Eagle-eyed hospital worker pushes doctors to outwit infections
Last month an Infection Control Today survey revealed that just one-third of healthcare workers adhere to recommended guidelines for patient skin antisepsis.
While that may be the norm, healthcare workers at some hospitals do far better when it comes to infection prevention and control. Case in point: A surgical ICU at the University of Maryland Medical Center went 24 weeks without a single central-line associated bloodstream infection, or CLABSI. Across the hospital, CLABSIs dropped by 70 percent over the past year, the Associated Press reports.
How did they do it? A mix of stringent rules and scrutiny to ensure the rules are followed helped.
In the ICU, anyone who went into a patient's room, including friends and family, was required to don a yellow gown and wear purple gloves before entering. It also helped that the hospital had a team of infection specialists who checked the teaching hospital for compliance with infection control best practices. And they didn't just collect data. They went to see how patients were cared for.
Among them, Michael Anne Preas, one of perhaps 10,000 infection preventionists in the U.S., made the rounds, on the lookout for areas where infection control and prevention practices needed work. Recently, she reminded a resident who was about to examine a man with a breathing tube that he forgot his gloves. The resident immediately washed his hands and put on a pair of gloves.
Looking at the IV tube inserted into a second patient's neck, Preas spotted another place bacteria could creep in. The man's long beard was obstructing what should have been an airtight seal. She told the nurse to shave the spot and put in a new catheter.
Did the janitor put on clean gloves after she gathered trash, but before moving carts that nurses might touch? Yes, she did.
Infection preventionists like Preas used to be "prophets in the wilderness," said Dr. Jonathan Gottlieb, the hospital's chief medical officer. With the growing recognition that IPs can help save patients and cut hospital costs by reducing hospital-acquired infections, she is not alone in her drive to keep infection from spreading by changing healthcare worker behavior.
"We can say, 'Do this, do this, do this,' but we have to convince people to change," said Dr. Kerri Thom, an epidemiologist who joins Preas on her daily rounds.
To learn more:
- read the Associated Press story
Pessimism about conquering infections is the biggest obstacle, Pronovost says
Two thirds of healthcare workers ignore skin antisepsis guidelines
The movement to eliminate hospital-acquired infections