Hospital Acquired Infections are unfortunately a common complication of hospital care. Despite recent progress in healthcare, infections continue to affect patient safety as well as hospital staff. Below is a collection of shocking statistics to showcase the dangers associated with poor hospital hygiene:
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What Does It Mean for Your Hospital?
Starting October 1, 2014, hospitals with the highest rates of nosocomial infections will suffer substantial financial penalties – will your institution be one of them?
A recent data report, Cross-Contamination Prevention: Addressing Keyboards as Fomites, released by Infection Control Today, discusses the topic of cross-contamination prevention focusing specifically on keyboards as fomites. A fomite is an object that has the potential to become contaminated with any type of germ or bacteria. Fomites are key players in the transfer of pathogens from person-to-person. These objects are responsible for the billions of dollars spent treating hospital acquired infections and paying for sick leaves taken by health care workers. In order to lessen these numbers we must understand the source of the infections.
The Frequency of Touch in Hospitals
High-touch surfaces. This is a phrase that gets thrown around quite a lot in the world of healthcare, but we are rarely told how many touches are considered “high-touch.” The Society for Healthcare Epidemiology of America offered this answer to the question in a report titled “A Quantitative Approach to Defining ‘High-Touch’ Surfaces in Hospitals.”
One of the most important selling points of a tablet is its battery life - these devices are only valuable as long as they have power. As tablets continue to become more widely utilized in healthcare, key features such as battery life are being evaluated with a more critical eye. These devices need to be readily available to meet the various needs of both clinical staff and patients. An inadequate battery life can result in wasted man hours and unhappy patients.
It is well established in infection prevention practice that surfaces in hospital rooms are continually contaminated by infectious pathogens. The sources of these dangerous pathogens range from people who enter the room with contaminated hands and compromised clothing, from contaminated instruments and items that are brought in and out of the room like personal and enterprise issued mobile devices, and from the patient themselves. In addition, the air entering the room is not sterile and deposits pathogen containing fomites which settle onto all the surfaces adding to the degree of bio burden compromise.
It is also well established that the accumulated pathogens residing on high touch surfaces are then transferred onto bare or gloved hands and clothing of nurses, doctors, visitors, and environmental workers when touched, which in turn puts patients at great risk since they or their immediate surroundings are consequently contaminated by touch transfer mechanisms. Hence, even perfect attention to between patient visit hand sanitation by healthcare workers (HCWs); 100% compliance, and effective sanitization of hands to – 4 log10 inactivation, (99.99%); which is not currently achieved), will leave the hands contaminated while performing tasks within the room. This situation is judged to be unavoidable.
Accordingly, the ultimate solution espoused by WHO is hand sanitation immediately prior to patient contact; the Five Special Moments (‘FSM’), so that patients or the patient’s surroundings are not contaminated as a result of attention or care from a healthcare worker, attendant, or a visitor. Currently, the use of alcohol rubs just prior to contact is recommended by WHO for hand sanitation despite the fact that during a shift 100 or more alcohol rub hand sanitations, each taking at least 30 seconds, almost one hour dedicated to hand sanitation per shift, would be required. Moreover alcohol rub is not free of hand irritation and is totally ineffective on spores such as C. diff and some viruses. Hand washing is usually less effective, takes more time and is generally more irritating. There is no currently available product that can meet the WHO FSM requirement so it remains an objective, but not yet a reality.
As a response to problematic hand hygiene, a number of companies are now offering UV-C-based, room disinfection devices which have as their purpose to supplement terminal cleaning. They nominally sanitize room surfaces in as little as 15 minutes, and by lowering bio burden levels, help to minimize additional contamination of hands and clothing when the surfaces are contacted later. This sanitation process must be carried out in a vacant room due to the dangers UV-C poses to unprotected eyes, so it is generally performed only after patient discharge and cleaning by environmental workers.
To understand the efficacy of this approach, it is important to recognize that to inactivate pathogens, especially hardy C. difficile endospores, to the nominal – 4 log10 or 99.99% sanitation level in 15 minutes, typically requires a direct, continuous, line of sight UV-C dose for the entire 900 second period on the entire surface area. Keeping in mind that UV-C intensity of a source falls off with dramatically with distance from that source. This approach could be effective in sanitizing most of a room’s surfaces from normal incidence rays falling directly on these surfaces. This would be the case for walls, which are actually not touch surfaces in most cases.
Tablet and other mobile devices are changing the ways in which healthcare providers access medical information and interface with patients. Apple’s iPad continues to be the tablet of choice for most physicians, followed by the Kindle Fire. For portability reasons, though, many clinicians still prefer toting a smaller smart phone than a larger tablet.
As tablet use in healthcare becomes more common place, the number of apps which boast usefulness to the medical professional also soars, and providers need to be sure that the apps they’re using in their practices provide relevant and accurate information, a rather daunting task considering the number of apps available.
Mobile Health Newspublished a list of their top 80 applications for healthcare
Mobile Health News’ complete list of 80 can be found here. professionals. The list covers apps relevant to physicians and nurses.
Here, 10 apps for medical professionals in the various care categories.
1. Medscape “The leading medical resource most used by physicians, medical students, nurses, and other healthcare professionals for clinical information.” Apple users give this app 4.5 stars. It’s free, and gives the user access to medical news, drug and disease information, medical calculators, and continuing medical education information.
2. Visual DX is a “support and reference tool for physicians includes 1300+ diagnoses and 28000+ medical images to aid diagnosis.” The app includes actual patient pictures depicting symptoms of different disease in order to help clinicians and students visually identify different illnesses.
3. Epocrates and Epocrates CME are both “trusted clinical resource[s]…[with] more than 2 million active members including physicians.” Through this app you can find consults and referrals in the provider directory, review drug-prescribing information, perform different clinically important calculations.
4. Muscle System Pro III was developed “in collaboration with Stanford University School of Medicine.” The app features 360 degree rotation of any body part, 10 layers of superficial and deep muscle visualizations, animations, and quizzes to allow students to test themselves on specific areas or muscles. Primarily a learning tool but can also be used as a reference app.
When developing a BYOD policy, most businesses put the majority of their focus on the major elements of the program (i.e. cost and security). This seems logical, considering that developing a clear road map that outlines a secure, cost-efficient plan is the heart of any major implementation. However, there is still one critical element that is often overlooked when creating these implementation plans: disinfection.
With healthcare costs at an all time high for both patients and hospital operations budgets, the price tag associated with staying healthy is often staggering. Patients may typically blame insurance companies and physicians for hefty bills, though clinics and hospitals funnel monies into several different channels that comprise the cost of doing business in healthcare.
Tags: Infection Prevention