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Top tags: ASPPS Member Spotlight  2016 NPSF Congress  Voice of the Patient  ASPPS  burnout  culture  2017 Patient Safety Congress  Ask Me 3  communication  Leape  med errors  overtreatment  Stand Up for Patient Safety  transparency  workforce safety  health literacy  infection  leadership  opioids  patient advocate  patient safety research  RCA  undertreatment  2016  antibiotic resistance  apology  Boothman  Campbell  CDC  children's hospitals 

Five Ways to Take Action Against Antibiotic Resistance

Posted By Administration, Tuesday, November 1, 2016

November 14-20 is Get Smart About Antibiotics Week.


by Patricia McTiernan, MS

Get Smart - Test Your Knowledge About Antibiotics

Take the CDC's quiz about proper use of antitbiotics.

     
     
   

 

According to the Centers for Disease Control and Prevention (CDC), each year, more than 2 million people in the United States get infections from germs that are resistant to antibiotics, and at least 23,000 of these people die as a result. The CDC considers antibiotic resistance to be among the most pressing threats to public health today, and the drive is on to increase education and awareness about the issue.


Antibiotic resistance happens when bacteria stop responding to the drugs intended to kill them. This happens over time, as bacteria adapt and change. Inappropriate use of antibiotics contributes to the problem, because when a strain of bacteria is weakened, but not killed, it can develop ways to survive, or resist, effects of antibiotics.


The CDC leads Get Smart About Antibiotics Week, November 14-20. In advance of the week, here are five ways health care practitioners, patients, and organizations can take action.

  1. Collaborate. It is important for all members of the health care team to work together and with patients and families to reduce the inappropriate use of antibiotics. Pharmacists and infection control professionals can help advise clinicians on the best antibiotic to use in each case. Clinicians can help patients understand when antibiotics are needed and instruct in the safe use of antibiotics. Find resources for patients and for health professionals.

  2. Stop the spread of bacterial infections. Practicing good hand hygiene consistently every time, with every patient, is the easiest way to reduce the spread of bacteria that cause infections. This applies to health professionals, but also to patients and family members. If you need a refresher course in handwashing, here’s how to do it right.

  3. Prescribe correctly and adhere to prescribing instructions. Estimates suggest that more than half of the prescriptions for antibiotics written in the US each year are, in fact, not necessary. When a bacterial infection is present and antibiotics are the best choice, health care practitioners need to be careful to use an antibiotic that will be effective while causing the least risk of side effects. Clinicians can learn more about safe prescribing.

    Patients need to understand the importance of taking antibiotics exactly as prescribed. Moreover, like all medicines, antibiotics come with risks that patients and families should recognize.

  4. Practice antibiotic stewardship. By instituting an antibiotic stewardship program, health care practices and organizations can improve individual patient outcomes, reduce the burden of antibiotic resistance, and reduce health care costs. The CDC has tools to help organizations get started on antibiotic stewardship.

  5. Share what you learn. Used appropriately, antibiotics save lives and allow for advanced treatment of disease. Yet, according to materials from the CDC, if antibiotic resistance continues unabated, “we risk turning back the clock to a world where simple infections could kill people as they did a century ago.” The World Health Organization and others recognize this as a global threat. Spread the word to your professional colleagues, neighbors, friends, and in your community.

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Do What are your plans for Get Smart about Antibiotics Week? Comment on this post below and visit the CDC at https://www.cdc.gov/getsmart/week/. Note: to post a comment you must be logged in. Register or log in.

 

Sources:

Centers for Disease Control and Prevention, Fact Sheets, https://www.cdc.gov/getsmart/community/index.html
Pew Charitable Trusts. How Antibiotic Resistance Happens. http://www.pewtrusts.org/~/media/legacy/uploadedfiles/phg/content_level_pages/issue_briefs/antibioticresistancepdf.pdf


Patricia McTiernan, MS, is editor of the P.S. Blog. Contact her at pmctiernan@npsf.org.

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Tags:  antibiotic resistance  CDC  infection 

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Breaking Health Care’s First Commandment

Posted By Administration, Friday, June 26, 2015
Updated: Friday, June 26, 2015
 

Creating communications bridges between departments is vital to avoiding breakdowns in infection protocol.


by Nanne Finis, RN, MS

 

The often-quoted phrase “First, Do No Harm” is not really in the modern Hippocratic Oath. But a recent study of medical errors in U.S. hospitals suggests that perhaps it should be widely adopted as the first commandment of health care.

 

That study estimates the true number of deaths due to preventable errors may be four times more than the 98,000 per year quoted by the Institute of Medicine in its report To Err Is Human.


 

A culture of safety?

Given the mission of health care institutions, the general public might be surprised to hear the rising chorus of health professionals calling for a “culture of safety” to be adopted in our nation’s hospitals. Yet a 2012 IOM study reported that one-third of all hospital patients experience some form of hospital acquired conditions (HACs), ranging from minor injuries to death.

