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Infection Prevention

What is Salt Lake Regional Medical Center doing to prevent infections?

Like many hospitals, part of Salt Lake Regional Medical Center’s Infection Control program includes tracking those infections that are “community acquired” versus “healthcare associated/acquired”. The Centers for Disease Control and Prevention (CDC) defines a healthcare-associated infection as, “infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting.” A “community acquired” infection is something that the patient has when he/she presents to the hospital for treatment or services. Why is it important to distinguish between the two? First, it helps the hospital identify those infections that we can have a direct impact on trying to prevent. Prevention starts with implementing evidenced-based practices, such as screenings on admission and “bundles” that help the healthcare team remember the correct processes to follow to prevent the spread of infection.

Hand Hygiene

Hand hygiene is the best means of preventing the spread of infection. Hand hygiene includes washing with soap and water or using alcohol hand sanitizer before and after each patient contact.

Salt Lake Regional Medical Center has taken a multifaceted approach to improving the hand hygiene practices of its health care workers. A comprehensive communications and educational campaign promoting proper hand hygiene technique was launched across the facility.

An example of Salt Lake Regional Medical Center’s aggressive hand hygiene efforts is the placement of alcohol hand sanitizers in public areas throughout the hospital including hallways, elevators and cafeterias, making them readily accessible to staff, patients, families, and visitors.

ICU Central Line Associated Blood Stream Infections (CLABSI)

 

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A central line is a catheter (small tube) that is inserted and passed into a large vein or the heart. Salt Lake Regional Medical Center tracks the number of infections developed by patients in the ICU because of central-line devices. Salt Lake Regional Medical Center looks at the rate of infection by the number of line days (number of hospitalized patients in a day with at least one central line).

For patients in the ICU, a central-line is often necessary so the patient can receive fluids and medication. Sometimes these lines can become infected, and because of their location in major blood vessels, can cause infection to flow through the bloodstream. This is called a “catheter-related bloodstream infection” and can be serious. From the bloodstream, infection can flow to other organs.

Salt Lake Regional Medical Center is joining hospitals across the country to keep our patients safe by adopting the Central Line Bundle (as developed by IHI), a set of practices aimed at reducing the risk of hospital acquired infections. CLABSI prevention uses a five- “bundle” to prevent infections:

  • Clean hands
  • Select the best site for inserting the central line
  • Use the proper solution to clean the patient’s skin
  • Cover the patient’s body with a drape (except the area where the central
  • line is inserted)
  • Remove the catheter as soon as possible

Steps must also be taken to properly maintain inserted lines (e.g.—cleaning the insertion site and changing the dressings around it), and assess whether they are suitable to be removed.

How are we doing?

With the implementation of these practices, there have been multiple quarters with a zero central line infection rate in the ICU. Salt Lake Regional Medical Center continues to monitor these best practices hospital wide to minimize or eliminate these infections.

This score tells you the rate of Central Line Associated Blood Stream Infections (CLABSI) among patients in the hospital.

Lower rates are better. Salt Lake Regional Medical Center tracks central-line associated infection rates for the ICU and we compare our performance to national rates published by the National Healthcare Safety Network (NHSN).

Hospital Acquired Clostridium difficile (C. diff)

 

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Clostridium difficile (C.diff) is a bacterial infection that causes diarrhea and more serious intestinal conditions, such as colitis (inflammation of the colon). People who get C. diff are usually taking antibiotics for another infection. Clostridium difficile bacteria are found in the feces (bowel movements) of an infected person. Other people can become infected if they touch items or surfaces that are contaminated with the bacteria and then touch their mouth or open areas on their skin.

How are we doing?

This score tells you the number of Clostridium difficile (C.diff) infections per 1,000 patient days (total number of days spent by all adult patients in the hospital). Only infections identified by the hospital laboratory that developed on or after day 2 (48 hours) of hospital admission are included.

Lower numbers are better. Currently there is no national benchmark or target for new cases per 1,000 patient days, so we compare ourselves to the previous month/quarter performance. The data presented below is for calendar year 2010 and January 2011 through September 2011.

 

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The bar graph above represents Salt Lake Regional Medical Center’s performance data, related to related to hospital acquired Clostridium difficile. The goal is to have zero hospital acquired Clostridium difficile infections. Salt Lake Regional Medical Center’s performance is trending towards zero.

Hospital Acquired Methicillin-Resistant Staphylococcus aureus (MRSA) Blood Stream Infections

Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a strain of staph bacteria that’s become resistant to the antibiotics commonly used to treat ordinary staph infections.

MRSA is resistant to antibiotics including methicillin, oxacillin, penicillin, and amoxicillin. Since these strong drugs are not effective with MRSA, these infections are sometimes called Multidrug-Resistant Organisms (MDROs). Staph infections, including MRSA, occur most often among people in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems. The infection can be spread by skin-to-skin contact, sharing or touching a personal item with someone with infected skin, or touching a surface or item that has been in contact with someone with MRSA.

How are we doing?

This graph represents the number of community acquired versus hospital acquired methicillin-resistant Staphylococcus aureus (MRSA) cases. Only infections identified by the hospital laboratory that developed on or after day 2 (48 hours) of hospital admission are considered as “hospital acquired.”

Lower numbers are better. Currently there is no national benchmark or target for new cases per 1,000 patient days, so we compare ourselves to the previous month/quarter performance. The data presented below is for calendar year 2010 and January 2011 through September 2011.

 

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The line graph above represents Salt Lake Regional Medical Center’s performance data, related to the number of identified cases of hospital acquired MRSA. The goal is to have zero hospital acquired MRSA cases.

Ventilator-Associated Pneumonia (VAP)

 

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A “pneumonia” is an infection of the lungs. A “ventilator” is a machine that helps a patient breathe by giving oxygen through a tube. The tube can be placed in a patient’s mouth, nose, or through a hole in the front of the neck. The tube is connected to a ventilator. A “ventilator-associated pneumonia” or “VAP” is a lung infection or pneumonia that develops in a person while on a ventilator.

How are we doing?

This score tells you the number of Ventilator-Associated Pneumonias (VAP) per 1,000 ventilator days (total number of days spent by all adult patients in the hospital who are on a ventilator). Only infections identified by the hospital that developed on or after day 2 (48 hours) of hospital admission are included.

Lower numbers are better. Salt Lake Regional Medical Center tracks VAP infection rates for the ICU and we compare our performance to national rates published by the National Healthcare Safety Network (NHSN).

What can you do to help prevent the spread of infection?

Patients and their families can help protect themselves from hospital-acquired infections by being vigilant. Be active in your care!

Before you let anyone touch you, or a family member that is a patient, ask them whether they have washed their hands. Don’t be shy about it; it’s your health.