont Newnan Hospital was selected as a winner of the 2008 VHA Inc. Georgia Regional Leadership Awards in the Operational Excellence category for improvements in the operating room that increased patient care and improved patient and physician satisfaction.
“Sustainability is probably the hardest part because you have to be willing to commit to it. If you conduct a 5S procedure on an area and then let it go, it’s going to end up looking like your junky kitchen drawer again,” Murphy observes. “Having someone come in from the outside gets you to think about how things can be done differently. Having another set of eyes that aren’t familiar with your process helps you open your eyes and see ways to make improvements.”
Through its Healthcare Performance Group, Georgia Tech project leaders work with health care professionals to conduct lean assessments, teach basic lean concepts, develop value-stream maps to analyze the flow of materials and information, create quality systems, and implement rapid process improvement projects.
This example shows that running hospitals safely isn’t just about infection control. Having the right equipment and training is equally important. Midbrook custom stainless steel and antimicrobial copper fabrication can help hospitals design the equipment they need, such as custom case carts, to make their operation run smoothly and efficiently, not to mention safely.
The High Cost of Infection
Both CNN and the Wall Street Journal commented today about a new study published in the Archives of Internal Medicine suggesting that two common types of healthcare-acquired infections (sepsis and pneumonia) were responsible for 48,000 deaths and added $8.1 billion to healthcare costs in 2006.
However, according to the Wall Street Journal, this apparently isn’t enough to force some hospitals into action:
While in many cases sepsis and pneumonia could have been avoided with better infection control in hospitals, Laxminarayan says, one issue is getting the financing to set up infection control programs. “Even when physicians are gung-ho to do something about infection control, they may not have buy-in from hospital administrators,” he says. “They may still ask why do you need $500,000 if it isn’t going to do anything for the bottom line?”
Everyone seems to agree that infection contol is a major issue for hospitals, but the question of how to improve infection rates without prohibitive expense is not such a simple one.
This is where Midbrook comes in. Our affordable custom equipment can help reduce infection rates at a price hospital administrators can handle. The simple addition of a few antimicrobial copper carts and tables or an Ozorinsesystem can can help healthcare facilities keep their patients safe without a huge investment.
Increasing Awareness of HAIs
The Association for Professionals in Infection Control and Epidemiology (APIC) recently announced that its membership has topped 13,000.
Washington, December 8, 2009 – The Association for Professionals in Infection Control and Epidemiology (APIC) today announced that their membership now exceeds 13,000, an indication of the growing emphasis on infection prevention and control in healthcare institutions throughout the globe.
With members in 41 countries, APIC is the largest infection prevention association in the world, educating infection preventionists, epidemiologists and other healthcare professionals in a wide variety of settings including hospitals, long-term care facilities and ambulatory care centers.
Since 1972, APIC has provided thought leadership on infection prevention to drive attention to the critical need to protect patients from HAIs and has established itself as an authority in the application of evidence-based infection control measures and hospital epidemiology. APIC has led the practice and shaped the environment to drive positive change for patients through comprehensive education, information, service and provision of expertise to state and federal governments and other healthcare organizations. Given the importance of healthcare resources, APIC continues to raise awareness about the economics of infection prevention and the need for adequately funded programs.
“Our growing membership is good news for patients,” said APIC 2009 President Christine Nutty, RN, MSN, CIC. “Healthcare providers are recognizing the value of infection prevention and APIC’s role as a thought leader and premier provider of education and information to improve patient outcomes. APIC will continue to deliver the latest evidence-based best practice on infection prevention, helping our members educate bedside workers, healthcare executives and others on strategies to protect patients.”
APIC’s mission is to improve health and patient safety by the reducing risk of infection and other adverse events. The association’s members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities around the globe.
As a leader in infection prevention, APIC adds to the knowledge base, advances the practice and provides practical resources to improve patient outcomes. In 2007, the association conducted the first-ever national MRSA prevalence study offering the most comprehensive understanding of MRSA to date, and in 2008 released similar findings on C. difficile. APIC plays a significant role in developing infection prevention standards and guidelines, and is frequently called upon by the Centers for Disease Control and Prevention, state and federal legislators, standards-setting bodies and other healthcare organizations for infection prevention expertise.