 

Infection, for example, was historically considered an acceptable risk of providing care, but recent changes in reimbursement regulations mandated reductions in medical errors and penalized re-admissions and infection-related length of stay. Now a whole range of technologies is available to contain the spread of infection, from robots that blast germ-killing ultraviolet light to remote monitors that keep track of hand hygiene compliance by health care workers.

 

But problems persist. The Joint Commission, which accredits more than 75% of U.S. hospitals, found infection prevention and control deficiencies in about half of the hospitals it surveyed in the first half of 2014. Although one in 25 hospital patients will acquire an infection during treatment, more than a third of U.S. hospitals that responded to a recent survey reported they do not have a certified infection prevention specialist on staff.

 

While progress is being made, it’s clear that more needs to be done. Although handwashing is regularly touted as the best way to fight infection, handwashing studies of hospital staff repeatedly place compliance in the 30% to 40% range. Health care providers need more tools to protect workers and the general population.

 

Readmissions and communication breakdowns are other areas of concern. A record 2,610 hospitals are under CMS penalties for readmissions. Last year, nearly 18% of Medicare patients were readmitted within 30 days. That’s two million patients at a cost of $17 billion.

 

The Ebola scare in a Dallas hospital last fall raised a number of new questions about communications breakdowns, preparedness, and the priority given to patient safety in U.S. hospitals. Two nurses infected with Ebola while treating a Liberian national were successfully treated for the disease, but the outcome could have been far worse. The death of “Patient Zero” in Dallas could have happened at almost any hospital in the world. And it could happen again, as long as the potential for breakdowns in communication exists.

 

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The Infection Multiplier Effect

A hospital that my organization worked with reported to us that one infected hospital patient was found to have come in contact with 216 people in a single day. This was during the course of a normal day of treatment. Even if a small percentage of that group was infected, imagine how quickly things could spiral out of control, especially with a virulent strain of infection.

 

With that kind of potential for exposure, it’s vital that hospitals have the means to identify within minutes all of the hospital personnel who may have come in contact with a contagious patient. The same goes for medical devices and transport equipment.

 

Creating communications bridges between departments is vital to avoiding breakdowns in infection protocol. Most hospitals still use manual processes to distribute warnings about infected patients, including physically posting isolation status at the entrance to patient rooms. This can lead to inadvertent infection exposure among hospital employees who enter the room before the warning has been posted.

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Leaders must lead

Saying that “safety comes first” isn’t enough. What drives continuous success are accountability, transparency, and regular communication. While it is laboriously time-consuming to monitor protocols and track infectious patients, health care IT is bringing real-time operational visibility to patient safety and care delivery.

  1. Check to see how well your departments talk to each other. Manual processes, like posting isolation status at the entrance to patient rooms, are too slow for the pace of today’s hospital environment. This outdated process could lead to inadvertently infected hospital employees because they haven’t been alerted to the presence of infection in a patient or patient room.

  2. Make sure there is a single source for infection information so employees don’t have to seek out details in patient records. Make someone in the organization the point person for mobilizing key stakeholders from nursing, emergency medical services, emergency medicine, critical care, infection prevention and control, and give that person the responsibility of working with external government health departments and emergency management.

  3. If your infection control processes have been in place for years and if infection rates have been trending up, find out whether hospital leadership has explored the benefits of implementing infection-tracking technology.

  4. Finally, find out if technologies currently in place have been optimized to support infection prevention. Some systems come with embedded features that only need to be activated. Among these are Real Time Location Systems (RTLS), patient flow systems, and capacity management platforms

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What’s available now?

Current technologies can also chart the path of anyone or anything (like medical devices) that came in contact with an infected patient. Some allow infection warnings to stay with the patient as long as the condition lasts and wherever the patient travels within the hospital, providing a second line of defense against the spread of infection. Isolation status can be instantly distributed to care team members, environmental services staff and transport employees via page, mobile and desktop computer alerts. Hand washing monitoring systems can provide real-time reports on compliance, including name, time, and location enterprise-wide.

 

Prepare, prepare, prepare

"If an Ebola patient walks into a hospital that has a high rate of infection,” says Leah Binder, president and CEO of The Leapfrog Group, “they are going to be woefully unprepared.”

 

Technology is no silver bullet. Without discipline, infection control is problematic no matter what plans are in place. Getting serious about safety is the first of many steps that will need to be taken to ensure the safety of patients, hospital employees, and the public at large, given the current state of infection control.

 

Does your organization do an effective job of communicating about infection control and risk? Comment on this post below. (To comment, please log in. If you are not already registered on our site, please register here.)

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Nanne Finis, RN, MS, is vice president of consulting services at TeleTracking Technologies, Inc. Contact her at Nanne-Finis@TeleTracking.com

Tags:  communication  infection  readmissions 

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