Surgical Products recently spoke with Linda Homan, RN, BSN, CIC, Senior Manager, Clinical and Professional Service, Ecolab
Healthcare, to talk about the medical community's
efforts to prevent healthcare-associated infections.
SP: Why are healthcare-associated infections
such a significant and costly problem for
Homan: Pathogens such as Clostridium difficile, MRSA,
and VRE can survive in the environment for extended
periods of time and can be very difficult to eliminate. If
surfaces are not cleaned and disinfected appropriately, these
pathogens can be passed on to patients and hospital staff
and cause significant health complications. In addition, by their nature,
hospitals are constantly exposed to pathogens from incoming patients,
which makes infection prevention a constant battle. Hospitals are getting
more aggressive with programs to prevent infections for multiple reasons
ranging from increased quality reporting requirements to reimbursement
changes, which incent better care and fewer readmissions.
SP: Is this a problem on the rise or on the decline? Why?
Homan: Infection prevention requires constant vigilance. A recent CDC
report on the prevalence of HAIs shows a moderate decrease in the prevalence of central-line associated bloodstream infections and surgical-site
infections. It’s interesting to note that 52 percent of the reported HAIs
were not in patients with indwelling devices or who had undergone
operative procedures, which means there is still work to do to decrease
the spread of dangerous pathogens among this subset of patients.
Fundamental infection prevention measures, such as hand hygiene and
environmental hygiene, when implemented in a programmatic and mea-sureable way, can help prevent HAIs.
SP: In what ways have facilities attempted to protect
their patients from these infections?
Homan: In addition to targeted interventions aimed at specific pathogens
and types of infections, diligent hand hygiene compliance and thorough
environmental hygiene practices are two fundamental lines of defense that
hospitals can use to protect patients from these dangerous pathogens.
Many are also employing multiple approaches that include process, products, and measurement to achieve and sustain lower infection rates.
SP: Why haven't these measures (in many cases) had
the desired effect?
Homan: Infection prevention measures are hard to sustain and require
constant refreshing in order to keep people engaged. It’s
important to implement programs that are sustainable
through training and positive reinforcement and that
also fit into an organization’s culture. We have heard
from hospitals that some of the challenges they face
in sustaining infection prevention programs include
staff turnover, difficulty standardizing processes across
departments, and unclear roles among clinical and EVS
staff. Also, some hospitals don’t measure and track their
performance to know where they could improve, which
is a missed opportunity.
SP: What is it going to take for facilities to
be able to get better results?
Homan: Often a “back to basics” approach that focuses
on the things we know work, like better hand hygiene and environmen-
tal cleaning, is a good first line of defense to prevent HAIs. Monitoring
and measuring these can help hospitals understand their hand hygiene
compliance and environmental cleaning performance and identify
where there is opportunity to improve. Once hospitals identify which
areas need more attention, they can implement training and education,
standardized processes, and use the right products and tools to support
better infection prevention.
SP: What technology or products can they invest in to
make that happen?
Homan: Every hospital has a unique set of requirements for infection
prevention, so there’s no perfect shopping list that will work across
the board. Using the right products and tools can go a long way. Such
products could include environmental monitoring programs. In addition, broad spectrum, multi-use products clean and disinfect hard
surfaces in a variety of areas within operating rooms, patient rooms, and
common areas to help hospitals reduce the risk of infections from C.
difficile and other dangerous pathogens.
SP: How do you see HAI prevention evolving with time?
What does the future hold for hospital facilities trying
to deal with this problem?
Homan: The major trends impacting HAIs, such as new MDROs,
ongoing financial penalties, and public reporting, are unlikely to
change, meaning hospitals will have more reason to focus on prevention. To help solve this we expect to see hospitals trying new combinations of interventions, such as innovative cleaning products and
processes, objective monitoring, and training and education programs,
to cover all bases.