This announcement is another indicator of the importance of HAIs to the healthcare industry. As more and more healthcare professionals see the danger of HAIs, the largest infection prevention association in the world continues to grow. The good news for them is that Midbrook is right there to meet their needs with regards to infection control. With antimicrobial copper fabrication, instrument washers, and the Ozorinse system, Midbrook is on the front lines of the worldwide fight against HAIs, helping hospitals and other medical facilities reduce their infection rate.
APIC Responds to Consumer Reports Article
The Association for Professionals in Infection Control and Epidemiology (APIC) has responded to a recent Consumer Reports article discussing the danger of healthcare-associated infections.
Washington, DC, February 3, 2010 — The following statement is attributable to Kathy Warye, CEO of the Association for Professionals in Infection Control and Epidemiology (APIC):
“The March 2010 issue of Consumer Reports (“Deadly infections: Hospitals can lower the risk, but many fail to act”) addresses one of the most pressing healthcare issues facing our nation today: healthcare-associated infections (HAIs). As a patient safety advocate, the Association for Professionals in Infection Control and Epidemiology (APIC) appreciates the fact that Consumer Reports has chosen to focus on the checklist that many hospitals are using to prevent deadly bloodstream infections and has included summaries of central-line associated bloodstream infection (CLABSI) rates in healthcare facilities.
“Since 1972, APIC has provided thought leadership on infection prevention to drive attention to the critical need to protect patients from HAIs. APIC has established itself as an authority in the application of evidence-based infection control measures and hospital epidemiology.
“In 2004, APIC announced its support of public reporting of healthcare-associated infections as a path to improved quality and patient safety. Further, APIC supported the HAI reporting language in the House of Representatives Healthcare Reform legislation, which would require nationwide HAI reporting through the Centers for Disease Control and Prevention’s National Healthcare Safety Network. We believe this surveillance network is the best method for ensuring the establishment of a scientifically meaningful reporting and monitoring system for HAIs.
“While not all HAIs are preventable, APIC believes that every healthcare institution should be working toward a goal of zero healthcare-associated infections. Many of our member facilities have seen that central-line associated bloodstream infections can be reduced to zero, and that in many instances zero can be maintained. We’ve also seen that reducing infections can significantly improve a healthcare institution’s financial bottom line. All institutions should be adopting evidence-based interventions to reduce CLABSIs and ensuring that these measures are consistently applied.
“But prevention can only occur when top leaders target zero as their goal, invest in their infection prevention programs to assure the resources needed for optimal programs — including resources necessary to track, monitor and publicly report these infections — and make infection prevention and control everyone’s job across the institution. Healthcare leaders must understand that the cost of infections erodes the bottom line, and they need to allocate the resources to infection prevention making it an institution-wide priority.
“At a time when these deadly infections still present a risk to patients, infection prevention departments at healthcare facilities need to be growing, not shrinking. Unfortunately, a 2009 APIC survey showed that 41 percent of hospitals in the U.S. are cutting staff, resources and education for infection prevention in response to the economic downturn.
“APIC’s Targeting Zero initiative provides education to help prevent the most common and deadly HAIs. APIC’s evidence-based elimination guides translate CDC recommendations into straightforward infection prevention strategies for healthcare workers.
“Protecting patients from harm is the motivation to eliminate preventable infections and is the right thing to do for our patients and for our healthcare institutions.”
This response to the Consumer Reportsarticle shows how concerned healthcare professionals are about HAIs, but also reminds us that the majority of them are preventable. This is where Midbrook comes in. Our Tempest washers and custom stainless steel and antimicrobial copper fabrications can be valuable tools with which to combat HAIs. We are committed to helping hospitals reach the zero HAI target that APIC wants to see.
Disinfectants = Infection?
It seems counter-intuitive, but new research is showing that disinfectants may actually increase the rate of infection.
Researchers from the National University of Ireland in Galway found that by adding increasing amounts of disinfectant to laboratory cultures of Pseudomonas aeruginosa, the bacteria could adapt to survive not only the disinfectant but also ciprofloxacin — a commonly-prescribed antibiotic — even without being exposed to it.
This highlights the important of design and material in fighting infection. Simple solutions, like easily available disinfectants, may not be the only answer to fighting infection.
Adding materials like copper or solid surface Corian are also critical to keeping infection levels low, by helping to stop bacteria growth on surfaces in the facility.