Here are some fantastic take-home points from our Infection Preventionists who attended APIC 2017 – the national meeting of the Association for Professionals in Infection Control and Epidemiology.
Water management Legionella – Building water safety & Management
Legionella is endemic to overall water systems, not just the cooling towers, therefore infection control programs need to be concerned about the sporadic nosocomial risk, not just outbreak risk. Even portable risks, such as patients bringing in personal equipment that may have biofilm due to poor cleaning and disinfection at home.
Urine antigen test is inadequate for water related testing as only one serotype is detected, therefore Legionella cultures are required instead.
When is Legionella considered a nosocomial infection? At >10 days, but 2-10 days may still be nosocomial, so think about performing an environmental investigation. Finally, don’t necessarily chase zero; zero legionella contamination is not the goal and may be impossible in some cases, zero patient cases is the goal. There are MANY waterborne pathogens with potential risk of infection. A water safety & management plan is the key component, not focus on mitigation and eradication of a single pathogen.
Central Line Insertion Site Assessment (CLISA Score)
There is a lot of focus on insertion, but maintenance is critical. Standardize criteria & expectations for early risk detection. At what point of site assessment, can you intervene and prevent a CLABSI? Beyond asking if you need the line, assess the site for signs of erythema and if progressing beyond 3mm radius of erythema, documentation of the scoring would prompt providers to starting looking toward removing the line BEFORE a CLABSI occurred. Multidisciplinary approach – daily site assessment & documentation, communication with providers when results warrant further assessment/intervention. Read more here.
Disinfectants used in the hospital and what should we use? Are we thoughtful enough in our choices?
There are many critical pieces of information to consider when choosing a disinfectant, but one piece that often has been overlooked is the consideration of the end-user – are we also considering the patients, nursing and environmental service staff?
3 Fatal Flaws – Hand Hygiene
The three Fatal Flaws of Bias are: 1) Sampling bias; 2) Observer bias; 3) Hawthorne Effect. Many Hand Hygiene programs across the country suffer from these Fatal Flaws. Due to lack of resources and competing priorities many Hand Hygiene programs are based on individual observations.
A successful Hand Hygiene program needs appropriate resource allocation, as well as an elevated design and reporting process. Particular attention needs to be given to the statistical design of the program to ensure meaningful data is shared across the organization. The design must highlight the link between clean hands and a reduction of all hospital-acquired infections. The most successful programs are embraced by each layer of leadership; linking hand hygiene scores to leadership goals/rewards have been successful to garner appropriate support and resources
Learn more about Infection Prevention and Control at UNMC here.
Content courtesy of Terry Micheels, Kim Hayes and Joleen Strosahl.